Trigeminal nerve injury is the most problematic consequence of dental surgical procedures with major medico-legal implications. The incidence of lingual nerve injury has remained static in the UK over the last 30 years, however the incidence of inferior alveolar nerve injury has increased; the latter being due to implant surgery and endodontic therapy.

Iatrogenic injuries to the third division of the trigeminal nerve remain a common and complex clinical problem. Altered sensation and pain in the orofacial region may interfere with speaking, eating, kissing, shaving, applying make up, tooth brushing and drinking, in fact just about every social interaction we take for granted. Thus these injuries have a significant negative effect on the patient’s quality of life and the iatrogenesis of these injuries lead to significant psychological effects.

With regard lingual nerve injuries related to third molar surgery most patients recover normal sensation without treatment but those with inferior alveolar nerve injury often have permanent deficits with severe disability, as indicated by the high proportion of lawsuits in such cases. Worldwide, surgical removal of mandibular third molars is the commonest oral surgical procedure.

We present case series of 120 patients with third molar related trigeminal nerve injuries and review or the literature will shed some light on the systematic approach may be considered to prevent or minimize the damage to the inferior dental nerve during such surgeries.