Management of inferior alveolar nerve and lingual nerve injuries in the UK - a cross-sectional study

Br J Oral Maxillofac Surg. 2022 Sep;60(7):927-932. doi: 10.1016/j.bjoms.2022.01.012. Epub 2022 Feb 3.

Abstract

Post operative nerve injury following mandibular third molar (M3M) potentially impacts a significant number of patients. A lack of consensus for the management of trigeminal nerve injuries exists. It is important to know how clinicians manage these injuries, and how confidently. A 16-question online survey using SurveyMonkey was developed and sent to all current UK members of three oral srelated societies (ABAOMS, BAOS and BAOMS) from January 2021 to March 2021. The survey consisted of open free text, binomial and variable scale responses related to the management of inferior alveolar nerve and lingual nerve injuries. A total of 158 clinicians responded to the survey. The average number of M3M removed monthly over the last three years by a clinician was 25. The average number of nerve injuries seen in a clinician's practice, within the last three years, was three. Over two-thirds of respondents were only somewhat confident, not so confident, or not at all confident in the management of patients with inferior alveolar nerve (IAN) and lingual nerve (LN) injury. In occurrence of an injury, only 45% stated they would make an onward referral and a minority of clinicians had access to surgical repair within their own unit. Free text responses highlighted themes of a lack of UK awareness of management interventions and pathways for these patients. Clear national guidance on managing trigeminal nerve injuries was a commonly desired theme from responding clinicians. Joint speciality partnerships and a national nerve repair registry is now required.

Keywords: Nerve injury; Post-traumatic trigeminal neuropathy; Third molar removal; Wisdom tooth surgery.

MeSH terms

  • Cross-Sectional Studies
  • Humans
  • Lingual Nerve / surgery
  • Lingual Nerve Injuries* / surgery
  • Mandibular Nerve / surgery
  • Molar, Third / surgery
  • Tooth Extraction
  • Trigeminal Nerve Injuries* / etiology
  • Trigeminal Nerve Injuries* / surgery
  • United Kingdom