Wisdom teeth removal is a common oral surgery procedure that requires the use of local anesthesia to manage pain during the extraction. This injected medication temporarily blocks nerve signals in the mouth, resulting in the familiar sensation of numbness. While the removal of the third molars is a routine process, the resulting lack of feeling in the lips, tongue, and cheek can feel unsettling afterward. Understanding the normal timeline for this numbness is helpful for patients, as the duration depends entirely on the specific agents used by the surgical team.
Expected Duration of Local Anesthesia
The feeling of numbness immediately following the procedure is a direct result of the local anesthetic injection, which is administered near the nerves that supply sensation to the surgical area. The duration of this effect is highly variable, ranging from two to 24 hours. The specific agent used is the primary factor; common anesthetics like Lidocaine typically wear off in three to four hours.
Longer-acting medications, such as Bupivacaine, are often used to provide extended pain control, sometimes lasting up to ten hours. In some cases, a long-lasting nerve block can keep the jaw, cheek, and tongue numb for a full 12 to 24 hours. Metabolism and the total dose also influence how quickly the body processes the anesthetic. The sensation usually returns gradually, often beginning with tingling or a “pins and needles” feeling.
Practical Care While Numb
While the mouth remains numb, preventing accidental injury to the soft tissues is a primary concern. The loss of sensation means a person cannot feel themselves biting their cheek, lip, or tongue, which can lead to significant trauma and painful ulcerations. It is highly recommended to avoid chewing any food until the numbness has completely resolved.
Patients should also avoid consuming hot liquids, such as coffee or soup, while the anesthetic is active. Without the ability to feel temperature properly, a person can easily cause a thermal burn to the oral tissues. Safe hydration methods, like sipping cool water, are encouraged, and soft, lukewarm foods like yogurt or applesauce are safer options during this period.
Understanding Prolonged Numbness (Paresthesia)
Numbness that persists beyond the initial 24-hour period is called paresthesia, indicating an altered sensation resulting from nerve irritation or trauma. This complication is uncommon, but it occurs when the extraction procedure affects the inferior alveolar nerve or the lingual nerve. The inferior alveolar nerve runs through the lower jawbone, providing feeling to the lower lip, chin, and teeth.
The lingual nerve, which supplies sensation and taste to the tongue, is also at risk because of its proximity to the surgical site. Trauma to these nerves typically involves stretching, compression, or bruising caused by the tooth itself or the surgical instruments. While this prolonged altered feeling can be disconcerting, it is often temporary, with many patients recovering full sensation over a period of weeks or a few months.
In a small percentage of cases, the sensory change can last six months or longer, which is sometimes termed persistent paresthesia. The risk of permanent sensory disturbance is low, affecting less than one percent of patients. Minor nerve injuries generally heal as the nerve fibers regenerate, but ongoing monitoring by the oral surgeon is necessary to track the recovery of sensation.
Warning Signs Requiring Immediate Medical Attention
While temporary numbness is expected, certain symptoms indicate an acute complication that requires immediate contact with the oral surgeon or emergency medical services.
- Uncontrolled or excessive bleeding that continues despite applying firm pressure for an extended time is a serious concern. Some oozing is normal, but heavy bleeding that persists should be evaluated promptly.
- Signs of a spreading infection, such as a high fever above 100.4°F, chills, or the presence of pus or foul-smelling discharge from the surgical site, also necessitate immediate care.
- Increasing pain that is not relieved by prescribed medication, especially if it worsens several days after the surgery, may indicate a complication like a dry socket or an infection.
- Difficulty swallowing or sudden trouble breathing, which can signal swelling in the throat or neck, should prompt an immediate visit to the emergency room.