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Mark Bornfeld, DDS
Mark Bornfeld, DDS, Dentist
Category: Dental
Satisfied Customers: 6021
Experience:  Clinical instructor, NYU College of Dentistry; 37 years private practice experience in general dentistry, member Academy of General Dentistry, ADA, American Academy of Oral Medicine
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What can cause numbness in my mouth?

Resolved Question:

I have been having a numbness in my mouth the past couple of days. It feels kind of like I got a Novocain shot but it comes for a few seconds, stops, and then happens again over and over at different intervals. It started Saturday when I had a sip of white wine at Olive Garden; actually I had two sips of wine and within a few minutes, the side of my mouth went numb; later turning into the Novacain feeling. I have had recurring problems with having small sores that periodically show up inside my mouth; it all started after having a filling in one of my teeth and has happened off and on for years now. The dentist and oral surgeon at the time told me it was some type of virus I believe it was and said any antibiotics like penicillin or the like would not help any but rather it had to run its course. I have not before experienced this kind of Novocain feeling however. Do you have any suggestions or ideas?

Submitted: 5 years ago.
Category: Dental
Expert:  Mark Bornfeld, DDS replied 5 years ago.

Please provide additional information:

--Indicate whether the numbness occurs consistently in the same area, or moves around to different areas. Also, please specify the precise locations inside and/or outside the mouth where the numbness is located.

--Please indicate whether the numbness is accompanied by any other symptom, such as pain, swelling, rash, etc.

--Please indicate whether you consumed seafood at the same meal when the numbness occurred, and what type of seafood.

--Specify any ongoing medical conditions for which you are being treated, and what those treatments are.

--If you currently have any of those sores visible in your mouth, could you provide a photograph of the involved area? You may use the "paper clip" icon on the text entry form toolbar to upload a digital picture. Alternatively, you may send your picture to a photo hosting site, such as Flickr or Photobucket, and provide a link to the picture in a reply to this information request. This will allow me to provide a more accurate and relevant response...

Customer: replied 5 years ago.

No, the numbness is all on the inside of the left side of my mouth, mostly the top of the mouth up to the bottom of my nose, top of my lips, and some on the bottom left side of my lips. It even affects the front tooth on the left; it feels totally numb like after a dentist visit but only lasts a few seconds or so each time it occurs; I should add I do not have any back teeth on my left side. I had four pulled about 4 years or so ago and on occasion it feels as if there is a bit of tooth or bone in the gums where the teeth used to be.

There really are no other symptoms; the spot on the roof of my mouth is tender and kind of burns a little, but mostly it is just the numbness coming and going. At the same time, I feel a numbness/tingling in the fingers of my left hand

No I did not have any seafood at the time I drank the two sips of wine. Actually all I ended up eating for the lunch was the salad and a couple of bites of eggplant parmigian

I am not being treated for any medical conditions

I am sorry but I do not have any photos.

Expert:  Mark Bornfeld, DDS replied 5 years ago.

The intent of my questions about seafood was based on the implied rapid onset of the symptoms after your meal, which implies an allergic reaction (perhaps to sulfites in the wine, or scombroid food poisoning, which is an occasional reaction to seafood). However, without other symptoms (edema, swelling), allergy is a less likely culprit.

The confinement of your numbness to the distribution of a particular sensory nerve (in this case, the maxillary branch of the trigeminal nerve) suggests a peripheral neuropathy. This can arise from mechanical compression-- for example, from an upper left tooth or an inflammation in your left maxillary sinus-- or due to some other neuropathy, due to inflammation or viral infection. For example, facial numbness may be a prodrome to Bell's palsy, or to recurrent herpes simplex or zoster-varicella virus infections. However, Bell's palsy is usually accompanied by facial muscle weakness, and the herpes simplex or zoster varicella eventually manifests with visible blistering of the skin on the affected areas; lacking these signs, they become less likely suspects.

Therefore, your best strategy would be to consult with either your dentist or an ENT specialist to assess you for either chronic sub-clinical dental infection or sinus disease. I would probably give precedence to seeing the ENT specialist, especially if there are few teeth in the vicinity on the upper left side. It is important to do a complete examination, if only to rule out the more remote but serious possibility of malignancy, because some lesions (particularly salivary gland tumors) tend to affect the sensory nerves in this way. If neither consultation detects abnormality, a reasonable next step might be to see a neurologist to assess for neurological disorder.

Hope this helps...

Customer: replied 5 years ago.
I am sorry but can you further explain what zoster varicella is? As I think I mentioned, I have for several years had a problem with development of small sores in my mouth after the filing of a tooth. It used to occur quite often, at least 3 or 4 times a year; once I had that tooth (and neighboring) pulled, I did not have any troubles for a while, but then started getting basically the same symptoms. It typically lasts a week or so, with varying degrees of discomfort. The worst symptom prior to this novacain feeling was a sharp pain that traveled up the side of my face. Further, what exactly do you mean by "neurological disorder"? I wonder about that mainly because of the feeling in my left fingers that are concurrent with the feeling in the mouth.

Also, oddly, this started on Saturday. Yesterday, Sunday, I did not have any problems at all until last night, when I had this feeling once. Today it has been nearly constant, so much so that I stayed home from work.

Is there anything I can take to alleve this prior to going to a doctor?
Expert:  replied 5 years ago.
Varicella-zoster is a virus that causes chicken pox in children, and shingles in the adult. It typically causes intense pain and a blistering rash along the distribution of a sensory nerve, and may occur anywhere on the body surface, usually confined to the specific "dermatome" (the area served by a particular sensory nerve). Treatment involves the use of antiviral medication (e.g., acyclovir, valacyclovir) and pain medication.

Pain that is described as "sharp" or "shock-like" is suggestive of neuropathic pain, such as a neuralgia, but subjective symptoms are in themselves insufficient to establish a reliable diagnosis. That is why if neurological issues are suspected, a formal neurological diagnostic protocol is needed.

The term "neurological disorder" in intended to refer to any disorder that may affect the brain, spinal cord, or peripheral nervous system. It could be anything from a neuropathy due to a medication or disease (for example, some medications are known to cause nerve damage, and some diseases, like diabetes, blood disorders, or nutritional deficiencies are known to damage the nerves). It could also be a primary neurological disease, such as multiple sclerosis or ALS. I used the term "neurological disease" in its broadest sense, to be all-inclusive, because I am not as a dentist qualified to provide guidance of a neurological nature.

Sores in the mouth are likewise difficult to identify simply by their presence. Often times they are just trivial canker sores, while other instances may reflect more serious mucous membrane disorder, such as Crohn's disease or lupus. These are matters that are best evaluated in person by a skilled clinician (dentist or ENT specialist).

If you were having pain, the usual recommendation would be to use an over the counter analgesic like ibuprofen until you could see your doctor. However, there is nothing that you could yourself if the predominant symptom is numbness. Proper management will depend on identification of the underlying cause for this symptom.

Hope this helps...
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