Lingual nerve damage associated with the removal of lower third molars

In a study of 1117 consecutive surgical procedures by a variety of operators to remove a lower third molar, the incidence of lingual nerve damage was determined to be 11%. Slightly more than half the cases made a full recovery within 6 weeks. All who would recover fully did so within 36 weeks. Six cases (0.5%) in the series failed to make a full recovery. Most strongly implicated in the temporary dysaesthesias was the raising and retraction of the lingual mucoperiosteal flap, especially in the case of unerupted teeth, when general anaesthesia was used. A variable incidence was found between individual operators. Cases of permanent damage arose when distal bone was removed with a bur, despite the use of a lingual flap retractor. The high incidence of lingual nerve damage in this series suggests that dental surgeons should be much more alert to the danger of this complication, and also that a warning of its possible occurrence should be given as part of the process of obtaining informed consent to operation.