I recently had a new patient in her early 50’s with unusual complaints.  One of her symptoms was facial numbness on her upper lip under her nose. She also had some areas of pus which would swell and expel pus or she could just pop the pus pocket. Far from an ideal situation.


An x-ray examination revealed three root canals on her front teeth, (two central incisors and her left lateral incisor). These had been performed when she was a young teenager after a bicycle accident. Crowns were placed in her late teens, and these were subsequently redone 15-20 years later. The endodontic therapy (root canals) looked perfect and were in fact performed by a well known lecturer in endodontics.


Even with a perfect root canal, over time there can be a weakening of the tooth structure of the root itself and this can lead to chronic infection, especially when there are small fractures on the root.  It was this type of chronic infection that lead to the numbness in her face.


Her final treatment will consist of extracting the existing teeth allowing the surrounding bone to heal, then placing bone grafting material in the sockets to get a solid foundation to place dental implants. She will have 2 implants placed which will be restored with a 3-unit bridge (the missing tooth will not have its own implant).


There are a host of causes for facial numbness. A thorough medical/dental history with appropriate x-rays and CT scans is very helpful. Also, there could be something as extreme as a brain tumor which can also cause the numbness, and this may need to be investigated by a neurologist. There is much data at http://www.md-health.com/Numbness-In-Face.html which can provide more info on what can be found to cause this condition.