Question: A local anesthsia has given 3 days ago but the area is still anesthetized?

Hammad Hassan: what was the treatment done after anesthesia…???

Amrit Anand: Lag Gaye h Bhai ke .. which block was given

Paul Delfin: Sounds like paresthesia

Arman Khan: Parasthesia its like damage the nerve

Paul Delfin: Exactly

Fazal Shinwari: So what will be the treatment?

Asad Ullah: May recover within week is temperary damaged

Paul Delfin: Fazal Shinwari we usually treated it whit b complex, laser therapy, Cold and thermal therapy and fisio treatments, I had a px 4Months ago that has a 43 (lower right canine) under the 35-34 (lower left premolars) and in the surgery we had to expose and manipulate the mental nerve, we treated as I say before and now he feels normal without any odd sensation

Fazal Shinwari: That’s was for rct lower 1st premolar and also not anesthetized the mandibular nerve just a local anaesthesia was given

Fazal Shinwari: Now no sensation that’s all

Paul Delfin: Fazal Shinwari I’m sorry I don’t understand what you say

Fazal Shinwari: Come to inbox

Yip Man Cheung: Fazal Shinwari it is not due to the LA. Probably there was periapical inflammation created a pressure on the ID nerve. I would immediately take out any dressing in the canal, replace it with a steroid base dressing or anything anti inflammatory.

Yip Man Cheung: For the recovery of nerve injury , NSAID like Ibuprofen and Vitamin B will be beneficial.

Yip Man Cheung: The most important thing to do right now is to relieve the pressure. Pressure gone, higher chance of complete recovery. More pressure for longer, damage can be permanent !

Paul Delfin: Yip Man Cheung I know that an inflammatory process could press the nerve and cause the paresthesia, but it’s rare that happens just after an anesthesia shot, that is what I believe that maybe e hurt the mental nerve with the needle 😕

Yip Man Cheung: Paul Delfin The cause can be infection around the the root apex, or irritation from the disinfectant of RCT, pressure from the infected tooth. We all know how close the 1st premolar root apex can be with the mental nerve.Pressure is my number one suspect on the list, damage during RCT being the second.

Yip Man Cheung: Paul Delfin Anyway, it was a nice discussion with you😊

Nada Abdelhamid: Paresthesia

Haider Ali: Now what’s the treatment?

Cristina De Leon: Vit b complex would help

Mariam Shabbir: Paresthesia

Paul Achim: if there was the mandibular nerve block, it is normal. in some cases you accidentally hit the nerve and the pacient feel like a lightining stroke in the lower jaw. the effect of the anesthezic is immediate and if you continue to inject, you might have this simpthoms. it it about the nerve lession and it will pass in the next couple of days/weeks or months. depends on how damaged is the nerve. usually no treatment required

Fazal Shinwari: Means the nerve will be ok automatically?

Paul Achim: Fazal Shinwari yes, if it is the situation described above

Katharina Rösch-Kanidis: Paul Achim we were told to tell our patients that with a mandibular block anesthesia, you could damage the nerve permanently. Or is it the mental nerve? Sorry, I’m just dental assistant still at school. So is it possible to damage a nerve permanently with the needle??

Paul Achim: Katharina Rösch-Kanidis a sensitive nerv might loose it’s “job” if you cut it. if you just touch it or make a minimum stress, it might recover close to 100%

Katharina Rösch-Kanidis: Thank you very much for your answer ☺️☺️this is interesting.

Paul Achim: Katharina Rösch-Kanidis sensitive versus motor nerv is different when you speak about recovery. you might have some chances with the sensitive one, but close to 0 with a motor one. so be advice about the facial nerv !

Akello Mercy: Paresthesia

Alyaa Mohsin: vit B tablets and reassurance to the patient

Parvez Ahmed Munna: Antagonist of anaesthetics..!

Dilawer Ali: Wait & watch : syp neurobioninj B12….if persist after a week consult MFS/Neurologist

Farhan Ibrahimi: U injured the nerve

Katharina Rösch-Kanidis: Nerve is damaged

Abbas Khan: Tegretal +delta cartril + nerve tonic

Fazal Shinwari: No pain …

Abbas Khan: Do not give pain killers

Gerrard Nona Messi: I saw once they were using a yellow powder on patient?What could it be?R u guys sure it definitely heals no surgery needed at all?

Mujahid Afzal: Nerve damaged…… Refer to dept of oral medicine and radiology or MDS if same dept.

Rojas Gómez Ana: Parethesia. Treatment: be patient, to wait and clinical control

Maria Stasinou: Exactly

Fazal Shinwari: ?

Maria Stasinou: It’s a reversible trauma of nerve.You just wait to pass away.You don’t have to do anything .It will take from 15 days- 3 months.The most common is 2-3weeks.Just inform your patient and keep him/her calm

Fazal Shinwari: What about vitamin b complex

Rojas Gómez Ana: Vitamin b complex is a excellent option. This vitamin will help to the prognostic.

Younus Afghan: Its a nerve trauma should wait and follow up pt .Don’t worry about .

Yip Man Cheung: How can you damage the ID nerve by giving local infiltration to a lower premolar ? It can only happen to a mandibular block, and it should be able to be prevented by simply aspiration before injection.

Paul Delfin: By using mental nerve blocking you can damage the nerve if your go to deep with the needle

Yip Man Cheung: Fazal said what he did was RCT by local infiltration！With modern LA drugs,it would be quite unnecessary to do mental block not to mention the stupidity of going deeper than needed.

Paul Delfin: Yip Man Cheung nether you and I where there… so we don’t know how everything happen… please moderate your language… this is not your group of futbol friends… 🙄

Yip Man Cheung: Paul Delfin Not intended to be rude to anyone. But I would think that doing a mental block deeper than necessary is a very careless and unnecessary mistake which can be avoided easily.Apologies to those felt offended.

Paul Delfin: Yip Man Cheung i know it, but like I say before, nether you or I where there… so we don’t know exactly how things happened

Yip Man Cheung: If you read more the comments above, you should have more information. Fazal was asking professional opinion from other dentists. I am not judging anyone, but there are lots of unreasonable answers to him.I was just trying to help.My point is:…See more

Fazal Shinwari: Lovely answer from Yip Man Cheung….Nice answer and a bright minded person ….

Yip Man Cheung: Fazal Shinwari thank you for the kind words.Just hope my humble opinion can help. Wish you luck and the patient recover well.Good to learn from each other here in the group😊

Fazal Shinwari: Yes that’s the main thing …We have to learn from each other as well

Venu Milton: U injured nerve it will take a 2 months also to come back to normal

Venu Milton: But no treatment

Fawwad Ahmed: Its common in iferior alveolar nerve block not a big issue

Paul Achim: everywere you expect to meet a sensitive nerv at the place it exits or enter a hole in the bone, you might damage it with the needle and have from little to medium parestesia or even anesthesia. those places can be : infraorbital foramen, foramen mentalis, spina spix (close to the lingual and bucal nerve)