Managing Numbness and Misalignment After Jaw Surgery: A Recovery Guide

Tingling or numbness in the mouth?

At the end of 2018, I was involved in a car accident and was treated for an open comminuted fracture with displacement of the left mandible, accompanied by malocclusion.
I underwent facial internal fixation surgery.
After the surgery, I experienced tingling and numbness in the left side of my jaw and lower lip.
At that time, I couldn't open my mouth because my upper and lower teeth were fixed with wires.
Now, as I begin to remove the wires and fixators, I am slowly practicing the opening and closing movements, but I notice that my lower lip deviates to the right when I open my mouth.
During the treatment process, it was found that the fracture impacted the nerve, causing damage, although the nerve was not completely severed.
It has been almost two months, and the tingling and numbness in my left jaw and lower lip have not improved significantly, and my lower lip is also misaligned.
What kind of rehabilitation treatment should I pursue, or should I be referred to another specialty (which specialty)? I have read online that nerve damage can take six months to gradually recover; is this true?

Zhang Xiaoxiong, 30~39 year old female. Ask Date: 2019/02/14

Dr. Zhou Hongzhang reply Plastic Surgery

1.
The recovery period after nerve damage can range from 2 months to 1-2 years.

2.
It is possible that complete recovery may not be achieved.

3.
The more severe the injury, the higher the likelihood of nerve discontinuity.

4.
You can consult your original plastic surgeon or visit a rehabilitation specialist.

Reply Date: 2019/02/14

More Info

After undergoing jaw surgery due to a traumatic injury, it’s understandable to have concerns about numbness and misalignment during the recovery process. Your situation involves a complex interplay of nerve healing, muscle reconditioning, and potential misalignment due to the initial injury and subsequent surgical intervention. Here’s a comprehensive guide to managing your recovery.

Understanding Numbness and Misalignment
1. Nerve Healing: Following trauma or surgery, it is common to experience numbness or tingling sensations in the affected area. This is often due to nerve irritation or damage. In your case, the left side of your jaw and lower lip may have sustained nerve compression or injury during the accident. While nerves can regenerate, the process is slow and can take several months. It is not unusual for patients to experience numbness for up to six months or longer, depending on the severity of the nerve involvement.

2. Muscle and Jaw Alignment: The misalignment of your lower lip during opening and closing of the mouth may be attributed to muscle imbalances or compensatory movements due to the initial injury. After a period of immobilization, the muscles may not function optimally, leading to asymmetrical movements. This can also be exacerbated by the fixation of your teeth, which may have altered your natural bite and jaw position.

Recovery Strategies
1. Physical Therapy: Engaging in physical therapy is crucial for your recovery. A specialized therapist can help you with exercises that promote jaw mobility and strength. They can guide you through specific movements to improve alignment and reduce compensatory patterns. Look for a therapist who specializes in orofacial rehabilitation or maxillofacial therapy.

2. Neuromuscular Re-education: This involves exercises that help retrain the muscles around your jaw to work together more effectively. Techniques may include gentle stretching, resistance exercises, and coordination drills. These exercises can help restore normal function and improve the symmetry of your jaw movements.

3. Massage Therapy: Gentle massage around the jaw and neck area may help alleviate tension and improve circulation, which can facilitate nerve healing and reduce discomfort. Ensure that any massage is performed by a qualified professional who understands the anatomy of the jaw and surrounding structures.

4. Consultation with Specialists: If numbness persists or worsens, consider consulting with a neurologist or an oral and maxillofacial surgeon. They can assess the extent of nerve involvement and may recommend further imaging studies or interventions if necessary. A dentist specializing in orthodontics may also be beneficial if there are concerns about your bite alignment.

5. Patience and Monitoring: Recovery from nerve injuries can be a lengthy process. It’s important to monitor your symptoms and maintain open communication with your healthcare providers. Document any changes in sensation or alignment, as this information can be valuable for your treatment team.

Conclusion
In summary, while the numbness and misalignment you are experiencing are concerning, they are not uncommon following jaw surgery and nerve involvement. Engaging in a structured rehabilitation program, consulting with appropriate specialists, and being patient with the healing process are key components of your recovery. Remember, every individual’s healing journey is unique, and it’s essential to stay proactive in your treatment and follow-up care. If you have any further questions or concerns, don’t hesitate to reach out to your healthcare team for guidance.

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