Numbness in Teeth and Gum

whoknew?

Hi. I was playing football 4 months ago and clashed heads with a guy, with his forehead hitting my cheekbone. I felt ok after but a few days later I was brushing my teeth and it felt as though I was under anaestetic in a section of my gum from one of my top front teeth back to my molars. X-Ray showed nothing broken but the consultant did say I may have damaged a nerve and there was nothing they could do. I am still numb and just wondering if anyone has advice. Basically, I'd like to feel my teeth at some stage!!!

btkm8unsl0w5r4

One of the facial nerves (infra orbital) comes out around the nose/cheekbone and supplies the sensation to the gums on the upper on one side.



You may have crushed the nerve or torn it. Several things may happen
1. The sensation never comes back.
2. The sensation comes back slowly over several months or years.
3. The sensation come back but is never quite normal.

You could look into a nerve repair however I have never head of one on that particular nerve. I am sure you have had the cheek bone checked for fracture?

Sorry op,

whoknew?

Aisha Spoiled Cereal wrote: »

One of the facial nerves (infra orbital) comes out around the nose/cheekbone and supplies the sensation to the gums on the upper on one side.



You may have crushed the nerve or torn it. Several things may happen
1. The sensation never comes back.
2. The sensation comes back slowly over several months or years.
3. The sensation come back but is never quite normal.

You could look into a nerve repair however I have never head of one on that particular nerve. I am sure you have had the cheek bone checked for fracture?

Sorry op,

Hi. The x-ray showed the cheekbone was ok and the point on the drawing is the exact point of impact. I have been assured that this will not affect blood flow to the teeth which means they will remain healthy.

Thanks again.

Oral Surgeon

Sorry op,
Cheek bone fracture is a common injury most likely to occur from sports or fights...
The diagnosis can be a little subjective if based on plain film (normal) xrays.
It can be fractured and displaced or fractured and not displaced.

Clinical signs that point to a cheek bone fracture are;

Dipolpia (double vision, the eye does not sit correctly in it's socket or the muscles that move the eye are trapped- this means that both eyes don't look at exactly the same spot and hence double vision

Enopthalmos or a sunken eye, again where the eye socket is disrupted and the eye falls a little into the underlying maxillary sinus

Sub-conjunctival haemorrhage, a bleed in the white of the eye, usually indicates some bony fracture in any bone of the eye socket...

Anaesthesia or parasthesis (numb or altered feeling) in the infraorbital nerve causing a numb feeling to some or all of the upper teeth and gums on that side and/or the skin around the cheek and side of the nose.

Deformity, a step in the bones may be felt on the rim under the eye or on either side of the eye, also the cheekbone arch may be depressed. This can be hard to detect initially as swelling makes examination difficult.

An altered bite (the bone and teeth may have moved), or a difficulty opening the mouth ( the coronoid portion of the lower jaw sometimes gets trapped on a fractured zygoma (cheekbone) arch)

Radiographic signs are;
obvious displacement of the bones

sometimes fluid in the maxillary sinus on that side indicates that the sinus lining has been torn by a fracture and has bleed


BUT
You can have a fracture that is not displaced and you can also just have a blunt trauma to the infraorbital nerve as it emerges from the bony opening

In general, altered sensation from such injuries tend to resolve. If the altered sensation is mild- I would not go down the road of nerve repair surgery as you risk making the altered sensation worse or widen the area involved or even risk dysaethesia (a painful numb or altered sensation).

Main thing here is if everything was done to help you and I think it has been.
Cheek bone injuries heal if left alone
Fractured cheek bones if displaced will heal in the displaced area leaving a deformity
Fractured cheek bones if non displaced just need to be monitored and refrain form contact sports for 6weeks approx and they heal
Displaced fractured cheek bones should be moved into the correct position for the best cosmetic result
The grey area is a fractured cheek bone displaced by 2mm, is it worth the surgery?? Will you get it back perfect but at the expense of a small scar....

Bottom line op, monitor, keep in touch with your consultant, nerves can take 12, even 18 months to heal themselves...

Good luck
OS