Hitting a Nerve: Dental Implants and Nerve Repositioning
A few popular sayings include the word “nerve,” or “nerves, such as “You are getting on my nerves,” or “You’ve got a lot of nerve.” In dental-speak, we talk about the nerves that lie under your gums. The nerve in your jaw, called the inferior alveolar nerve, gives feeling to your teeth. Not the mushy, love kind, but sensations to outside stimuli such as temperature and touch. The feelings can also come from inside the body, including tooth pain from infection. When you receive a dental implant, the jaw nerve needs to be below the gum line far enough that it won’t be affected.
When a tooth or teeth are missing, the jawbone deteriorates. The lack of bone tissue causes the jaw nerve to be closer to the gum line than it should be. Although this is not common, it can happen in the lower jaw, specifically toward the back of the mouth. One option for the dental implant specialist would be to reposition the nerve to create enough space for the implant.
Is There Space Available?
Dental implants typically measure 2mm to 6mm in diameter in sizes called mini dental implants, standard width dental implants, and wide width dental implants. You can find lengths up to 16mm, but particular positions in the mouth require implants that fit the space left behind by the missing tooth. Whatever the implant size, enough space must be available for the tiny implant screw without disturbing the inferior alveolar nerve. Occasionally, the best course of action is to remove a section of jawbone to expose the nerve, move the nerve out of the way, place the dental implant, and return the jaw nerve to its proper position over the new implant. Next, the bone material is augmented with donated bone tissue, cadaver tissue, or synthetic bone material. Finally, the gums are stitched up for healing.
Nerve repositioning surgery can be tricky for the oral surgeon or dentist. If a nerve is damaged during the process, the patient can experience numbness or partial loss of sensation in the jaw, chin, or lower lip. The numbness can last a period of time, or it can be permanent. For this reason, the dental implant specialist will use other options, such as bone augmentation only, for the tiny screw if possible.