Loss of movement and clamp injury?

[VeryScart]

Hi - I had a deep cleaning Friday and a filling Saturday; the latter was supposed to be a root canal but the root wasn't involved. Because of this, I was prepped as if for a root canal.

Fast forward to today:
- I can't scrunch one side of my nose or snarl the right side of my lip (think Elvis)
- I have a wicked bloody hole in the gum over the tooth in question

Dentist said I don't have nerve damage because I can move 99.99% of my face, just can't curl my lip. She also said the gouge is from the clamps.

Can someone explain what's happening here? What clamps? And will I be able to snarl my lip again? I need a lot of work and this is making my scared to do anymore.

 

[Judythecat]

Not a dentist, and can’t comment on the nerve issue, but I had a similar “clamp injury” when I did have a root canal. If the dentist used a latex sheet to isolate the tooth (a dental dam) it’s fixed on with clamps, which I assume are made of metal. I had a long appointment (2h) which left me with a bleeding sore gum, where the clamp had cut or irritated it. I got a fright at the bloody taste, and I also think that you feel any sore bit in your mouth is HUGE when it might in reality be quite small. The good news is that it healed up very quickly, and has never bothered me again. (On a similar note, I sneezed really hard on Saturday and in the process bit my tongue so hard it was bleeding, and it’s absolutely fine now!)

I hope someone else can help with your other questions!

 

[Gordon]

The lack of lip movement might be a result of some soft tissue damage during your treatment. It should be improving a bit by now? Try some ice packs/hot compresses to see if you can speed up recovery.

 

[VeryScart]

The lack of lip movement might be a result of some soft tissue damage during your treatment. It should be improving a bit by now? Try some ice packs/hot compresses to see if you can speed up recovery.

She suggested that the issue was one of swelling - but she also said that it may resolve or may not. She did not think it was nerve damage because I don't have parasthesias or any of the sthesias. Do you agree? Can it be nerve damage without any pain, numbness or odd sensations - just an inability to move something?

My partner, an internist, also thought that there was probably a lot of inflammation going on in my face- behind that giant gouge and just in my gingiva overall. She felt like once it went down, I should be able to move more freely. Agree?

 

[Gordon]

Nerve damage would normally give rise to loss of sensation (paraesthesia), so it doesn't seem likely. It's also difficult to see how the dentist would have managed to do such catastrophic damage without you realising!

I tend to agree with your better half, has there been any change since Friday?

 

[VeryScart]

Nerve damage would normally give rise to loss of sensation (paraesthesia), so it doesn't seem likely. It's also difficult to see how the dentist would have managed to do such catastrophic damage without you realising!

I tend to agree with your better half, has there been any change since Friday?

No real changes so far. I just don't understand all of this and how to make it go away other than drinking salt water to heal the ulcer (gouge!). I have two more root canals AND other fillings AND the other half of a deep cleaning to do.

I don't feel able. And it was such a big deal for me to get started on this stuff. Is there no way to anesthetize without needles?

 

[Gordon]

Do NOT drink the salt water, just rinse with it! If you can buy some Difflam (Benzydamine Hydrochloride) mouthwash from the pharmacy, that will help more than the salt water.
I don't think it was the anaesthesia that's caused the problem so it's a moot point. And no there isn't really.

 

[VeryScart]

Alright, I don't want to be one of those people with the same question 14 ways, so I'll try to make this my last post on this matter. I appreciate all your input so far!

1) Basically, the thought is the inflammation is somehow preventing movement. Can you explain the mechanism of that? Because all I find online is nerve damage - which I know is a function of Google's algorithm not necessarily facts.
2) I've been encouraged that, because I do have full sensation, whatever is going on is mild and more likely to resolve than say, a dramatic loss of movement and sensation. Fair way of thinking?
3) Should I be taking NSAIDs or steroids or something?
4) Dear god, how long should I expect this to linger? It really only effects a particular ugly type of face I make, and even then, it just makes it look like I'm sneering. But I'm super self conscious while I'm speaking that I may slip up and make that face

 

[Gordon]

1) Best explanation I can come up with is that the inflammation is causing swelling deep in the tissues blocking impulses from passing down the nerve fibres. Bit like compressing a hose by standing on it!
2) Yes. The nerves in your face are unique in that they carry both sensation and motor impulses, in the rest of your body it's either, not both. The fact that sensations are working would imply that there is no catastrophic nerve damage.
3) Sometimes a steroid injection near the affected site can help.
4) About a week, maybe two. I bet you can do a great Elvis impression now though, silver linings and all that! (Many years ago, I had Bell's Palsy, a sort of paralysis of the muscles on one side of my face) I did a great Elvis and could also raise one eyebrow just like Spock

 

[VeryScart]

Thanks that actually helps a lot! I can't imagine having Bell's - that would set me off bad! Right now, when I make an ugly face it's just slightly uglier lolol

Fingers crossed and I'll keep your words in mind as I try to keep an even keel!

 

[Gordon]

It was more annoying than anything else.
The biggest issue I had is that the Buccinator muscle is paralysed. Now, when you chew, your tongue moves the food from the tongue side outwards towards the cheeks, while Buccinator contracts and moves the food back towards the tongue. However, when Buccinator doesn't work, the food just keeps going and you finish up with a cheek full of food like some kind of mutant hamster

I had to keep stopping chewing every minute or so to shove food back over with my hands. Took me ten times longer to eat than it usually did.