rmmchl is correct that dentists cannot avoid hitting the nerve. They inject very close to the nerve and on rare occasions they hit it. This is a known complication of the procedure.

As I have stated in another message, I do think that the dentists could improve in a few ways as well. Not to complain, but there is always room for improvement.

Informed consent to the anesthesia, with a discussion of alternatives including no anesthesia would be nice, and some dentists do this well now. I think some of the alternative techniques have not been popular with dentists because the current blocks are pretty effective in most people. Still, a one size fits all approach may not be what the patients want. Some of the other options for dental anesthesia have not been given much of a chance to get off of the ground since the blocks are ubiquitous and fairly standard.

The settting up of hand signals to allow the patient to communicate, would also be an improvement. There are some dentists that do this now, but from what I can tell most do not.

The other area that I have seen mentioned is the use of too fine of a guage of needle. The oral surgeons that I speak with tell me that the smaller needles sometimes break off and have to be retrieved. They point to several studies in which the large gauges cannot be distinguished by the patients. Everyone assumes smaller is better, but that may not be the case. This is also complicated by the fact that as the gauge number gets larger, the needle gets smaller, which confuses many people trying to make the correct selection. The local anesthetic procedures listed in the books I have state the preferred needle sizes, but most dentists that I have spoken with are using smaller gauges.

The public does seem to think that malpractice insurance should be like automobile insurance, but this is not correct. If the complication is a known one and cannot be avoided by a more skillfull dentist, then (assuming proper consent was obtained) this is not malpractice. They inject blindly into the region where the nerve is suppose to be. With the current techinques and equipment, there is no way for them to avoid the nerve or know that it has been hit until the patient responds.

The follow-up after the injury is pretty poor though, in many cases. I think that angers most of the people. Denial that anything has happened or false reassurance that everyone recovers are both common.

Hope this helps calm the waters.

Ross

What is a patient to due? We only know what we are told by the dentist performing the procedure. I highly doubt a dentist is going to admit if he accidentally "screwed up " to his patient when all he needs to do is come up with a medical excuse of what went wrong knowing the patient does not have the experience to dispute it. All dentists are aware that most patients are literally at the mercy of the dentist due to their dental insurance limitations. Once your in the middle of a treatment, most dental insurances make it mandatory that it is finished by the person you started with or they create hell for you if you try to switch dentists in the middle of a treatment.
Also most dentists know that the average citizen can't afford to take on a malpractice lawsuit. Very few people have the time, money or resources to "sue" a dentist.
Your average citizen will do what I do, keep searching, year after year, going from dentist to dentist, preying that one day we will find that well educated, highly trained, honest, sincere dentist.
I have many friends and coworkers that can tell you dental horror stories and whom are still seeking a "good" dentist to this day.
Not one of us has filed any lawsuits. Few have filed formal complaints
which amounted to nothing. Being sued or not sued has no bearing what-so-ever on how good a dentist is.
I have yet to see a dentist office hand out "How am I doing" cards to get input as to what his patients think of them. Or how about giving a call to all the "one-time patients" who never came back, and ask them why they never returned.
If the dentists are so well patrolled by themselves as you say they are then how about having the ADA take a nationwide poll of each and every dental office and practitioner and publish the results.
Who do you think you are kidding? Not me!

And for those few dentists who are truly professionals and deserving
of praise (many of whom don't accept HMO insurance which is highly understandable), I say, keep up the good work. One day I hope to find you!

Sincerely,
A Patient in Pain!

When the procedure itself has an inherrent risk it is not malpractice.
When skill level comes in to play it IS MALPRACTICE~!

Most dentists go their entire careers without maiming thier patients. How about the dentist who has permanently injured 15 people in his career vs the one who has never done it. Just bad luck right? You make out these injuries to be just dumb luck and you know much more than that. There are "roadmaps" in the mouth to understand where you are injecting as well as techniques to limit damage. Just because some err, it doesnt vindicate ALL dentists of careless practices.

The healthcare profession, is the only profession I can think of that feels they shouldnt be held responsible for damage they cause. (well maybe politicians too) If your carpenter lets slip with his hammer and smashes your stained glass window, you wouldnt hold him liable because he was just hammering like any other carpenter would have, right? Just an accident, dont fuss over it.

BS...youd be screaming at him to pay for it! Even if he told you it happens to carpenters all the time.

I thing the points Aaron made are right on target. I fully intend to see if I can find out if others have been injured by my dentist as I have. It makes a difference.

My wife discussed my injury with her dentist, who is retiring after over forty years. He told her that he had not caused a single injury in his career like she described had happened to me.

I don't understand. Do you do it all the time, or is it a rare occurence?

-a dentist who has a numb patient and wonders why

The first is proper informed consent, to let people know that local anesthesia is optional for many dental procedures. We have a high rate of use of local anesthesia in the US, higher than most other countries from what I can tell talking to people around the globe.

The second is as you suggested, that they do not setup a way for the patient to telll the dentist that the nerve has been hit. Hand signals would be best since with the needle in your mouth the options for oral communication is limited.

Ross

I am a different person altogether, but have read all of these comments. I too have had nerve problems in my tongue and pallette for over two years, beginning immediately after a deep scaling procedure and injections - lots of them. I don't know the type of injection however. I will call and ask.

Since the scaling I have also been in and out of braces. When the braces came off - I was put in a normal retainer with band around the teeth and hard plastic on roof. That hard plastic, as you know, was between the roof of my mouth and my tongue. When I wore it the numbness went away. My orthodontist said that the retainer was inadvertantly taking the pressure off of the damaged nerve, apparently. The numbness went away, but the burning sensation was still there but not as bad. So he built it up a little bit near the front of the roof of my mouth to stop me front being able to touch my bottom and top teeth (even less pressure on the nerve)and that helped more.

I have since had a bridge made so the retainer does not fit anymore and the burning sensation has come back. But not the numbness. My bridge maker doctor (can't think of the title - sorry) said he would help by making one of the teeth on the bridge in the back bigger so that the pressure is off of the nerve, permanently. The numbness is still gone, but not the burning - so they are making me a retainer that pops in - without a band. It will at least keep the tongue from touching the roof of my mouth - somehow, keeping the two seperated helps a lot. It's almost as if my tongue is allergic to the roof of my mouth! Any ideas?

Anyway,I will call and ask what the injection was and let you know.

Please keep in touch,
netti@attbi.com

It is now 2-19-04 and all but the tip of my tongue has returned to normal feeling and my finger "tastes" salting when I touch it (guess the tastebuds still work). I may be getting better...slowly.

I must thank all on this forum for providing information, especially about septocaine and possbly aerobic exercise. I will look into these.

I will also chime in periodically if I get better or stay the same.

It's been about a month, and almost all of the numbness sensation is gone. In fact, if I don't consciously think about it, it seems perfectly normal.

I believe this is going to fully recover. I am posting this message as positive hope for any newer "victims" that this injury can get better in time. Though my sympathies to those who haven't.

One thing is for sure, I will not allow a dentist to make such injections in my mouth again unless it's an emergency. And I do believe they should be informing their patients of these risks. In fact, I personally consider it malpractice for those who neglect to do so and end up permanently injuring their customers. If a real doctor has to do so, why shouldn't a dentist?

Thanks,

Maria

thank you

Thanks, Jean

I have inferior alveolar nerve damage from an injection I received in late November prior to a wisdom tooth extraction. After six weeks of agony, my oral surgeon decided that the tooth in front of that wisdom tooth also had to come out. On Jan 12, he did another IAN block by injection and removed that tooth. Now, nine days later, the numbness in my teeth, gums, lip and chin has intensified and it covers a larger area than before. Unfortunately, I didn't discover this website until Jan 15, otherwise I never would have allowed another injection.

I will never allow another injection into my mouth. I am exploring other options, many of which are mentioned on this website.

Good luck!

First, you do not need an injection for the placement of a crown. It should cause no pain. Next, I hear you when you say that you are about to go crazy. I have been in this nightmare for six months. It has been so hard to do everything. I feel like an invalid. I have never experienced such a long and slow recovery and most of the time I cannot tell if I am recovering. I have just discovered today that Septocaine is causing all of these very similar symptoms that people are describing on this website. I hate living with this. I feel like I have lost 6 months of my life.

I heard that aerobics will help, but I have not had the strength to be that active. I am losing a lot of weight as it is. I feel I have no energy to spare. Before the injection I was a member of an aerobic club and I was there 3-5 times a week for 30 to 45 minutes. I was never able to complete a session again after the injection.

But perhaps the worse thing has been the mystery of it all. No one has told me what is wrong with me. It took a lawyer to tell me to look into Septocaine. Now I have found this website. I am not going crazy, this is real and I am not alone. I feel so dreadfully bad about what has happened to us. It is torture.

I went to the dentist about 10 months ago to get a cavity filled. I was injected with novocain and it HURT when it was injected. More than usual. My lip was numb all day and the next morning, it was still numb. I called my dentist and his receptionist called him and he said to tell me it will go away but it can take up to a week for it to go away. Well, all week it went away slightly, but everytime i drank or ate something, it felt "warm" and really weird over there, just like when you come right from the dentist. To this day, i still have a slightly numb lip. Food tastes normal now but if i touch my lip with my finger, it tingles. This is nerve damage, right?? Isnt there anything i can do about this?? I never went back to that dentist again. My email is Lrist1@hotmail.com if anyone wants to email me. Thanks and im glad i found im not alone in this horrible situation.

Will it do me any good to see an oral surgeon in South Carolina? This injury is soon to be 7 days old tomorrow at 1:20 PM EST......

What would you do? I think it has affected my speech, the pain is ridiculous when I eat anythink warm to hot, and it pretty much consistently hurts. It feels better than the day after, but no noticable change in three days. I have numbness in the right tounge from back to the tip. No taste on the right side, a burning sensation, and the tip tingles when I touch it.

Hi Carol,

I was also injured by an injection. It has now been four months. I did not suffer as much numbness as I do pain. It is unpredicatable and almost never behaves the same day after day.

I went to a Neurologist who told me I have suffered from an Inferior Alveolar Nerve injury, and that he expects me to have a full recovery in time. As time goes on it is less hopeful to me.

My question for you is do you feel you have improved at all in the last two years? What medications seems to work best for you, and do they help much? Also, have you heard that Septocain is more likely to cause injuries than Lidocain, I have heard that there is 22% greater chance of this with Septocain.

I hope you are feeling better and would appreciate input on some of these questions.

Thanks very much!

Karen

I would have like my dentist to look me in the eye and say how sorry he was. I would have liked the dentist to offer me continued care. I would have liked the dentist to offer me a refund on the big bucks I paid him for his expertise. It would have been nice if my dentist was honest with me, but my dentist didn't do any of these.

What do you want from your well paid dentist? Do you want him to say... Oops... ##### happens. I don't think you would settle for this excuse.

PS.. Give it a break. If you don't have anything helpful to offer go somewhere else.

"T"

I'm sorry you recieved this injury. I have an injectional injury too. It is unfortunate that your dentist has not taken this injury seriously, because it can be life altering. That said, the odds of you recovering are in your favor and hopefully this altering will only be temporary.

Since you are having a lot of pain with your injury I suggest you go to your general doc for help. It is important to control the pain early on so the pain doesn't become a chronic condition. Read the treatment page on this site and you will see there are several things you could take. These meds will not speed up your healing, but can make you more comfortable as you heal.

Many of us also take vitamins such as Methly-B12, B-complex, etc in the hope it will help the nerve heal. Do a search on supplements or vitamins and you should find many postings on this topic.

Hang in there and keep us all updated on how you are doing.

"T"

I wish I could offer more encouragement, but in my case there has been only slight improvement, if that. Some days it does not seem quite as intense, others it does. I will say that the numbness I had in the lower jaw area has abated, but the stinging in my tongue persists.

I suppose I am actually becoming used to the stinging, but another factor may be that I took a direct hit on my right cheek bone from a soft ball (not very soft, actually) that was thrown very hard, and all of the nerves on that side of my face were smashed and the bones fractured. Now in addition to the stinging on the left side of my tongue I cannot feel any of the teeth on the upper right side of my mouth, so maybe it's that I just don't notice the injectional injury as much. I have had to learn a new way to eat, for sure.

I saw a specialist about a month ago. He performed a test where he had me close my eyes and indicate to him whether I felt one or two prongs from his touching my tongue very lightly with a large pair of tweezers. The farther apart he has to hold the prongs before you sense that there are two of them indicates the level of damage. He put my damage level at 5 percent. Well,I will tell you that if what I am going through is only 5 per cent, I pity anyone who has a higher level of damage than that!!

The specialist said he did not feel I needed surgery, but that it might take several years to heal, and perhaps never will completely. Apparently there is an option for microsurgery to repair the damage, but I think I will wait longer before I consider that to see if it will heal on its own. I do think he could be right and, as I said, some days it does seem less intense. He thinks I will recover completely, I hope he is right.

The doctor's name Dr. Roger Meyer and he is both a dentist and a surgical doctor. I was referred to him by my dentist (the one who injured me) and according to him, Dr. Meyer has a great deal of experience with these injuries. He gave me a prescription to help with the pain, but since he said it would make me drowsy I decided not to use it since I have to drive to work and be alert on my job. His office is at Atlanta Oral & Facial Surgery on Johnson Ferry if you are near the Atlanta area, 770-977-0364.

There is hope for your daughter, tell her to hang in there. If you would like to explore the microsurgery option, I was told it should be done within the first six months.

Good luck!!

Kirk

Perhaps then he'll be laughing on the other side if his face! The STUPID MORON!

Get a referral from your Doc for a neurologist and see what he/she says about your numbness, and keep in mind its still only a few weeks at this time, so you will hopefully start to improve soon

Take care J

If you are in pain there are several meds that may help you. Check out the treatment page for your options and then go to your primary doctor for help.

I have an injectional injury and I understand how painful it can be. I had to use medications to control the pain.

"T"

It took weeks before I notice any improvement while taking meds. I'm not sure what your second med is. I had to take 4-6 different meds together to control my pain. I took neurontin, trileptal, topamax, effexor, ultracet and xanix at the same time, but as time went on I have been able to stop them. Hopefully you will not have to add more meds, but if you find you need more pain control it may benifit you to add another medication. Also, make sure you get extra rest. I find I hurt more when I was tired or stressed.

This injury can take a long time to heal, but the odds of healing are good. Hang in there.

"T"

Sorry you have to deal with this issue. The first few days after an injury like this can be horrible. It is understandable that you feel so miserable. This isn't an easy thing to deal with, but try to remember that most of these injuries heal within the first few weeks to months and by 1 year 85% are completely recovered.

This healing process can be a very slow, painful and distressing time and many of us have found our family doctors helpful. There are meds to help the pain caused by a nerve injury. You may need help sleeping for awhile because of the pain and stress too. You doctor should be able to help you too.

Many of use take supplements that help nerves heal. Try methyl B-12 and B complex. Do a search on this site on supplements or vitamins and you should find many other suggestions.

Hang in there and keep us posted on how you are doing.

"T"

Kirk

I'm sorry to read you haven't gained any relief. It took me quite awhile before I had significant relief after my injury. The first year was very hard, but every month I was on meds helped lower the pain just abit. The second year things started to get a lot better. This year I've been able to drop several meds and still do ok. I'm still taking one med and have some tingling and minor pain. It is livable these days. Never thought I would be able to say that.

Have you tried Trileptal (anti-seizure)? This meds was one of the most helpful. Are you taking an anti-depressant? I had to take several meds at the same time to the best benefit. At the 10 month mark for me I was still in pain so please don't give up. It took me many months to get the relief I needed.

I'm glad you have a great OS and he is working with you to help. I personnally needed to take medications to control the pain and that wasn't always easy, but it did make a difference for me.

Hang in there.

"T"

Don't give up. I had to use several meds at a time to get the best relief. Maybe using several different meds will help you better then using just one. The longer I was on the meds the better I started to heal.

I didn't get 100% relief, but each of the meds did a bit. It was dose dependent too. I took high doses of the meds. Time and dose and med combo mix helped me. Did you try an antidepressant and an antiseizure med together? With a pain med like Ultracet? How long and what doses of these meds did you take? Have you seen a facial pain management specialist?

Time was what finally gave me the best relief and I was able to get off most of the meds. I'm 2.5+ years out from my injury and it has gotten better.

"T"

It has been three weeks since the injection of Lidocaine that caused my trauma. I've been to an oral sugeon for evaluation and treatment in the meantime, and he says its muscle spasms and something he commonly sees in his office. He put me on antibiotics, ibuprofin, and vicodin for one week, along with a liquid diet, and hot compresses. After one week I returned to his office, still in constant pain, still unable to eat or sleep. He asked...how would you rate the pain, still present but slightly improved, still present and getting worse, or no change. I said I guess still present but slightly improved (my tongue dosnt hurt anymore), and he said well thats the best we can hope for, its gonna take time, but thats all I can do for you. End of visit, end of treatment, and end of scripts.

I left in tears. Now what. I'm back to square one and still enslaved by the pain. I cope by taking advill and tylenol, alternating and with three hours in between dosings. I've lost about 5 pounds already, and I've as yet to get more than three hours of straight sleep. Yet this is the best I can hope for as treatment? I paid several hundred dollars, not to mention the original 1000 for the crown that caused this whole thing, and the best I can hope for is suffering and self medicating myself with over the couter drugs. And on top of that my medical insurance which does cover dental treatment that is a result of accidents or trauma wont cover me here...this they say is not trauma, not an accident?

I really do feel victumized many times over.

The next step I guess is my doctor's office. Which will result no doubt in refferals to others, tests and whatever. I dont however feel very encouraged by that, if the dentist who did this to me, and the oral surgeon who says he sees this all the time cant help me, I dont see specialists further removed from dental science having much to offer.

However rare this complication may be, it is so horrible the dental industry should be looking for a better way, or at least a better way to treat those unfortunate enough to have this happen. This is truely a case of doing harm to a patient, and the harm done is far far worse then the ailment the patient was seeking help for. I can only guess that a price tag has been placed on this pain, and we who suffer it are not worth the cost to find the better way.

If you are a fifth year dental student truely interested in this issue...then please find that better way. I see it this way. If 1 in 160,000 tylenol capsules caused this, regardless of the highly effective 159,999 capsules, the product would be pulled off the shelf.

As far as when to get a patients consent, and what to inform them of, should be a given. It should be handled no different that any other medical specialty. No where else is anestesia or a surgical procedure done without getting the paitients informed and signed consent. I really do think by law, dentists should be required to offer more than one means of anestesia, and get the patients informed written consent of which they are chosing. It should also be required by law that when one of these injections goes wrong, the dentist take responsibility for it, and provide the right support and followup to the patient. My dentist refused to admit anything went wrong, ignored every question I had while in agony in his office, and did and was ready to do more of exactly the last thing that would have helped me, and what would have caused even more harm...more dentisty. As it is he filed down the tooth below the crown in response to my complaint, and that tooth ever since is on fire. I dont know how else to explain it, but the oral surgeon suggested it may now need a root canal...not for decay, but because the dentist likely filed off the enamle and made it hypersensative. (And I get to pay for that too?) In addition my dentist was ready to have me come back the next day so he could remove the temporary and poke around some more. Thank god I did not do that.

I am ruined for dentistry. I will never be able to accept another injection in my mouth again. Yet I have some more work that needs to be done. I just dont know how I will face that. Yet this is not trauma, not an accident, no one is responsible, and its not covered under my medical insurance.

Something is very very wrong with dentistry..and that is it is run by Insurance companies and shuned by medicine as a sub-art, and its doing harm!

That being said, your dentist should have more knowlege, and should be of more help to you. The prognosis for surgical repair is not good with injections so medical expertise is the best road now. That will probably include a referral to a neurologist or pain clinic versed in these tratments.

If you have an injury from the injection then it can take months for you to get better. The odds are good you will improve especially since you've already seen some change.

I had to go to my Family Doctor to find treatment for my injectional injury. This treated was medication to help control the pain and help me sleep. Your health insurance should cover this treatment as it is now a medical problem. There isn't any surgery that can fix this type of injury and so it comes down to waiting for the nerve to heal on it's own. Nerves can heal very slowly and cause a lot of pain during this healing. It can be a hard thing to go through, but with the help of medication and support of your family/friends you will get better.

I cried everyday for weeks... months after my injury. The early days were the worse because I didn't understand what was going on and I was scared this would last for ever. It was devatating for me. As I got treatment for the pain I started to cope better with the situation. There are several medications that can help a nerve injury. Read the treatment page on this site for more info. If your injury is also muscular then treatment by a physical therapist may help you too.

It may be a long hard road you'll have to walk, but you will make it. There is light at the end of this dark tunnel. Most people recover withing the first few weeks/months and by the 1 year mark (85%) will be recovered.

It has taken me a bit longer then 1 year to heal, but I continue to heal even after the 2.5+ mark.

Hang in there.
"T"

Has anyone else had their jaw ache while getting the shot? And did the aching ever stop weeks or months later?

Good luck to you.