The analysis of dysesthesia reported by 276 dentists after tooth extraction and implant surgery

The analysis of dysesthesia reported by 276 dentists after tooth extraction and implant surgery
April 2005
Editor: Martin S. Greenberg
Oral Medicine
Objectives. Neuropathies can affect a single nerve or several nerves and result in sensory, motor, and/or autonomic deficits in the affected region. Reported dental causes of dysesthesia include tooth extractions, implant placement, needle trauma following local anesthesia, periapical inflammation, denture compression of the nerve, and endodontic treatment. In many cases reviewed, tooth extraction was the main cause of dysesthesia in orofacial region. Moreover, there has been a dramatic increase in the number of practitioners performing implant surgery over the past 15 years. The acceptance of challenging cases may increase the incidence of related problems and complications. The number of malpractice suits related to implants and tooth extractions has increased significantly, with awards among the highest in dentistry. Altered mandibular sensation following implant surgery or extraction may result in liabilaty claims. Therefore, it seems prudent to review these cases to better understand the causes and characterization of such actions to prevent complications and reduce future litigation.
Study design. Questionnaires were delivered to people who attended implant seminars directly and returned at that time; 276 questionnares were returned. There were 16 questions, 8 of which related to tooth extraction and 8 to implant surgery.
Results. Tooth extraction: Of the 276 dentists, 108 (39.1%) experienced dysesthetic patients after tooth extraction. Rate of persistent dysesthesia reported by respondents was 14.6%. The most frequent problem associated was pain and a burning sensation. Implant surgery: Of the 276 dentists, 68 (24.6%) experienced dysesthetic patients after implant surgery. Rate of persistent dysesthesia reported by respondents was 25.4%. The most frequent problem associated was pain and a burning sensation.
Conclusions. In this study, most dysesthesia may be resolved within 1 year. However, 14%-25% of dysesthesia may be persistent. The oral and perioral regions are known to be among the most sensitive areas in the human body. This explains why minor oral nerve damage can be a major handicap for the patients. Most dysesthetic pain resolves spontaneously over 1-2 years. While the pain is present, however, a patient's quality of life can be substantially diminished.