Our mouth is the gateway to our body. Through it, we can taste so many different things, but at the same time, it is also the entry point for many injuries. Most of the times, it is external sources like food and bacteria that cause oral problems.
A somewhat unspoken dental problem is nerve damage. It is caused due to surgical procedures, tooth extraction, and sometimes unknown reasons.
Surgery, medicines, and therapy can treat lingual nerve damage.
Lingual Nerve Supply
The lingual nerve is a branch of the mandibular nerve. It supplies the anterior two-thirds of the tongue, whereas the glossopharyngeal nerve covers the posterior one third. It responds to stimuli of pressure, touch, and temperature.
Causes of Lingual Nerve Damage
- The most common cause of lingual nerve damage is the extraction of the lower wisdom tooth. (1) The nerve lies near the third molars, and during removal, there is a chance that it can get damaged.
- During surgery on the floor of the mouth, the nerve can get damaged. However, this is a rare cause.
- Another possibility is an injection of local anesthesia. Like the former case, this is also rare.
- There are also instances of lingual nerve damage during a laryngoscopy. (2)
- Theoretically, any surgical procedure in proximity to the nerve presents the risk of injury.
When there is damage to a sensory nerve, the consequence is that you will lose sensation to that particular part. Similarly, when the lingual nerve is injured, the sensation is lost from the anterior two-thirds on the tongue.
This means that you may have a partial or complete loss of taste sensation. You may not completely lose your taste sensation. It may show some alterations, and you may feel a tingling sensation on your lower lip or chin.
Depending on the degree of damage, there could be an abnormal taste sensation or a decreased response to any stimulus.
If the damage is extensive, the patient has difficulty in talking. This eventually leads to social anxiety, awkwardness, and psychological stress.
It is also uncomfortable to chew food when you have a lingual nerve injury. Generalised pain in areas of the mouth is also not uncommon.
This loss could be temporary or even permanent. However, the majority of the times this loss of sensation is reversible, and perception returns in about two to three months.
If it has been more than six to seven months that your nerve damage has not resolved, then it holds a possibility of being permanent.
Nerve damage can be tackled both surgically and non-surgically. The objective of the procedure is to improve or regain sensation to the affected parts. Intervention is through surgeries, medications, laser therapy, exercises, and counseling. (3)
Microsurgery is performed to repair lingual nerve injuries. Though there is little data available on the techniques and methods, these procedures are known to improve touch perception significantly. But the improvement in pain was only marginal.
Microvascular decompression is an effective surgical technique to correct nerve damage.
Low-intensity laser treatment is given to patients of nerve damage to improve the sensation of taste. This treatment method is often conflicted since many clinicians believe it is only a placebo.
The class of drugs used for the treatment of this condition is painkillers, antidepressants, and anti-inflammatory medicines. The physician prescribes analgesics to reduce the pain accompanying nerve damage.
Strong corticosteroids reduce the inflammatory reaction and bring the injury damage to a minimum. Topical gels containing lignocaine are supplementary to these medicines.
These gels superficially numb the pain. However, the effectiveness of this remains doubtful to many doctors.
Though the damage to the nerve is due to a procedure or surgery, it has serious psychological implications. This is why patients suffering from this condition undergo counseling through cognitive and behavior therapy.
Before beginning the therapy, a behavioral assessment is conducted. This assessment is to evaluate the patient’s attitude, compliance, and psychology about the injury.
Based on this, the person receives intervention through relaxation techniques, behavior management methods, and biofeedback mechanism.
Lingual nerve damage is a serious condition to keep in mind during any surgical procedure. Depending on the injury, it can have implications ranging from temporary loss of taste to more permanent life-altering consequences.
It is best if it is diagnosed early on and treated by an appropriate surgical or non-surgical method. (4)