My Actual Risk of Nerve Damage After Wisdom Teeth Removal

How likely are you to have nerve damage during wisdom tooth removal?

What exactly is nerve injury or damage? During a wisdom tooth removal, there is a rare but potential risk where a crucial nerve may be damaged or, in extreme cases, severed. This can result in various disturbances of sensations, often described as numbness, tingling, or itching in certain areas of the face and mouth.

The symptoms you may experience can refer to different conditions, including Paresthesia (sensitivity disturbances), Dysesthesia (burning sensations and pain), or Anesthesia (total loss of sensation). The severity of these symptoms depends mainly on the extent of the injury and the specific nerve affected during the procedure.

Now, back to our question: How likely are you to experience nerve damage during wisdom tooth removal? The risk varies based on several factors, including the position and location of your tooth, whether it's impacted, its proximity to nerves, and your age.


The type of tooth being extracted also matters, with lower wisdom teeth carrying a higher risk due to their close relationship with the major nerves of the lower jaw.

The good news is that the overall risk is relatively low, ranging between 0.35% to 8.4%, according to many studies (1,2).

Even if it does happen, most cases are temporary and typically resolve themselves after a few weeks or months.

Permanent sensory disturbances are exceptionally rare, accounting for no more than 2% of cases (1).

What Nerves are More Likely to be Affected?

The nerves most likely affected during wisdom tooth removal are the inferior alveolar nerve (also called the mandibular nerve) and the lingual nerve. Both branch off from the trigeminal nerve, which controls facial and mouth sensibility.

These nerves travel down to the lower jaw, passing near the wisdom teeth. In some instances, they may even be in direct contact with the tooth, increasing the likelihood of injury.

Another important thing to note is that both the lingual and mandibular nerves are sensory, meaning they transmit sensations like temperature, touch, and pain to the brain. They do not control facial muscle movements.

Therefore, when these nerves sustain damage, you may experience sensitivity issues, but by no means paralysis or loss of control over your facial expressions.

What happens when the lingual nerve is damaged?

The lingual nerve is responsible for the sensitivity of a significant portion of the tongue (front two-thirds), the floor of the mouth (area under the tongue), and the gums on the inner side.

Damage to this nerve can lead to loss of sensitivity in the tongue, affecting your sense of taste and other associated areas.

Since the lingual nerve is involved in the innervation of salivary glands, you may notice reduced saliva production and dry mouth.

Effects of inferior alveolar nerve damage

The inferior alveolar nerve provides sensation to the teeth, the front part of the gums, the lower lip, and the chin. Injury to this nerve can result in numbness in all these areas.

What increases the risk of nerve damage?

The risk of damaging a nerve during wisdom tooth removal depends primarily on its proximity to the tooth. In cases where the nerve lies far from the tooth, the risk is practically non-existent.

However, when the nerve runs very close to the tooth—whether on its front or back sides or even between the roots—there is a heightened risk of damage during the extraction procedure.

To effectively assess this risk, we often use two radiographic tools: Panoramic X-ray and the CBCT scan.

When the nerve is too close to the tooth, it may appear on a Panoramic X-ray as a deviated or discontinuous trajectory or a darkening of the roots, indicating overlapping.


In cases where panoramic doesn't provide detailed information, we turn to the CBCT scan, which offers a more accurate three-dimensional view.


Age is another significant factor. Between the ages of 18 and 20, wisdom teeth are shorter and still forming. The surrounding bone is softer and more flexible, making extraction at this stage generally easier with fewer complications.

After the age of 30, wisdom teeth are fully developed. While the procedure can still be straightforward if the tooth has fully emerged, removing impacted teeth can be more challenging and carry higher risks.

What type of nerve damage can occur in wisdom tooth extraction?

Nerve injuries can be classified based on their cause and severity:

Based on the cause:

• The accidental contact of the nerve with a sharp instrument used during the extraction. The injury may be a simple irritation or, in extreme cases, a cut.


• The injury happened during the administration of anesthesia. The needle used for the injection may pierce a nerve. This is usually minor and reversible.


• Nerve compression due to the post-operative swelling and bruising. Post-operative swelling can put pressure on the nerve, causing tingling or numbness. These sensations usually fade quickly as the swelling goes down.

Based on the severity:

In most cases, the injury is simply a stretching or rubbing of the nerve, causing temporary sensory disturbances that resolve quickly as the nerve heals.

In more severe cases, the nerve may be completely cut, leading to more serious and potentially permanent symptoms.

Even when the damage initially appears permanent, recovery can sometimes occur months or even years later.

Rarely, abnormal sensations in the jaw can suddenly appear weeks after the procedure. This is called delayed paresthesia. Like other mild nerve injuries, it is usually temporary and resolves on its own over time.

I feel a tingling sensation after anesthesia. Is this normal?

Feeling a tingling sensation in your lower jaw right after anesthesia injection is a positive sign that the anesthesia is taking effect. This sensation should resolve within a few hours after the procedure.

If the nerve is accidentally damaged by the needle, symptoms can persist even after the anesthetic wears off.

There is also a small risk of injuring the facial nerve, which controls facial expressions, if the needle is inserted too deeply. This can cause temporary facial paralysis, which typically resolves within a few hours.

What are the most common symptoms?

During the first week or two, it can be hard to tell normal side effects from a potential nerve injury.

The only way to know for sure is to monitor your symptoms and see if they last longer than expected.

Normal side effects gradually improve over time, while nerve injuries may take longer to heal.

It’s important to note that even if symptoms persist, recovery can still occur within the first six months, and improvement may continue for up to 24 months.

Here are the most common signs to be aware of:

Sensation impairment:

This may appear as tingling and prickling sensations on the lower lip, lower cheek, chin, and tongue.

Intense, radiating pain:

Others may experience intense, radiating pain, often described as a burning sensation. This pain may extend to other parts of the face and can occur periodically, lasting for hours.

Complete loss of sensation:

In cases where the nerve is completely severed, there may be total numbness in the involved area.

Disturbance of oral functions:

Nerve damage can cause difficulties with speaking and increase the risk of accidentally biting your lip or tongue.

Taste impairment and dry mouth:

The lingual nerve, which passes near the lower wisdom tooth, carries nerve fibers that control taste and saliva production. Damage to these nerves can result in problems like dry mouth, bad breath, and loss of taste, impacting oral health.

Can nerve damage lead to facial paralysis?

The nerve most likely to be damaged is mainly sensory and does not control facial movements, so an injury to it cannot cause paralysis.

After the wisdom tooth removal procedure, it's not uncommon to experience difficulty opening your mouth, speaking, or chewing. These reactions are completely normal and expected. Swelling, bruising, and the surgical extraction itself can strain the jaw muscles, leading to temporary soreness, stiffness, and muscle tightness.

Keeping your mouth open for a long time during the procedure can also put extra stress on the joints and surrounding ligaments.

These reactions are usually temporary and should improve gradually. However, if the discomfort persists, don’t wait to talk to your dentist.

When does recovery from nerve damage usually occur?

Recovery usually occurs within the first six months after surgery. If symptoms persist beyond this period without any improvement, there is a possibility that the damage could be permanent.

However, recovery and improvement can sometimes continue for up to 24 months, so it’s important to be patient and avoid jumping to conclusions.

Nerve damage treatment

Even in the worst-case scenario—where the nerve is completely severed—there are several options to support healing and regeneration.

The first approach is to allow time for natural recovery. Nerves have a strong regenerative potential, so there’s a good chance of repair, especially for minor damage. This process can take some time, particularly for the inferior alveolar nerve.

If symptoms persist or the injury is severe, a surgical procedure may be considered. This intervention aims to decompress and repair the damaged nerve by reconnecting its ends, helping the severed parts fuse and regenerate properly.

Should wisdom teeth that carry a risk be left in place?

Deciding whether to remove or keep your wisdom teeth involves weighing the pros and cons of the procedure. Your dentist will explain the potential risks and benefits so you can make the best choice for your situation.

If your wisdom teeth have erupted correctly and are in the right position, you may never need to have them removed.

Unfortunately, these teeth often don’t have enough space in the jaw to fit properly. This can lead to problems such as infections, cavities, cysts, and pain. In such cases, the benefits of extraction usually outweigh the risks of the procedure.

But what if a wisdom tooth must be removed but is located very close to a nerve? In these situations, careful examination with X-rays is crucial to prevent potential nerve complications.

If X-rays show that the nerve is too close to the roots and injury is likely, a technique called a coronectomy can be used. This involves removing only the crown of the tooth while leaving the roots in place.

However, coronectomy has its limitations, especially in cases of infection, cysts, or when the tooth is positioned horizontally.