Paresthesia is that sensation of tingling and numbness that can occur following an oral surgery. Dental paresthesia typically affects the lower alveolar nerve, a particularly vulnerable tissue.
What is meant by paresthesia of the alveolar nerve?
As a rule, paresthesia is not a pathology that causes pain, but causes the patient many inconveniences. It is manifested by the absence of sensitivity to the lower lip and up to the chin, sometimes accompanied by itching or burning. What happens scientifically is an injury to the central nervous system or peripheral nervous structures.
Paresthesia can be temporary or definitive depending on the condition that caused it. Let’s talk about temporary paresthesia if it was a compression of the nerve bundle that determined it and therefore eliminated the compression also rehabilitates the affected part. In the condition of final paresthesia the condition is unfortunately 
irreparable.
Paresthesia in dentistry
In dentistry, the interventions for which the patient is at risk of paresthesia are:
- wisdom tooth extraction;
- implantology;
- maxillofacial surgery (for the treatment of malignancies or cysts);
- endodontic treatment (devitalization).
Among all, the extraction of third molars, or wisdom teeth, is certainly the most frequent cause. The possibility of trauma to the lower alveolar nerve is in fact, in this case, increased by the proximity of the roots of the third molars with the tissue of the lower alveolar nerve.
Cases of paresthesia can also occur following an endodontic treatment. During the curettage (cleaning) of the alveolus, some bone splinters can get into the mandibular canal and compress the nervous structure, usually the phenomenon is reversible.
During more complex operations, such as for example an implantology operation, it may happen that during the insertion phase of the implants a stretch of the alveolar nerve can occur with consequent paraesthesia.
Probability of running into a paraesthesia and how to solve it
The scientific literature reports one case of paresthesia per 1000 dental operations. The highest incidence recorded regards, in particular, wisdom tooth extractions and implantology interventions.
In most cases the pathology is reversible, it is sufficient to eliminate the cause of the compression of the nerve to restore all functionality. To bring the situation back to normal in the shortest possible time, it is possible to combine an anti-inflammatory drug therapy.
As with any pathology, not only of the oral cavity, prevention is always better than cure. For this reason, it is essential, before each dental intervention, to analyze in detail the position of the alveolar nerve through diagnostic imaging.
Planning the intervention in every phase avoids annoying and dangerous complications due to the compromise of the nervous tissues.
Diagnostic tests carried out with state-of-the-art equipment, such as the CT Cone Beam, allows for a three-dimensional image of the patient’s anatomical condition. Detailed and very high definition images help the dentist to reduce the operating risk because you can exactly know the position of the nerve with respect to the intervention area, avoiding any type of damage.
