How to Get Rid of Numbness After Jaw Surgery

Numbness after jaw surgery is one of the most common side effects of the procedure, and for most people it fades on its own over weeks to months as the affected nerve heals. That said, recovery is not entirely passive. A combination of sensory retraining exercises, low-level laser therapy, and in some cases B-vitamin supplementation can speed things along. The specific approach depends on how severe the nerve injury is, how long ago your surgery was, and which procedure was performed.

Why the Numbness Happens in the First Place

The numbness you feel in your lower lip, chin, or gums after jaw surgery almost always traces back to the inferior alveolar nerve, a branch of the trigeminal nerve that runs through a canal inside your lower jawbone. Orthognathic procedures on the mandible, particularly the bilateral sagittal split osteotomy (BSSO), require cutting and repositioning bone dangerously close to this nerve bundle. Electrophysiological recordings taken during surgery show that the nerve sustains measurable injury at multiple stages of the operation, from the initial bone cuts through the placement of fixation screws.¹ The screws themselves can compress the nerve between the repositioned bone segments, adding another layer of damage on top of what the cutting already caused.

The type of injury matters for your recovery. Some injuries involve bruising and swelling around the nerve, which resolves as inflammation goes down. Others involve damage to the nerve’s protective insulation (the myelin sheath), and the most severe involve actual tearing of nerve fibers. Your surgeon may not always know which type occurred, which is one reason timelines vary so much from person to person.

What Affects How Quickly You Recover

Several factors influence how fast numbness resolves, and some are outside your control. Patient age is one of the strongest predictors: older patients tend to recover sensation more slowly and less completely. The amount the jaw was moved during surgery also matters, as does how much the nerve had to be physically manipulated or shifted during the procedure. A study of patients who had bilateral sagittal split osteotomy found statistically significant links between lingering sensory loss and the patient’s age, the magnitude of jaw movement, and the degree of nerve manipulation.²

The surgical technique your surgeon used also plays a role. For mandibular setback procedures specifically, intraoral vertical ramus osteotomy (IVRO) tends to cause significantly less nerve disturbance than the sagittal split approach, because the bone cut is made further from the nerve canal.³ One comparison found that the number of oral mucosa points showing reduced sensation after BSSO was significantly higher than after IVRO at every assessment point through eight weeks.⁴ If your surgery has not yet been scheduled, this is worth discussing with your surgeon, though the choice of technique depends on the type of jaw correction needed, not just nerve risk.

Piezoelectric instruments, which use ultrasonic vibrations instead of traditional rotating saws and drills, also appear to reduce nerve damage. A meta-analysis found roughly 25% less severe nerve disturbance with piezoelectric surgery compared to conventional techniques, with the difference visible at both three and six months after the operation.⁵ The evidence base is still relatively small, and another systematic review cautioned that sample sizes in piezoelectric studies are limited, so those near-zero complication rates should be interpreted carefully.⁶ Still, the trend favors the newer technology for nerve preservation.

Sensory Retraining Exercises

This is the single most actionable thing you can do at home to speed recovery, and the research behind it is solid. Sensory retraining involves systematically stimulating the numb areas of your face with different textures and temperatures to help your brain recalibrate its interpretation of nerve signals as they return. Think of it as physical therapy for your face.

In a randomized clinical trial, patients who performed sensory retraining exercises were about twice as likely to report lower interference from numbness by six months compared to those who only did standard mouth-opening exercises.⁷ The benefit persisted for up to two years after surgery: the group that only did opening exercises continued to report more interference in daily activities related to numbness and lip sensitivity than the retraining group.⁸ A follow-up analysis of sensory thresholds confirmed that retrained patients performed better specifically on two-point discrimination, meaning they could distinguish two separate touches closer together, which suggests the brain was processing the returning nerve signals more effectively.⁹

The exercises are straightforward. The typical protocol involves lightly touching and tapping the numb area with different objects like a cotton ball, a soft brush, or a textured cloth. You close your eyes, try to identify where and what you’re feeling, then open your eyes to check. You can also practice with warm and cool objects. Most protocols recommend doing this several times a day for short sessions, starting as soon as your surgeon gives the go-ahead post-surgery. Your oral surgeon or physical therapist can give you a specific routine, but the general principle is to provide your recovering nerve pathways with varied, gentle stimulation so the brain re-learns to process those signals correctly.

One detail worth noting from the research: older patients and those with higher psychological distress before surgery reported a greater burden from the altered sensation regardless of which group they were in.⁸ This suggests that managing stress and expectations around recovery matters, too.

Low-Level Laser Therapy

Low-level laser therapy (LLLT), also called photobiomodulation, involves directing a low-power laser at the skin overlying the affected nerve. The light energy is thought to stimulate cellular activity and promote nerve repair. Your surgeon or a specialist in oral rehabilitation would administer this in-office, usually over a series of sessions.

The evidence here is encouraging but still developing. A systematic review of randomized controlled trials found that one study reported significantly faster return of sensitivity on the laser-treated side compared to the untreated side, with the difference appearing as early as 15 days post-surgery and remaining significant at 60 days. Another included trial found that six months after surgery, about 69% of patients in the laser group reported recovery of general sensitivity compared to only about 21% in the placebo group.¹⁰ A placebo-controlled trial reported similar figures and found that roughly 63% of patients in the laser group regained normal two-point discrimination, while the visual analog scale for sensitivity reached normal levels in the laser group.¹¹

A more recent study comparing two types of laser directly against vitamin B therapy alone found that both approaches promoted nerve regeneration, but laser therapy outperformed the B vitamins.¹² One limitation is that LLLT is not available in every practice, and protocols vary in terms of wavelength, power density, and treatment frequency. If you’re interested, ask your surgeon whether they offer it or can refer you to a provider who does.

B Vitamins

B vitamins, particularly B12, B1, and B6, are involved in nerve maintenance and repair. Vitamin B12 supports myelin production, B1 helps with nerve signal transmission, and B6 contributes to the synthesis of components that make up nerve insulation. These are commonly recommended as supplements after jaw surgery, partly because they are safe, cheap, and widely available.

A retrospective study of patients who received early vitamin B12 administration after bilateral sagittal split osteotomy found a statistically significant benefit at both six months and one year after surgery, though no significant difference was seen at the three-month mark.¹³ Several other studies have reported positive results with different formulations, including oral B-complex supplements for 30 days, intravenous B12 for one week after surgery, and even intranasal B12 spray started two weeks before surgery and continued for six months afterward.¹⁴

The honest assessment, though, is that the overall evidence for B vitamins as a treatment for post-surgical nerve numbness is modest. A recent literature review summed it up well: B vitamins are commonly used as supplements for peripheral nerve conditions because they are well-tolerated and accessible, but there is not yet strong evidence of a significant effect on the course of sensory disturbance after jaw surgery.¹⁴ They are unlikely to hurt, and they may help at the margins, but they should not be your primary strategy.

Steroids

Corticosteroids are a logical candidate because they reduce inflammation, and inflammation around the nerve is one of the drivers of post-surgical numbness. The evidence, however, is mixed enough that you shouldn’t count on them as a standalone solution.

One study suggested that steroid treatment has the potential to accelerate sensory recovery and that it appears desirable to start treatment later than one week after surgery, rather than in the immediate post-operative period.¹⁵ However, a randomized controlled trial testing betamethasone specifically found that it did not reduce neurosensory disturbances over time.¹⁶ The discrepancy may come down to timing, dosing, or the specific steroid used, but the bottom line is that steroids are not a reliable fix for numbness on their own. Your surgeon may still use them in the peri-operative period for swelling and pain management, which is a separate benefit.

Electroacupuncture

Some research has explored acupuncture as an adjunct therapy for post-surgical facial numbness. A study comparing electroacupuncture, laser-acupuncture, and a sham control in patients who had combined orthognathic surgery and genioplasty found that electroacupuncture improved the return of tactile sensitivity on the chin and lower lip, as measured by a brushing test. The laser-acupuncture and control groups did not show this benefit.¹⁷ This is a single study with a relatively specific patient population, so the evidence is thin. But if you’re already open to acupuncture and your surgeon doesn’t object, it’s a low-risk option to explore.

When Numbness Does Not Resolve on Its Own

Most numbness after jaw surgery does improve significantly within six months, and most patients will have meaningful recovery by one year. But some percentage of patients are left with long-lasting sensory disturbance. Studies report that persistent numbness occurs in roughly 4 to 12% of patients, depending on the technique used and whether you measure by patient self-report or clinical records.¹⁸ If you are past the six-month mark and still have significant numbness, it’s time for a detailed conversation with your surgeon about whether the nerve may have sustained a more serious injury that warrants further intervention.

For cases where the nerve was severely damaged or partially severed during surgery, microsurgical repair may be considered. This involves a specialist exploring the nerve under magnification and either freeing it from scar tissue, bridging a gap with a nerve graft, or reconnecting severed ends. A study of microsurgical repair after sagittal split osteotomy found that after at least one year of follow-up, about half the repaired nerves showed full recovery and another 35% regained what researchers classified as “useful sensory function.” Roughly 15% showed no sign of recovery.¹⁹ Those numbers reflect cases severe enough to warrant surgery, so they represent the harder end of the spectrum. The timing of microsurgical intervention matters. If the nerve was visibly damaged during the original operation, repair is sometimes performed at the same time; otherwise, most specialists recommend waiting three to six months to see whether the nerve recovers on its own before considering surgical exploration.

Hyperbaric Oxygen Therapy

Hyperbaric oxygen therapy (HBOT) involves breathing pure oxygen in a pressurized chamber, which increases the amount of oxygen dissolved in your blood and, by extension, delivered to recovering tissues. A scoping review of the research on HBOT for peripheral nerve injury found that it was reported as beneficial in the vast majority of included studies, improving nerve regeneration or time to recovery with no major adverse events.²⁰ An animal study on facial nerve regeneration found that HBOT promoted increased average axon diameter in treated subjects, suggesting a more advanced regeneration process.²¹

The catch is that most of the evidence comes from animal models and studies on peripheral nerve injuries generally, not specifically on the inferior alveolar nerve after jaw surgery. HBOT is also expensive, not always covered by insurance, and requires multiple sessions in a specialized facility. It is not part of standard post-orthognathic care, but it may be worth discussing with your medical team if your numbness is persistent and other approaches have not helped.

Living With Numbness Day to Day

While you’re waiting for sensation to return, the numbness itself creates practical problems that nobody warns you about before surgery. Eating is the big one. When your lower lip and chin are numb, food and liquid can dribble out without you noticing. Biting your lip or cheek while chewing is common because the normal feedback that keeps your teeth from closing on soft tissue is absent. Drooling can be embarrassing in social situations.

Some practical adjustments help. Eat slowly and take smaller bites. Use a mirror during meals early on to catch food you cannot feel on your face. Be cautious with very hot food and drinks, because your numb lip will not register temperature until the nerve recovers. If lip-biting is a persistent problem, a soft dental guard worn while eating can reduce the risk of tissue injury. Patients who reported being aware of their altered sensation all the time expressed the greatest distress in daily life, and the most common emotional response was disappointment.²² Knowing that this frustration is normal, and that most people see improvement, can help psychologically even before the nerve fully heals.

Putting Together a Recovery Strategy

There is no single silver bullet for post-surgical numbness. The most evidence-backed approach combines patience with active effort. Sensory retraining exercises have the strongest trial data and are free to do at home. Low-level laser therapy is the next best-supported option if you have access to it. B vitamins are a reasonable, low-risk supplement but should not be your primary strategy. Steroids have an ambiguous track record for this specific problem. Microsurgical repair is reserved for the small percentage of cases with severe, persistent injury.

The timeline matters for setting expectations. At three months you may still have noticeable numbness, especially if you had a sagittal split procedure. By six months most patients report meaningful improvement. By one year, most recovery that is going to happen has happened, and any remaining numbness is likely to be the long-term situation. If you are approaching the one-year mark without significant improvement, pressing your surgeon for advanced assessment or referral to a nerve specialist is appropriate.

Emerging Research in Nerve Regeneration

For patients dealing with long-term numbness who feel they have exhausted the current options, there is at least some interesting work in the pipeline. Researchers have experimented with stem cells modified to produce nerve growth factor to improve inferior alveolar nerve recovery in animal models. In one study, rabbit bone marrow stem cells were engineered to carry a human nerve growth factor gene and transplanted around the nerve at the site of jaw distraction surgery.²³ Processed nerve allografts are also being studied for bridging gaps when a segment of nerve is lost during surgery, with some early clinical data showing encouraging recovery scores over the first year.²⁴ Advanced imaging techniques like diffusion tensor tractography are also being developed to visualize the inferior alveolar nerve in detail inside the jawbone, which could help surgeons plan procedures that minimize nerve injury in the first place and assess damage more precisely when it occurs.²⁵ None of these are available as standard treatments yet, but the direction of travel suggests that options for stubborn cases will expand over the coming years.