An Inferior Alveolar Nerve (IAN) injury occurs when the mandibular branch of the trigeminal nerve—responsible for sensation in the lower lip, chin, and teeth—receives damage during a dental procedure. The nerve travels through the mandibular canal within the jawbone, providing sensation to the lower molars and premolars. If you sustain an injury to the IAN during a procedure, let our attorneys at Dental & Podiatry Malpractice Lawyers of New York tell you what you need to know. Call today for an appointment.
How Might IAN Damage Feel Day to Day?
IAN damage can feel like numbness (anesthesia), tingling (paresthesia), or painful abnormal sensations (dysesthesia), which can affect your everyday functions such as speaking and eating.
Patients often describe a “pins and needles” or burning sensation in the lower lip or chin. Simple tasks—like sipping hot coffee or biting into a sandwich—trigger their discomfort or completely numb the area of the injury. In severe cases, the victims of IAN damage may experience drooling or difficulty controlling saliva.
As a result, many patients withdraw socially from activities like eating in public or speaking at work due to their altered speech patterns and reduced confidence in their appearance.
Who Is Most at Risk for IAN Injury?
Research indicates that older women face the highest risk of IAN injury during dental procedures, with women accounting for over 60% of reported cases, and a median age of 63 years among affected patients. Several factors cause this increased susceptibility to IAN injuries:
- Smaller mandible size
- Changes in bone metabolism due to hormonal fluctuations
- Development of osteoporosis
- Lower bone density
These physiological differences can lead medical professionals to misjudge the nerve’s location and increase the risk of damage during procedures.
What Typically Causes IAN Injuries During Dental Work?
IAN injuries most commonly arise from mandibular third molar (wisdom tooth) extractions, with reported injury rates of up to 1.6% for persistent dysfunction.
Jaw surgery carries the highest risk, with injury rates ranging from 20% to 98% temporarily, and persistent dysfunction in up to 82% of cases. Additionally, mechanical compression, thermal damage from overheating during drilling, or chemical neurotoxicity from local anesthetic can all contribute to nerve impairment, with bleeding during bone preparation occurring in 50% of IAN injury cases.
What Anatomical Factors Increase Injury Risk?
The inferior alveolar nerve’s proximity to the most common surgical sites makes it vulnerable to damage and injuries: The nerve’s pathway through the mandibular canal places it at risk when dental procedures involve bone removal, drilling, or root elevation near the canal walls. Variations in canal anatomy, including unusual positioning, can also increase vulnerability during routine procedures.
Why Does Early Detection Matter?
Scar tissue starts forming around the nerve approximately two weeks post-injury, which reduces the potential for recovery. The earlier you detect any weird feeling in your mouth and seek a medical evaluation, the better. Any delayed diagnosis can impact your healing outcomes once inflammatory responses and scarring have established around the damaged nerve tissue.
How Are IAN Injuries Evaluated?
Clinicians use both subjective patient reports and objective testing to assess nerve function, including the following tools:
- Mechanoreceptive tests to evaluate static light touch, brush directional discrimination, and two-point discrimination to assess A-beta fibers
- Nociceptive tests to examine pinprick and thermal discrimination for A-delta and C fibers
- Grading systems to categorize deficits into three levels: mild (only two-point discrimination impaired), moderate (multiple sensory modalities affected), and severe (all sensory modalities compromised), which help guide their treatment decisions and prognosis
Used in tandem, these systems can help surgeons accurately assess the location and extent of any injury to the IAN.
What Treatment Options Are Available?
Most mild IAN injuries improve with observation and rest, along with avoiding any activity that requires excessive jaw movement.
High-dose corticosteroids administered within 10 days of the initial injury can reduce the initial pain. Vitamin B12 supports the nerve’s self-repair and regeneration, and when taken early on, patients have shown significant improvement in six months and one year post-injury. Additionally, some emerging therapeutic interventions include low-level laser therapy, nerve stimulation, and botulinum toxin A for managing pain.
When Might Surgery Be Necessary?
If your symptoms persist beyond three months or worsen significantly, you may want to consider a surgical option, which includes the following:
- Nerve decompression
- Direct repair
- Grafting procedures
Up to 50% of patients have reported significant improvement after surgery, with up to 86% recovery rates documented in peripheral nerve injury cases.
What Role Does Prevention Play in Dental Practice?
Modern preventive strategies focus on comprehensive pre-operative planning and risk assessment. Advanced imaging techniques, such as cone beam CT scans, help identify the precise location of the injury and assess the patient’s bone density before any surgery.
For high-risk extractions, your surgeon may perform a coronectomy—removing only the crown while leaving roots in place—to reduce IAN injury risk.
How Can I Pursue a Malpractice Claim for IAN Injury?
If you suffer an IAN injury during a dental procedure, you may have legal grounds to sue for dental malpractice—but you will need to prove that your provider owed you a duty of care, breached that duty through negligent treatment, and directly caused your injury. You will also need to demonstrate that you suffered measurable losses, which can include medical expenses, lost wages, and pain and suffering.
These sorts of legal claims often require detailed procedure records, pre-operative imaging studies, post-operative assessments, and expert testimony from dental specialists to corroborate your side of the case.
Seeking Justice with the Inferior Alveolar Nerve Injury Attorneys at Dental & Podiatry Malpractice Lawyers of New York
If you need to file a dental malpractice claim after an Inferior Alveolar Nerve injury, trust the Dental & Podiatry Malpractice Lawyers of New York to handle your case with professionalism and compassion. We bring over 40 years of combined experience to nerve injury cases, having recovered millions for victims of medical and dental malpractice.
Our New York City office serves Manhattan, the Bronx, Queens, Brooklyn, Nassau, Suffolk, and Westchester. For a free consultation about your IAN injury case, call 212.730.0200 or fill out our online contact form today.