Severed Lingual Nerve During Wisdom Tooth Removal

This case involves a young woman who underwent a dental procedure for the removal of molar teeth by a maxillofacial surgeon. During the procedure, the lingual nerve was damaged which caused paresthesias on one side of the patient’s tongue. The patient followed up with the surgeon but no surgical or medical intervention was recommended. The physician informed the patient that she should take a wait and see approach since the issue should resolve itself with time. After several weeks, the patient sought counsel from another surgeon and he suggested that the patient undergo a nerve decompression procedure with a possible nerve graft repair. The patient went ahead with the corrective procedures but regained minimal benefit. The delay in treatment allegedly caused nerve damage too severe for regeneration.

Question(s) For Expert Witness

1. Could a more timely diagnosis have made a difference in this case?

Expert Witness Response E-001156

Microsurgical techniques for nerve repair have been used for many years. There is little standardized manner in assessing outcomes, and the numbers studied are very limited, especially when it comes to the lingual nerve. Repair may entail decompression, direct suture, or grafting. This case hinges on the severity of the nerve damage. If the injury was of the type that was supposed to be noticed right away, then they should have referred the patient to a nerve specialist immediately. This would have greatly altered the nerve regeneration potential.