“I am terrified of having any work done at the dentist’s which involves my mouth being numbed. When my mouth is numb I feel like I am choking.”
“I’m almost as afraid of the numb sensation as of the needle itself.”
On this page, you will find:
- some of the reasons why people fear feeling numb
- tips for dealing with these fears
- detailed explanations of what actually happens when you’re numb
- what to do if you are worried about accidentally swallowing topical or local anaesthetic
There are many different reasons why people may have a fear of the numbness associated with local anaesthetic. Some common ones include:
Loss of Control
Some people hate the numb feeling because it symbolises a loss of control for them.
To not know what a part of your body is “doing” can be scary and warnings from dentists (although very important) about the potential to bite, burn or otherwise injure your mouth whilst numb can add to the perceived loss of control over this part of your body.
Some people are simply embarrassed about the potential for slurring words and/or dribbling from the mouth whilst numb and don’t want others to see this inability to control these functions – in this case it may be sensible to schedule appointments on a non-work day or at another time when you know you won’t have to face anybody immediately afterwards whilst the effects wear off.
Fear of Suffocating
The numb feeling makes some people feel as if their throat is swelling “shut”. You may be afraid that you will no longer be able to breathe, or that you will choke or suffocate.
For example, you may have a history of asthma, throat problems, or a near-drowning incident, and associate the feeling of tingling and numbness with not being able to breathe.
Many people are also worried that the numbness means that they won’t be able to swallow or carry out other motor functions. There is one thing you need to understand:
Local anaesthetic at the concentrations used in dentistry doesn’t effect motor nerves at all. Movement and swallowing are unaffected.
It’s thought to be something to do with the fibre diameter of the motor nerves but nobody is absolutely certain. The numbing only affects the sensation (the sensory nerves).
If you are afraid of having panic attacks, you may be terrified of the numb sensation because it is similar to the feelings you experience when you panic. Numbness or tingling sensations and a feeling of choking are common symptoms of panic, and experiencing these symptoms may remind you of what you feel during a panic attack. And of course, you may be afraid that the numb feeling may trigger a panic attack.
Numbness as a Threat
Even if you don’t have a history of any of the above, it could be speculated that human beings may be genetically predisposed to interpret numbness as a threat. For example, numbness is a common symptom of poisoning. So if your body were to interpret the numbness as an effect of having been poisoned (even though your rational mind is perfectly aware that’s not the case), this could produce a panic reaction in response to the threat your body perceives. Being aware that the feelings of panic originate in very “primitive”, life-preserving parts of your brain may help some people override the feelings of fear and panic they experience with the more “rational” parts of their brain.
Also, the word “numb” is often used in a negative way. When people receive bad or devastating news they are said to feel “numb” so the phrase “nice and numb” does not sit easy on a subconscious level with some people. So even though this phrase can be a great comfort to people who are afraid of feeling pain at the dentist’s, it can sometimes backfire, because a person who has one or more of the above fears may be unable to interpret numbness as a positive feeling.
For the majority (if not all) of the above fears, the key to overcoming these is familiarity. Fear of the Unknown affects most people in some way and when you are already dealing with a specific phobia (in this case dentistry) and are then faced with a new or different aspect of this (e.g. an unfamiliar treatment) the anxiety can be intensified. Feeling numb is already an unnatural and unfamiliar sensation to the human body so it is actually quite reasonable to feel afraid of numbness in this situation.
By working with a friendly dentist and gaining positive experiences of dental treatment, the numbing sensation will hopefully begin to feel less threatening and more familiar and comfortable. Of course, we don’t suggest that you volunteer for lots of treatment and injections to achieve this level of comfort. It is also achievable simply by being prepared for what to expect and – more importantly – what not to expect.
What Can I Do About My Fear of Feeling Numb?
Avoiding Feeling Numb
When an upper tooth gets numbed, the numbness is usually confined to just that single tooth and the cheek area. Many people with a fear of feeling numb can cope with this. A bigger problem arises when it’s a lower tooth, because usually, a block injection is used. The block injection numbs the whole lower side, right up to the midline of the mouth, and makes the lip go numb as well.
- You could try and find a dentist who uses the STA Wand and who can give single tooth anaesthesia for lower teeth. It may be possible to use this instead of the block injection, which numbs the whole side.
- A manual PDL (periodontal ligament) injection can also numb a single lower tooth, but it’s harder to achieve a painless injection that way compared to the STA wand.
Is it possible to make the numbing last shorter?
- You could request adrenaline (epi) free local anaesthetic, as this will wear off quicker. This is ok for most things, but if a tooth is to be removed, the adrenaline containing local is better.
- There is a drug called OraVerse™ (phentolamine mesylate) which makes the numbing last shorter because the local anaesthetic is carried away more quickly. OraVerse has to be injected like local anaesthetic… probably why it has not taken off! It more than halves the time it takes for the numb sensation to disappear. If you don’t mind extra injections, you could ask your dentist if they have it in stock. If you are in the U.S., you can search for dentists who use OraVerse on the OraVerse website.
Some of our readers have suggested desensitisation as a way of getting used to the numb sensation. You should only try this if you feel safe doing so:
“So, I have tried using orajel. I put it along the lower left gumline and bottom lip. First things first. It tastes foul. Foul beyond belief. But, I managed not to just rinse it all off immediately and it did make me numb. Not deeply numb like a proper anesthetic but numb enough to start drooling out the corner of my mouth and make my tongue feel like it was swelling. It only lasted 10-15 minutes max but was quite useful to “get to know the feeling”. The most important thing for me was that I was doing this in a “safe” environment (at home rather than dental office) and I was in control (doing it to myself rather than have someone else adminster).”
Topical anaesthetics like orajel come in both regular strength (10% benzocaine) and maximum strength (20% benzocaine), so if you’d like to try this method of desensitisation, you could try the lower strength first. Always read the label, do not use more than directed, and do not use if you have a known allergy to topical “caine” anaesthetics.
Below are some commonly asked questions about the fear of feeling numb, and the answers given by dentists on our message board and by e-mail. Some of the explanations are quite scientific in nature, but the aim is to de-mystify the feeling of numbness. By being aware of what your mouth is doing and why, you can regain control and understand that you are in no danger from the situation.
Fear of suffocating, choking, and not being able to swallow after lower jaw numbing
❓ “I’m not afraid of the needle, it’s the numbing sensation that comes afterward that gives me the creeps. I suffer from panic attacks and get really nervous when I see the doctor preparing the syringe. I never had that injection that numbs your teeth on the lower side of your jaw and it terrifies me. Can somebody calm me down about it? I heard stories from friends telling me you won’t feel your tongue and part of your throat and it makes me sleepless. I’m always afraid I might choke, or suffocate, or I don’t know what. Is it really true that a large part of your mouth loses sensitivity? Will I be able to swallow? Is it really that different from upper teeth numbing shot?”
❗ “Hi, I have a few patients who describe the same problem. They are not afraid of having the injection, they just hate the way it feels. If you are that worried about it to the extent that it gives you panic attacks, no wonder you feel so terrible! But you can feel better about this.
To give you a bit more information about it: The upper jaw is more poreous (sponge like) meaning that when anaesthetic is injected next to a tooth, it can get through to the root, making the tooth go numb. The lower jaw is denser and an injection next to the tooth is often not enough on its own to make that tooth numb enough for dental procedures. Therefore the main nerve which supplies sensation to that half of the jaw is frozen to make sure that the procedure is as painless as possible. Sure – your tongue may feel numb on the side of the injection, and your lip too. This is because the Inferior Dental Nerve and Lingual Nerve become frozen. However all that is frozen are nerves which transmit sensation and feeling. Nerves which allow movement e.g. swallowing, are not affected. You WILL be able to swallow, and you will NOT choke or suffocate. It is not really that different a feeling to the upper teeth being numb – just in a different place.
Most people say that the feeling of numbness for an hour or two is unpleasant. However, as you conquer your fear and your negative feelings you will be pleasantly surprised after your lower jaw injection and you will wear that numb feeling like a medal, feeling proud and happy with yourself for your achievement and success.”
❓ “I went to the dentist the other week to have some fillings. I was surprised at how easily I coped with the injections. But then, my tongue became numb and soon I began to feel like I may not be able to swallow and that my throat may close up. I had my very first anxiety attack and it was soooo scarey! Now, I will have to go back because I left with a numb mouth before any work could get done. I’m terrified of going back, because I fear that my tongue will swell, causing my throat to close up, leaving me unable to breathe. Any advice??”
❗ “It’s normal that half the tongue may go numb when a nerve block in the lower jaw is given (either on the left or on the right side, depending on which side the nerve block is given). If you’re not used to the sensation, it may feel “swollen” (just like when you sit or lie in a position where the blood supply to an arm or leg gets cut off and you get the numb feeling, the arm or leg may also feel swollen). It’s very easy to mistake the numbness for swelling. You WILL be able to breathe.”
❓ “Does this mean that my throat cannot close up at all due to my tongue being numb?”
❗ “No, your throat can’t close up – all normal function of the muscles of the throat remain. Very occasionally the throat just feels really numb. You will still be able to swallow, breathe, and all appropriate gag responses to foreign objects will remain to prevent you choking. Remember that even if the throat does feel numb, the numbness will only ever be on half the throat and half the tongue anyway, the other side isn’t affected at all as the injection only works on the side it is given. Having a local anaesthetic will not close the airway/throat, or prevent it from closing. Also – the tongue does not swell at all when numb – just FEELS that way!! The only thing that could make it swell would be anaphylaxis (a severe allergic reaction) and that is VERY VERY VERY rare. Again we have emergency drugs to use in the rare event that that may happen. So the tongue swelling isn’t an issue with a block injection, it won’t happen.”
❓ “If my throat did close up, would the dentist know what to do or have something that would open it back up?”
❗ “We do have emergency equipment which can get the airway open, but this is for real emergencies like if someone has a heart attack or something (nb heart attacks happen at the dentist the same as they can happen anywhere, a trip to the dentist doesn’t cause it!!!). So yes, we can open the throat/airway if need be, but I have never had to do it.”
- When numbing teeth in the lower jaw, usually the nerve which supplies sensation to the half of the jaw where the tooth or teeth are being worked on is frozen. This means that your tongue and lip may feel numb on the side of the injection.
- All that is frozen are nerves which transmit sensation and feeling. Nerves which allow movement, such as swallowing, are not affected.
- The numbness will only ever be on half the throat and half the tongue – the other side isn’t affected at all as the injection only works on the side it is given. If your dentist suggests numbing both sides during the same appointment, you can ask to split it up into two appointments where only one half is numbed (if you feel this would help you).
- The tongue does not swell at all when numb – it only feels that way.
- For upper teeth, only the individual tooth is numbed.
Is it possible to numb a single tooth at a time in the lower jaw?
❓ “My dentist has also told me he is numbing the entire lower jaw next week. I asked if this will make my tongue and throat numb and he has said yes. I am so panicked already that I am literally sleepless and nauseous and shaking… Can he just numb a single tooth at a time or what else could be done???”
❗ “Rarely, after a standard lower ‘block’ injection, your throat may feel numb. It can be possible to just numb the individual tooth in the lower arch. The dentist needs to use either a system called X-tip, or a system called Stabident (I know such a bad name!) or an intraligamental anaesthetic device like a peripress or Wand. To be honest, you sound to me like a great candidate for IV sedation, it would make things much easier for you.”
- It may be possible to numb a single tooth in the lower jaw, to avoid lip or tongue numbness.
- Some dentists use this technique with great success. But it is one of those things that most dentists can’t do reliably.
- There are three main types of lower jaw injections that can achieve single tooth numbness. These are:
- Periodontal Ligament Injection/PDL
- Intraseptal Injection
- Intraosseous Injection
- They all have the advantage that they don’t make the lip or tongue go numb, but they each have disadvantages as well (for example, they may not last long enough, the injection may not be as comfortable, or they may not be appropriate for certain procedures or for numbing certain teeth). The dentist needs to have experience with them and some techniques require special equipment.
- Ask your dentist if they think they can numb just the tooth, and what the advantages and disadvantages would be. Some dentists use these techniques very successfully, so you may be in luck.
Fear of swallowing topical or local anaesthetic
❓ “I’ve suffered with asthma and other throat problems all of my life and I associate the feeling of tingling and numbness with not being able to breathe. I had local anesthetic last week, and as soon as the topical dripped and went down into my throat, I panicked. I jumped from the chair and was convinced my throat was swelling. After a few minutes I was able to calm down because it started to wear off. Why did this happen and could this have been avoided?”
❗ “Sometimes the topical gel, or fluid from the cartridge (a drop or two of the solution can come out as the dentist is preparing to give the injection) – when swallowed can make the throat feel numb. It does also rarely happen sometimes after a standard lower ‘block’ injection. It is important to remember that when this happens – it is a sensory problem only. This means that although you may hate the feeling, and as much as it has ‘freaked you out’ in the past – you CAN breath and swallow normally. Swallowing especially feels odd as although you can still do it – you can’t feel that you’re doing it.
Ask the dentist to use a minimal amount or no topical anaesthetic and ensure that they do not ‘dribble’ any solution into your mouth (you will know if this happens as it tastes horrible!).”