Post-Wisdom Tooth Extraction: Addressing Tongue Numbness and Pain - Neurology

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After undergoing wisdom tooth extraction, particularly for impacted teeth, it is not uncommon to experience various symptoms, including numbness, pain, and changes in sensation in the tongue and surrounding areas. Your description of numbness on the right side of your mouth and tongue, along with the sensation of biting your tongue, suggests that there may have been some trauma to the nerves during the extraction process.
The inferior alveolar nerve, which runs through the lower jaw, is particularly susceptible to injury during the extraction of lower wisdom teeth, especially if they are impacted or require surgical intervention. Nerve damage can lead to numbness, tingling, or altered sensations in the lower lip, chin, and tongue. In your case, the gradual improvement in numbness is a positive sign, indicating that the nerve may be healing. However, the persistent pain and changes in the tongue's structure are concerning and warrant further investigation.

It is essential to monitor your symptoms closely. If the numbness continues to improve, that is a good sign, but if you experience any worsening of symptoms, such as increased pain, swelling, or signs of infection (like fever or pus), you should seek medical attention promptly.
Regarding your question about whether to see a neurologist or an oral surgeon, it would be advisable to start with an oral surgeon or an oral and maxillofacial specialist. They can assess the surgical site, evaluate the extent of any nerve damage, and determine if further intervention is necessary. They may also perform imaging studies, such as X-rays or a CT scan, to visualize the area and check for any complications, such as bone fragments or infection.

In the meantime, here are some recommendations to help manage your symptoms:
1. Pain Management: Continue taking any prescribed pain medications or over-the-counter pain relievers as directed. Nonsteroidal anti-inflammatory drugs (NSAIDs) can help reduce pain and inflammation.

2. Oral Hygiene: Maintain good oral hygiene to prevent infection. Gently rinse your mouth with warm salt water several times a day, especially after meals, to keep the extraction site clean.

3. Dietary Adjustments: Since you are experiencing difficulties with eating, consider a soft diet that minimizes the risk of biting your tongue. Foods like yogurt, mashed potatoes, and smoothies can be easier to manage.

4. Avoid Irritants: Stay away from spicy, acidic, or very hot foods and beverages that could irritate your tongue and the extraction site.

5. Follow-Up Appointments: Keep all follow-up appointments with your oral surgeon to monitor your healing process. They can provide additional treatments if necessary, such as corticosteroids to reduce inflammation or other therapies to promote nerve healing.

6. Patience and Observation: Nerve healing can take time, sometimes several months. It’s essential to be patient and allow your body to recover.
If your symptoms do not improve or if you have significant concerns about your recovery, do not hesitate to seek further evaluation. Early intervention can often lead to better outcomes in cases of nerve injury. Remember, your health and comfort are paramount, and it’s always better to err on the side of caution when it comes to post-surgical complications.