One of the most serious complications that can result from a dental procedure is damage to the inferior alveolar nerve or lingual nerve. As you might imagine, people who have suffered this type of nerve damage often experience numbness, and they often experience this numbness for the rest of their lives.
However, as horrible as this sounds, nerve damage can be much worse than a loss of feeling. Specifically, in addition to permanent numbness, a person with nerve damage may experience constant odd and painful sensations, and these sensations can last forever. This is worst case scenario for a person with dental nerve damage, and it’s often an indication of an extremely severe trigeminal nerve condition known as “anesthesia dolorosa.”
Anesthesia dolorosa is a complication that can develop after a traumatic injury to the trigeminal nerve during a dental procedure, typically a surgical procedure. Anesthesia dolorosa is often experienced as feelings of pain in areas that are numb to the touch because of damage to the inferior alveolar nerve. The literal translation of anesthesia dolorosa is “painful numbness.” It arises because of damage to the nerve that results in spontaneous pain signals to the brain.
In this article, we will talk more about anesthesia dolorosa and how it can affect a person’s life.
Causes of Anesthesia Dolorosa
Anesthesia dolorosa occurs when a dentist or doctor damages the trigeminal nerve, which includes the inferior alveolar nerve and the lingual nerve. Most often, dental patients suffer permanent nerve damage as a result of dental implant procedures, extractions, injections of local anesthesia, and root canals. Below are some of the more common ways a dentist may cause a patient the type of serious nerve damage that can cause anesthesia dolorosa.
- Dental implant placement;
- During osteotomy;
- Root canal overfill;
- Perforating the root during a root canal procedure on a bottom molar;
- Extraction of wisdom teeth;
- Instrumenting through the apex of the root during a root canal procedure.
Anesthesia Dolorosa Symptoms
The name, “anesthesia dolorosa” or “painful numbness” very accurately describes the primary symptom of this horrible condition: serious pain in numb areas. Although most of us think of numbness as a complete loss of feeling, it’s often accompanied by other unusual sensations in the context of dental surgical injuries. Anesthesia dolorosa may cause pain in all the patient’s areas of numbness, or it may be isolated to one smaller location of numbness. Some of the more common symptoms of anesthesia dolorosa include the following:
- Numbness or loss of sensation, including the inability to feel touch, heat, or cold on a portion or all of the face;
- Constant pain experienced in the areas of numbness that occurs without stimulation and does not subside;
- Serious and never-ending pain that can be described as burning, tingling, chemical, cold, or electrical;
- Odd sensations, including pressure or weight, pulling or tugging, overall heaviness, or tightness.
How Do People Describe the Sensations of Anesthesia Dolorosa?
Anesthesia dolorosa may manifest in a variety of ways, and each person may describe the pain differently. For example, we’ve heard people say that it feels like “a bolt of lightning in my face” or like they are “constantly being shocked in the face.” Other clients have described this pain as a constant burning sensation, like “having someone hold a torch to your face.” One particular client described the sensation as being like “someone started a campfire in your mouth and poured gasoline on it.”
This is serious stuff. If you or a loved one has experienced this, you know that nobody would wish anesthesia dolorosa on their worse enemy. This is the type of pain that causes people depression and despair. One of the saddest aspects of this condition is that there’s no known cure. If a dentist causes this condition, you could be dealing with it for the rest of your life.
How is Anesthesia Dolorosa Diagnosed After Dental Nerve Damage?
Anesthesia dolorosa after dental nerve damage can be diagnosed through a combination of physical examination, medical history, and diagnostic tests. The following steps may be used to diagnose anesthesia dolorosa after dental nerve damage.
Your dentist or healthcare provider may perform a physical examination of your lips, mouth, face, cheeks, gums, and neck to assess the location and severity of your symptoms.
Your dentist or healthcare provider may ask you about your medical history, including any previous dental procedures and any other medical conditions you may have experienced that could be relevant to your anesthesia dolorosa symptoms.
Your dentist or healthcare provider may perform a series of tests to assess the sensation in the affected area, including light touch, temperature, poking, and pressure sensitivity tests.
Depending on your individual case and your unique symptoms, your dentist or doctor may order one or more imaging tests, such as X-rays, radiographs, or MRI scans, to rule out other causes of anesthesia dolorosa and determine the precise location of any nerve damage you may have suffered.
Nerve Conduction Tests
Nerve conduction tests measure the electrical activity of the nerves and muscles, and they can help to determine the severity and extent of your nerve damage. Once your doctors determine the cause of your anesthesia dolorosa, they will probably work with you to develop some sort of personalized treatment plan to manage your symptoms.
It is important to keep in mind that anesthesia dolorosa can have multiple causes, and it may take a long time to determine the underlying cause of your symptoms. Working closely with your dentist or healthcare provider is essential to getting an accurate diagnosis and effective treatment.
Anesthesia Dolorosa Treatment
Unfortunately, there is no known effective treatment for anesthesia dolorosa. However, there are a number of pain management approaches that can help. Each person may benefit from a number of different approaches or medications, as we’ll talk more about below.
Medications Used to Treat Anesthesia Dolorosa
Anesthesia dolorosa that results from dental nerve damage can be an extremely challenging condition to treat, and various medications may be used to help manage the pain associated with this condition. Some commonly used medications for treating anesthesia dolorosa resulting from dental nerve damage include:
- Antidepressants: Tricyclic antidepressants, such as amitriptyline (Elavil) and nortriptyline (Pamelor), have been found to be effective in treating neuropathic pain, including anesthesia dolorosa.
- Anticonvulsants: Drugs such as gabapentin (Neurontin) and pregabalin (Lyrica) are commonly used to treat neuropathic pain and have been found to be effective in treating anesthesia dolorosa.
- Opioids: Strong pain relievers such as morphine, fentanyl, and oxycodone may be used to treat the severe pain associated with anesthesia dolorosa. However, these drugs can be extremely addictive and have significant side effects, so their use should be closely monitored.
- N-methyl-D-aspartate (NMDA) receptor antagonists: Drugs such as ketamine can be used to treat neuropathic pain, including the pain associated with anesthesia dolorosa.
Folks that have come to us with anesthesia dolorosa are often prescribed gabapentin. However, the best medication for each person suffering from anesthesia dolorosa resulting from trigeminal nerve damage may vary depending on the individual and the severity of their pain.
Other Treatments for Anesthesia Dolorosa
In addition to medications, there are several other types of treatments that can help with anesthesia dolorosa, including the following.
- Physical therapy: Gentle exercises, such as jaw and mouth movements, can help to reduce pain and improve function.
- Dental interventions: Procedures such as nerve repositioning and nerve grafting can be used to help restore function and reduce pain.
- Transcutaneous electrical nerve stimulation (TENS): A TENS machine delivers small electrical impulses to the area affected by nerve damage, which can help to relieve pain.
- Acupuncture: This traditional Chinese medicine technique involves the insertion of fine needles into specific points on the body to relieve pain and promote healing.
- Cognitive behavioral therapy (CBT): This type of therapy can help individuals with anesthesia dolorosa to better manage their pain and reduce the impact it has on their daily life.
- Hypnotherapy: Hypnosis may be used to help individuals with anesthesia dolorosa to manage pain, as well as reduce the anxiety and depression related to the condition.
- Cold and heat therapy: Applying cold or heat to the affected area can help to relieve pain and improve function.
Again, as we’ve talked about, each injured person’s experience with nerve damage will be unique. Thus, the best combination of treatments for anesthesia dolorosa resulting from nerve damage after a dental procedure may vary depending on the individual, their symptoms, and the severity of their pain.
Is There a Cure for Anesthesia Dolorosa?
Unfortunately, there is no cure for anesthesia dolorosa. The condition is often chronic, and it can be very difficult to treat. However, there are a number of treatments, including medications, physical therapy, and nerve stimulation techniques, that we talked about above. These treatments aren’t known to cure the condition, but they may help to manage the pain associated with the condition.
In some cases, surgical intervention may be necessary to repair or regenerate a damaged nerve. However, the success of these procedures is not great, and surgery may not eliminate the pain associated with anesthesia dolorosa. Additionally, sometimes surgery can make the symptoms of anesthesia dolorosa worse.
Overall, anesthesia dolorosa usually involves some sort of individualized multidisciplinary treatment plan that addresses the specific symptoms and needs of each person with anesthesia dolorosa. A combination of treatments may be most helpful in managing the pain effectively and improving the injured person’s quality of life.
Does Anesthesia Dolorosa Go Away?
Anesthesia dolorosa is a chronic condition that typically will not go away on its own. The severity of the pain each person experiences as a result of this condition will vary. For example, some individuals experience periods of increased pain or improvement, while other people experience constant debilitating pain.
Although anesthesia dolorosa doesn’t typically go away, there are a number of treatments, including medications, physical therapy, and nerve stimulation techniques, that may help to manage the pain associated with the condition. As we’ve talked about above, the types of treatment that a person may benefit from will depend upon the individual, and a patient may benefit from a combination of treatments.
Have You Suffered Serious Nerve Damage as a Result of a Dental Procedure?
If you or a loved one has suffered serious or permanent nerve damage as a result of a dental procedure, you should speak with an experienced Florida dental malpractice lawyer as soon as possible because you may be entitled to compensation. Please don’t hesitate to contact us on our website to set up your free consultation by email, or you can call our Orlando, Florida personal injury law firm at (321) 352-7588 today to schedule your free consultation by phone. When you schedule a consultation at our law firm, you will get a consultation with a personal injury lawyer, not a customer service representative or intake person.
If you need a South Carolina dental malpractice lawyer, please don’t hesitate to reach out to us at (843) 638-6590. We have at least one lawyer licensed in Florida, Georgia, South Carolina, and North Carolina.