This case involves a college-aged male patient who had 2 impacted wisdom teeth that required removal. He underwent a prophylactic removal of his right molar, which was impacted but asymptomatic. After the surgery, the patient began experiencing numbness in his tongue. The patient reported this to his treating physician and was reassured that this post-operative symptom was temporary. No followup was made. He ultimately saw a specialist 6 months after his surgery and was diagnosed with traumatic neuropathy of the lingual nerve. The patient suffered a total loss of taste sensation on his tongue.
Question(s) For Expert Witness
- 1. Are you experienced in treating patients who require the removal of their wisdom teeth? Please explain.
- 2. Have you ever had a patient develop lingual neuropathy subsequent to a wisdom tooth removal you performed?
- 3. What screening techniques would you have used to avoid injuring the lingual nerve?
- 4. What is the appropriate time frame to refer a patient to a specialist when surgical complications are apparent?
Expert Witness Response E-001522
I have crafted my specialty in oral surgery over a 40+ year career, and in the course of that time, I have lectured at various medical schools. I am experienced in treating patients who require the removal of their wisdom teeth and am very familiar with the process of evaluating patients for the suitability of the procedure. Neuropathy of the lingual nerve is a rare but not an unusual complication of wisdom tooth removal, and it can occur within the reasonable standards of care. In my long career, at least one of my patients has developed neuropathy, though the condition typically does resolve with time. To determine if there was any wrongdoing on the part of the surgeon, I’d have to look at two factors. Firstly, I would like to review the patient’s records and determine if removal of the wisdom teeth was necessary and if there may be an informed consent issue. Secondly, I will need to see if there were any insults to the patient’s jaw bone. Cutting too deep and causing abrasions on the jaw bone would indicate a breach of the standard of care that would have increased the risk of lingual neuropathy.