Nerve block caused partial facial numbness during routine filling replacement

[AW]

I went to my new dentist today to have a filling replaced and I am totally freaked out. She told me she was numbing the area, and although the needle hurt more than it has when I have had cavities filled before, I still assumed it was ok. I then lost sensation in my cheek, and it moved up to my right eye and and forehead. It felt like I was touching someone else's face...I had no feeling on the right side. I told her it was making me nervous, and asked if this was normal. She looked at me oddly, asked if I was feeling any heart palpitations, and then reassured me that it would wear off. After she was finished, I told her I have never experienced this before, and she said I've probably only had local, and that this was a "nerve block". She also mentioned the trigeminal nerve, and said obviously I am very sensitive and she would make a note not to use a nerve block on me again. How common is it for this to happen??

[drhirst]

Hi AW,

What happened you is a well known but unusual complication of a lower nerve block.
What happened was the needle missed its target and went a little too deep. The resulted in the local anaesthetic entering the parotid salivary gland. There is a branch of the trigeminal nerve which passes through the parotid gland and this was numbed resulting in the extensive numbing of your face.
This can be alarming but will pass off as the anaesthetic wears off.
There is no reason to avoid nerve blocks in the future as long as the dentist is aware this has happened to you, they just need to careful not to go in too deep.

I have caused this complication three times in 23 years on my patients!

Hope this helps

Lincoln

[brit]

she said I've probably only had local, and that this was a "nerve block". She also mentioned the trigeminal nerve, and said obviously I am very sensitive and she would make a note not to use a nerve block on me again.

I find her explanation extremely inaccurate and face-saving on her part. Sorry this happened to you. As Lincoln said it is not something a dentist should regard as a normal occurence. No need to be blase about it. I have had a similar thing (eye anaethetised in error and blurred vision) and I agree it is very scary. It is the main reason I first posted on this forum actually.

Feel free to change your dentist if this has shaken your confidence.

[AW]

The simple explanation of what happened would have easied my mind immediately! I am a registered nurse, so I understand things don't always go according to plan. My dentist did call last night to check on me to make sure I was OK. She is young, has been in practice for 3 years, so I have a feeling it was a learning experience for both of us! Thanks you both for you responses!!

[comfortdentist]

They are right. A dentist might give a thousand of these blocks a year so to have 1 go into the wrong space over some years is not unusual. Every person's anatomy is different and the land marks for these blocks are not always clear.
When I was in the Dominican Republic with a group of M.D.s an emergency medicine doc ask me to help him get better at giving facial blocks for pain control. He was missing an excessive number.