Depression and Trigeminal Nerve Impairment

Third molar surgery is not an uncommon procedure. Many people undergo this dental procedure without suffering any complications. But for others, the lingual and inferior alveolar nerves can become injured, causing permanent sensory deficits to a person’s lower lip and tongue. There are theories suggesting that this type of injury, referred to as trigeminal nerve deficit, can lead to psychological problems and in particular, distress or depression. However, there is little evidence to support this theory.

In an effort to determine if trigeminal nerve deficit can lead to depression, and if so, how often does this occur, Yiu Yan Leung of the Oral and Maxillofacial Surgery Department at the University of Hong Kong recently conducted a study to using the Satisfaction with Life Scale (SWLS). The SWLS has been shown to accurately assess a person’s subjective life satisfaction. This tool is easy to administer and can help clinicians evaluate whether someone is at risk for mood issues or depression as a result of overall dissatisfaction with life.

Yan administered the SWLS to 49 participants, 24 of whom had received third molar surgery and experienced trigeminal nerve deficits. The SWLS results showed that those with deficits had significantly less satisfaction with life than those without. Further, the older participants with deficits had the highest levels of depressive symptoms.

Yan believes these results are clinically important for several reasons. First, the SWLS is an effective tool that can be easily administered to patients. It has been shown to be able to accurately assess global well-being and overall psychological health and satisfaction as opposed to only identifying temporary mental states. Second, “Older age of an individual with permanent trigeminal neurosensory deficit after lower third molar surgery appears to be related to the development of more depressive symptoms,” said Yan.

This finding suggests that perhaps third molar surgery should be considered at the earliest age possible. Finally, the scores of the at-risk individuals were equal to those reported in other studies by individuals with major traumas, such as spinal cord injuries or chronic pain. This fact underscores the importance of identifying those who experience depression as a result of this type of procedure because according to these results, their symptoms are significant.

Leung, Y.Y., Lee, T.C.P., Ho, S.M.Y., Cheung, L.K. (2013). Trigeminal neurosensory deficit and patient reported outcome measures: The effect on life satisfaction and depression symptoms. PLoS ONE 8(8): e72891. doi:10.1371/journal.pone.0072891

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  • Nina S

    Nina S

    September 21st, 2013 at 9:52 AM

    I have worked for an oral surgeon for years and have never once heard this theory brought up! Yes, there is a slight chance of some nerve damage or the chance that there could be some residual numbness in the weeks and months after surgery, but nine times out of ten the feeling comes back and there are no lingering maleffects from the surgery. Our surgeons do encourage people to have the third molars removed at an early age, typically as a teenager, usually because this is when overcrowding would occur and for many there would be pain or messing up of orthodontic work if you waited for the teeth to erupt, not to mention the fact that adults who have to have the surgery generally have a far worse recovery time than do younger patients.

  • Deeni


    September 22nd, 2013 at 5:28 AM

    It’s a good idea to be prepared for anything, you know? I mean, just because a surgery is common doesn’t mean that it will be without risks necessarily.
    As long as the doctors let you know in advance what the risks are and then you can choose whether or not you will consemt to having the surgery done

  • brad e

    brad e

    September 23rd, 2013 at 3:43 AM

    No one thinks about how surgeries can impact someone who could be prone to depression, even a surgery that seems so remotely unrelated to anything that should trigger a depressive episode. But if the proof is there and you think that you or your child could be someone who could easily become depressed or have synptoms that would indicate that, then I think that I would think pretty seriously before signing on for a surgery that in many cases seems more like a rite of passage than something that is absolutely necessary.

  • Brandon


    September 23rd, 2013 at 10:40 AM

    This on the surface sort of sounds absurd until you start reading about people who come out of surgery with a totally different accent and stuff like that and so then you start thinking that this is a real possibility.

    I know that it won’t happen to everyone but it is not so crazy that it can be totally ruled out. Crazier stuff has happened, and with anesthesia and cutting and surgery you just never know.

  • jade


    September 24th, 2013 at 3:56 AM

    Maybe we should put in bold type that there is actually very little evidence to back up this theory?

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