Evidence-based Means of Avoiding Lingual Nerve Injury Following Mandibular Third Molar Extractions

The aim of this paper is to alert dentists and maxillofacial surgeons that they must learn the variable anatomy of the lingual nerve in order to avoid damaging it during lower third molar extractions. Severe damage or severance of the lingual nerve can result in permanent numbness, loss of taste and dysthesia of the anterior two-thirds of the tongue on the side of the mandibular third molar extraction, causing a lifetime of distress. The evidence for variation in the anatomical location of the lingual nerve and the technique of proper extraction of lower third molars are discussed with references in the literature. Knowledge of its location can lead the surgeon to prevent injury to the lingual nerve by an appropriate extraction method, or when not possible to avoid the lingual nerve, at the very least to identify and protect it with delicate retraction.