Renton T, McGurk M . Valuation of factors predictive of lingual nerve injury in third molar surgery. Br J Oral Maxillofac Surg 2001; 39: 423–428. Evaluating the presence of IAN injury in patients with juxta-apical radiolucency after third molar surgery: a retrospective cohort study

However, the larger the changes that need to be made, the more time it takes. Longer treatment means more office visits, more aligners, and any additional costs related to imaging and attachments. As a result, more complex cases usually mean a bigger price tag. 2. Doctor Expertise Complaints to the General Dental Council are predominantly related to implants and often involve IAN injury. Neuropathic pain can be very debilitating and when compounded by poor management may result in subsequent litigation. Litigation is often based on inadequate consent procedure, inadequate planning and assessment, causation of avoidable nerve injury and poor management of the patient once the nerve injury has occurred.Hillerup S, Jensen R H, Ersbøll B K . Trigeminal nerve injury associated with injection of local anesthetics: needle lesion or neurotoxicity? J Am Dent Assoc 2011; 142: 531–539.

Thus prevention of LA nerve injuries is possible and some simple steps may minimise LA related nerve injuries: To reach Diamond II, a doctor needs to accumulate 20,000 points within a given timeframe. This means that any provider who has reached this tier has significant experience with the system and has likely treated fairly complex cases. Identification of 'high risk teeth' by recognising radiographic risk factors for IAN injury such as:Renton T, Yilmaz Z . Managing iatrogenic trigeminal nerve injury: a case series and review of the literature. Int J Oral Maxillofac Surg. 2012 May; 41: 629–637. Robinson P P, Loescher A R, Smith K G . The effect of surgical technique on lingual nerve damage during lower 3rd molar removal by dental students. Eur J Dent Educ 1999; 3: 52–55. In the US, liability claims and malpractice suits are inherent risks associated with iatrogenic nerve injury and the reasons for avoiding such injuries are obvious. Iatrogenic nerve lesions may produce symptoms ranging from a minimal irritation to a devastating effect on of quality of life. Few studies, however, describe the range of neurosensory disturbance in terms of signs and symptoms related to impaired nerve conduction and neurogenic affliction and there is a need for better standardisation and documentation of sensory deficits resulting from nerve injuries and their recovery. 24 Due to the incidence of nerve injuries in relation to dental anaesthesia, warning of patients is not considered routine and indeed in the UK these iatrogenic injuries are not considered negligent. In some cases, private dental policies will cover certain cosmetic treatments, especially if the policy provider feels that they will prevent actual health problems from developing later on. So, if you have a private policy in addition to National Insurance, be sure to verify if coverage will apply from either provider. How Does the Cost Compare to Other Clear Aligners? Note: It is recommended that you wash the InvisiLift™ after each use. Wash it in warm water and allow it to air dry. Once dry, the self-adhesive properties will be restored.

Smith M H, Lung K E . Nerve injuries after dental injection: a review of the literature. J Can Dent Assoc 2006; 72: 559–564.The incidence of lingual nerve injury related to third molar surgery, one day after surgery (excluding the use of lingual flap elevation) varies from 0.4% to 1.5%. 10 The incidence of persistent involvement (still present at six months) varies from 0.5% (with the use of a lingual flap) to a low of 0.0%. 14 The author uses a minimal access buccal approach (see Chapter 4 of the associated BDJ Clinical Guide) for M3Ms as lingual flap access surgery is associated with increased temporary lingual nerve injury (LNI). Causes of lingual nerve injury include dental local anaesthetic injections, intubation, ablative surgery and submandibular gland surgery. The most common cause of LNIs is third molar surgery, with a reported incidence of 1-20% temporary and 0-2% permanent. 9 Persistence of any peripheral sensory nerve injury depends on the severity of the injury, increased age of the patient, the time elapsed since the injury and the proximity of the injury to the cell body (the more proximal lesions having a poorer prognosis).