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
Reasons for a fear of feeling numb
There are many different reasons why people have a fear of the numbness associated with local anaesthetic. Some common ones include:
Loss of Control
You may hate the numb feeling because it symbolises a loss of control for you.
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.
Or you may be embarrassed about the potential for slurring words 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 while the effects wear off.
Fear of Suffocating
The numb feeling may make you feel as if your 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.
You may also be worried that the numbness means that you won’t be able to swallow or carry out other motor functions. Here’s a useful fact:
Local anaesthetic at the concentrations used in dentistry doesn’t affect motor nerves in the throat at all. Movement and swallowing are unaffected. The numbing only affects 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 feeling you get 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 then worry that the numb feeling will trigger a panic attack.
Numbness as a Threat
Even if you don’t have a history of any of the above, it’s possible that human beings are 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.
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 during dental procedures, 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 most of the above fears, the key to overcoming them is familiarity. Fear of the Unknown affects most people in some way and when you are already dealing with a 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. Simply preparing for what to expect and – more importantly – what not to expect can help a lot.
What Can I Do About My Fear of Feeling Numb?
Avoid Feeling Numb
When an upper tooth gets numbed, the numbness is usually confined to just that single tooth, the lip and the cheek area. Some people with a fear of feeling numb can cope with this.
A bigger problem can arise 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 tongue go numb as well.
- You could try and find a dentist who uses The Wand STA (Single-Tooth Anaesthesia) or a device called the Quicksleeper 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 PDL injection using The Wand STA.
- An intraosseous injection works in a similar way to the periodontal ligament injection but is delivered differently. Like the periodontal ligament injection it can be done manually (with an X-tip® or the unfortunately named Stabident®) or via a computer-controlled delivery unit called the Quicksleeper.
Another tip: after giving the local, your dental nurse or dental assistant can use the saliva ejector to remove any potential spillages of local anaesthetic. That way, the local won’t sit in the back of your mouth for long enough to numb it.
Is it possible to make the numbing last shorter?
- You could request epinephrine-free local anaesthetic, as this will wear off quicker 1. This is ok for most things, but for tooth removal, the adrenaline containing local is better.
- A drug called OraVerse™ (phentolamine mesylate) makes the numbing last shorter. OraVerse has to be injected like local anaesthetic. 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 (very few dentists do though, because there isn’t enough demand for it, and it’s expensive). If you are in the U.S., you can search for dentists who use OraVerse on the oraverse.com website.
Some of our members 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 anaesthetic 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 in the dental practice) and I was in control (doing it to myself rather than have someone else administer).
Topical anaesthetics such as 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 dentist Mike Gow. 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.
1. 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 afterwards 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 porous (sponge-like) meaning that when the 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.
2. Fear of tongue swelling, throat closing up, and being unable to breathe
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 scary! 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 or throat, or prevent it from closing.
3. What would happen if my throat did close up?
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.
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.
- When you numb teeth in the lower jaw, usually you freeze the nerve which supplies sensation to the half of the jaw where the tooth or teeth are being worked on. This means that your tongue and lip may feel numb on the side of the injection.
- The numbness will only ever be on half the throat and half the tongue – the other side isn’t affected at all. If your dentist suggests numbing both sides during the same appointment, ask to split it up into two appointments. That way, only one half is numb.
- Only nerves which transmit sensation and feeling are frozen. Nerves which allow movement, such as swallowing, are not affected.
- The tongue and throat do not swell at all – even if it may feel 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? Is there anything else he can do?
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 The Wand. To be honest, you sound to me like a great candidate for IV sedation, it would make things much easier for you. – Gordon Laurie, BDS
- 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 anaesthetic 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 breathe and swallow normally. Swallowing especially feels odd as although you can still do it – you can’t feel that you’re doing it.
Ask your 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! The saliva ejector can be used to quickly suction the solution away).
Make sure that your dentist is aware of your fear of your throat going numb. This way, the dental nurse or assistant can use the suction to ensure that you don’t swallow any:
I was explained this past year by my dental assistant that the feeling of the throat being numb is the topical mixing with your saliva and swallowing it… so my assistant makes sure she is right there with the suction when they are dealing with the topical. – from our message board
Visit our support forum to get help with this and other fears, or to simply get things off your chest!
You may also like:
- Terrified of numb throat and not being able to breathe – from our message board
- Fear of Choking
- Bad Reaction to Local Anaesthetic
- Fear of Panic Attacks
Sources of Information
- Common fears and their relationship to dental fear and utilization of the dentist. Fiset L, Milgrom P, Weinstein P, Melnick, S. (1989). Anesth Prog. Nov-Dec;36(6):258-64.