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What is Numb Chin Syndrome (NCS) / Mental Nerve Neuropathy?

Numb Chin Syndrome (NCS), also known as mental nerve neuropathy, is characterised by facial and oral numbness, rarely pain, restricted to the distribution of the mental nerve of the inferior alveolar nerve.

Although NCS is most commonly associated with non-malignant disease states, it may be the presenting symptom of a systemic malignancy and its prompt recognition is essential for proper management. NCS is most commonly seen as a manifestation of local dental disease but it becomes clinically more significant when it is associated with neoplastic processes, particularly with breast cancer and malignant lymphomata, as any malignant metastasis to the head & neck region shows poor prognosis.

Dental causes, especially odont-iatrogenic ones (such as oral surgery), are by far the most common; if not related to those, this complaint is considered a “red flag” symptom of a distant malignant neoplasm.

When confronted with a possible diagnosis of NCS, clinical evaluation should include evaluation for occult malignancy or relapse of any known previous cancer.

Careful medical history is required to alert the clinician to appropriate diagnostic procedures and ensure correct management.

Distribution of Mental Nerve & Numbness associated with the Mental Nerve Neuropathy

The association of NCS with metastatic malignant disease has been called Roger’s sign.

Dentists need to be aware of the relationship between malignancies and paræsthesia or complete loss of sensation in a jaw segment.

In particular, dentists should be aware of NCS and its clinical manifestations, as well as the limitations of using panoramic radiographs to detect the causative malignancy.

Useful Articles & Websites


New Eng J Med 1994. The Numb Chin Syndrome

Respiratory Medicine 1997. Case Reports. Metastatic Large Cell Lung Cancer presenting with Numb Chin Syndrome

Tr J Med Sci 1999. Tooth Pain and Numb Chin as the Initial Presentation of Systemic Malignancy

Hospital Physician 2000. Numb Chin Syndrome – A Subtle Clue to Possible Serious Illness

Arch Iranian Med 2005. “Numb Chin” as the First & Sole Presenting Sign of Multiple Sclerosis

World J Surg Oncol 2006. Numb Chin Syndrome – A Reflection of Systemic Malignancy

Headache 2008. Numb Chin Syndrome

British Dental Journal 2010. Numb Chin Syndrome – A Case Series & Discussion

British Dental Journal 2010. Numb Chin Syndrome – An Ominous Clinical Sign

Dent Update 2010. Numb Chin Syndrome – A Metastatic Deposit in the Mandible

Ind J Dent Res 2010. Numb Chin Syndrome. A Case Report & Review of the Literature

Annali di Stomatologia 2013. Numb Chin Syndrome

Int J Surg Case Reports 2013. Unusual presentation of ‘Numb Chin Syndrome’ as the Manifestation of Metastatic Adenocarcinoma of the Lung

Int J Contemp Med Res 2016. Numb Chin Syndrome – A Dentist Perspective

Frontiers in Neurol 2017. Numb Chin Syndrome leading to a Diagnosis of Salivary Ductal Adenocarcinoma – A Case Report & Review of the Literature

Dental Update 2017. Case Report – Metastatic Infratemporal Soft Tissue Myeloma Presenting as a Numb Lower Lip

J Ind Acad Oral Med Radiol 2017. Numb Chin Syndrome as a Primary Presentation of Metastatic Breast Cancer

J Thoracic Oncol 2017. Numb Chin Syndrome – An Ominous Sign of Lung Cancer

Oxford Medical Case Reports 2018. Case Report. Two Cases of Numb Chin Syndrome diagnosed as Malignant Disease

Proceedings of UCLA Health 2019. Numb Chin Syndrome – A Benign Diagnosis?