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Abcess=Root canal=not able to freeze

G

Guest

Former Member
Hi everyone. Well I am so terrified of dentist. Recently I went with severe pain in my jaw. They found out that I had a abcess and I needed a root canal. They started me on antibiotics and immediately that day drilled a root canal to relieve the pressure. Easy enough said but I would not freeze after 5 or 6 needles I was still able to feel every thing. The pain was incredible.This dentist still worked on me even though he knew I was is such pain. My question is Do I leave my dentist and go to another who will not subject me to another horrible visit?This is what prevents me on going to begin with. The fear is so real and my anxiety level is so high everytime I go. Thanks
 
Hi there! I'll try and answer as best as I can... there are really 2 components to this:

(1) "They started me on antibiotics and immediately that day drilled a root canal to relieve the pressure. Easy enough said but I would not freeze after 5 or 6 needles I was still able to feel every thing."

Generally speaking, local anaesthesia works very well with just a standard injection, especially if you're not in already in pain. But a severe abcess is a different story. Freezing depends on the pH of the tissue, and when there is an abcess the pH drops and the environment becomes acidic, not allowing the anesthetic to seep into the nerve fibers (or rather only allowing them to seep in very slowly). As a result, a LOT more anaesthetic has to be used. And even then it may not be totally effective (as you found out :cry:). Most of the time, it's possible to bring the infection under control using antibiotics first. In that case, the pH in the tissue rises again, and the local anaesthetic will work. I'm not sure, but there may be circumstances where rapid action is required and it's not possible to bring the infection under control first ??? ? Maybe our resident dentists can help us out with this one :) (and correct any mistakes in the above ;)).

"My question is Do I leave my dentist and go to another who will not subject me to another horrible visit?This is what prevents me on going to begin with."

Provided that whoever dentist you choose knows his or her local anaesthesia (in other words, most dentists :p - there appears to be the odd exception or two :(), pain control would be easy to achieve because you would have no inflammation that hasn't gotten out of hand (hence the recommendation for twice-yearly check-ups).

OK, that was the physiological component.

(2) Obviously, there's also a psychological component involved here. Rather unsurprisingly (to my mind, in any event), research has shown that pain inflicted by a dentist who is perceived as caring has less of a psychological impact than pain inflicted by a dentist who is perceived as cold and controlling. While the intensity of the pain may be the same, it is usually perceived and interpreted differently. If you're aware that someone cares about you and is doing their damndest to reduce your pain, but simply cannot succeed, you may curse the pain, but you're not actually blaming the person who's trying to help for it (or at least, you shouldn't ;)). You were saying that "The pain was incredible.This dentist still worked on me even though he knew I was in such pain." This would suggest to me that you felt this dentist didn't give you the feeling that he cared about you or your pain. Maybe he also didn't offer much in the way of an explanation.

If the above strikes a chord, I'd suggest the following: start over with a new dentist. Ask friends, family or colleagues for recommendations (or if that doesn't bring any results, see tips on the website). Don't delay it until the next time an emergency comes along - it's much much harder to build a trust relationship under those circumstances (apart from the possibility of the anaesthetic not working :(). Make an appointment for a chat, see if you like the place and the dentist and let them know about your fears. You WILL know when you've found the right dentist (sorry, that's stolen from the Beyond Fear website, but it's so true!). You may also find some tips on our website which you would like to use (it's very much pick'n'mix - don't take it as gospel). It's much easier to communicate your preferences to your dentist when you have some idea beforehand of what might help you.

Think I've rambled on enough now ;D - many thanks for posting here!
 
Can't add much to Let's usual eloquence. One of the factors you haven't touched on is your fear, which by itself would make the anaesthetic more difficult to achieve, does your dentist offer sedation at all?

Next point is that the cardinal rule for treating infection is to establish drainage. In the case of a dental abscess, opening up into the abscess through the tooth will produce almost immediate rapid relief of pain (I know, it's happened to me!) and is 'way better than waiting for 12-24 hrs for antibiotics to kick in. The dentist was possibly trying to be kind by getting the root canal started right away...

--
Gordon
 
Usual eloquence? You crack me up :p... I sort of doubt that pharmacosedation would help in the long run if the fear is primarily of the dentist's behaviour (rather than treatment itself). Though it's not always that clear-cut.

Just a small thing I'd like to add for future reference - I had been wondering about what happens if you're allergic to penicillin and amoxyllin (the most common antibiotics) and came across the following usenet post:

"The most common problem with using penicillin is allergy, which can be severe. Many patients with penicillin allergy (but not all) will react to cephalosporins as well, as the chemical structure is similar.
The first line substitute for penicillin in penicillin-allergic patients used to be erythromycin. But recently there has been an association between erythromycin and heart problems, so its use has markedly decreased. Clindomycin is also used, but it has a significant incidence of gastrointestinal problems."

Just in case anyone else was wondering.
 
The cross allergy between Penicillins and Cephalosporin only affects about 10% of the population.
Personally I would use Metronidazole instead of Erythromycin since most dental infections are anaerobic anyway and it would work better.
 
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