下歯槽神経麻痺の症状は抜歯後の膿が原因で現れることはあるのでしょうか。

親知らずの抜歯から数日後に顎に麻酔を打った後の様な感覚があることに気が付きました。
舌や口の中に麻痺はありません。
その時はすぐ治ると思い放置してそのままにしていました。
その後、抜歯跡が痛むので地元の歯科医に行ったところ膿が出ているということで抗生剤を貰いました。
1週間半程、麻痺のことは忘れていましたが先日まだ麻痺が残っていることに気が付きました。
調べたところ下歯槽神経麻痺(オトガイ神経麻痺)の名前が出てきました。
抜歯跡が鎮痛剤も効かないほどに痛み、前歯の歯茎の下の方まで痛みを感じる為早めに診てもらおうと、抜歯してもらった大学病院ではなく再度地元の歯科に行きました。
抜歯跡の治りが悪く膿も出ている。神経麻痺も膿のせいである可能性が高く、そっちの治療で良くなるから様子見しよう。
とのことでした。・下歯槽神経麻痺の症状は抜歯後の膿が原因で現れることはあるのでしょうか。
・麻痺の症状が酷い時とそうでもない時があるのですがそういうものですか?
・下歯槽神経麻痺の症状で歯茎が痛む事はありますか?
・このまま様子見して大丈夫なのでしょうか?

お忙しい中大変恐縮ですが何卒、ご教示いただけますと幸いです。

こんにちは!三木照久歯科、院長の三木照久です。
ご相談の件ですが…ご丁寧な文面のご相談、ありがとうございます。こうして回答させていただくことでまたお一人、また一つ、誰かのお役に立たせていただけることが何よりの幸せです。忙しさへのお気遣いも大変感激ですが、それも日々誰かに必要としていただいているが故と…頑張るのは、社会への恩返しと心得ます。重ね重ね、お礼を申し上げるのは、私の方です。
さて、麻痺も痛みもあるということですと、さぞかしご不安と思います。少しでもお心楽になるお手伝いができればと思います。
さてご相談の件ですが…抜歯後に麻痺が出ているとなると、道理としてはまず抜歯に至った時点での状態にもよります。そして、抜歯による何らかの影響が考えられます。術後の細菌感染も、要素としてはあり得ます。
大学病院で抜歯の施術を受けられたのなら、その可能性は事前にお聞きになっていらっしゃることとは思います。
まず、抜歯する時点で、周囲の骨への感染の波及が大きかったりすることは、抜歯後のリスクも増大させ得ます。親知らずの形や根の深さ、神経との距離や位置関係、骨の硬さ、根の本数なども抜歯後のリスク要因の大小に影響する因子です。
施術時の影響の一つは、抜歯とは「手術」…人様のお体を健康に戻すために、一時的には怪我をさせていることになる、わけですから…外傷的な要因での麻痺も可能性はあります。
もちろん診てくださっている先生ご指摘のように、(術後感染等の)感染…膿みもその症状の一つです…が、影響を与えることも考えられると思います。
その他にもいくつかの原因が考えられますが…いずれにしても、まずはその原因、外傷なり感染なりを、一つ一つ治していくことが大切だと思われます。それで症状が軽減していくかを診ていくことになります。
膿が出ているということでしたら、先生からうがい薬等も貰われましたか?状態にも依りますが、それも有効な手の一つだと考えられます。その場合は、ヨード系等の強いものは避けた方が良いと思います。
原因が治癒すれば、(あくまで当院の症例ベースでですが)ほとんどの場合、麻痺も徐々に回復します(ただし当院の場合、元々の麻痺発生率も全体平均より遥かに低いです)。いわゆる「日にち薬」です。短いと数日で回復することもありますが、3週間〜1ヶ月ほどかかることもあります。
さらに稀には、数ヶ月〜半年ほど症状が長引くこともあります。徐々によくなってきたものが、ここまででほぼ「よかったですね」となります。
ですが…「ごく稀」に、半年経って(余程でなければ範囲や程度は改善•軽減するとは思いますが)症状が残っている場合は不可逆性…それ以上の回復が難しいケースもあります。
と、教科書的にはそうなのですが、当院の膨大な症例の中には、半年以上経って一部(直径1センチ程度)にまだ麻痺が残っていた方で、数年で完全に回復したという実例もございます。残念ながら、いかなる医療(だけではないですが)にも絶対安全はないですが、逆も同じです。100%回復しないとも言い切れないのです。
麻痺のお話が中心になりましたが、痛みに関しては、それより早く回復することが多いと思われます。これも必ずではないですが、当院のケースにおいては、一ヶ月以上痛みが続いたことは99%以上ないです(2,3ヶ月、「時々ふとした時に」レベルでわずかに痛みや違和感があるということは稀にあります。また、術後の注意を守っていただけなかった方で、しつこい術後感染を起こしたケースは一度だけあります)。
抜歯した部位の骨レベルでの(外傷としての)「治癒」は、実は3〜4ヶ月ほどかかります。さらに言えば「変化」の終了=周りの元々あった骨と同じ成熟した骨になるまでには、1年ほどかかることもあります。
術後、レントゲンなどは再度撮られましたか?苦労して抜歯されたケースだと、骨に何らかの一時的なダメージが出ている確率も0とは言い切れません。あまり長く、強い痛みが続くのなら、確認のため確認してもらってもいいかも知れません。
お気持ち穏やかざるのは本当に分かりますが…どうか不安になり過ぎないで下さい。落ち着いて、しっかりと治療をお受け下さい。まずは、感染を治していくことです。
そして、症状の強い弱いは別として、抜歯後の回復には時間がかかるものだということもご理解いただければ、少しはお気持ち楽ではないでしょうか。痛みも含め、1日単位ではなく数日〜1週間単位で、症状に冷静に向き合ってくださった方がいいと思います。
症状にそのときどきで変化があるなら、神経が完全に麻痺はしていない一つの希望とも考えられます。正座したときの、足の痺れを思い起こしてみてください。あれも、神経の圧迫による一時的な麻痺です。
補足として、回復の一つの補助手段として、ビタミンB製剤も神経の回復を助けると言われています。
考えられる限りの回答をさせていただきましたが…まとまりがなく感じられたら私の文章構成力不足です。どうかお許しください。
最後に…お住まいがどこか存じませんが、通院可能な範囲でしたら、私とその仲間が是非ともお力になりたい。そんな熱い、暑苦しいお節介心で胸がいっぱいです。
では、本当にお大事になさってくださいね。

 

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    References:
    https://blackcoin.co/list-of-casinos-in-brisbane/

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    References:
    https://blackcoin.co/free-100-pokies-no-deposit-sign-up-bonus/

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    References:
    https://blackcoin.co/best-payid-pokies-in-australia-a-comprehensive-guide/

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    References:
    https://blackcoin.co/best-paying-online-casinos-australia-high-rtp-pokies-2025-update/

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    References:
    https://blackcoin.co/new-online-casinos-australia-2025-guide/

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    References:
    https://blackcoin.co/the-best-high-roller-lounges-in-australia/

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