Abscess Tooth in an Old Root Canal-Terrified of Numbing Medications

[LDW]

Hello,

My right first molar on the bottom is abcessed and has been for the last two or three years. Luckily, it was root canaled 35 years ago, so it isn't causing much pain. Just occasional aches in my jaw and ear. I had two upper molars pulled several years ago after months of intense pain, and I couldn't take it any more. The dentist was amazing and slowly worked with me to get the teeth out. He has since retired. So, in the upper molars, he was able to numb just the gum around the teeth and I couldn't even tell that anything was numb but the procedure was pain free so it was definitely numb around the tooth. So, the problem now is that this is a lower molar and I have been told that I must have the nerve block, which numbs the whole side of my face and mouth. I am terrified of any kind of medication, I don't even take aspirin. I would be much more comfortable if I can have the infiltration and not the nerve block on this lower molar. I am wondering if it will be enough considering the nerve is long gone and the tooth is not 'hot'. I also read that sectioning the tooth would also make for an easier removal. The tooth is broken in the front almost down to the gum line. I really want to get this tooth out, but I need the least amount of safe numbing with the lowest chance of any side effects. I also have PVC heart palpitations so I read that Carbocaine would be the safest option. I am 64 years old. Any chance that Infiltration might work in this case with a low dose of maybe one cartridge of Carbocaine? Or is that just wishful thinking? Thank you.

 

[Gordon]

Any chance that Infiltration might work in this case with a low dose of maybe one cartridge of Carbocaine?

Better than a zero chance but not great.
Using something like a Wand to administer the local would help, also the best chance of it working would be to use Articaine, in terms of your heart issues it really doesn't matter which local is used, Articaine is generally the best at diffusing through bone.

I also read that sectioning the tooth would also make for an easier removal.

Not a lot in it, TBH.

 

[LDW]

@Gordon Thank you for your reply. It makes a lot of sense. I had five fillings done last year without any numbing at all and that went well. My point is that I know tooth extraction is much more painful, but I don't need to be completely numb. I can handle some discomfort and pressure. But not a lot of pain. Do you think I might be able to achieve that with infiltration with either Lidocaine or Carbocaine? The nerve is long gone, so that isn't an issue.

 

[Gordon]

Do you think I might be able to achieve that with infiltration with either Lidocaine or Carbocaine? The nerve is long gone, so that isn't an issue.

Maybe, is there some reason why you don't want Articaine? As I said, it's likely to be the most effective.

The presence or absence of a nerve in the tooth is not really relevant in an extraction.

 

[LDW]

@Gordon I really appreciate you taking the time to help me get past this fear and get this tooth out. It has been abcessed for two or three years and it needs to go. As far as Articaine, I read that it lasts longer and in a nerve block it has a slightly higher chance of causing nerve damage. I prefer Lidocaine actually because I had a breast biopsy several years ago and they used Lidocaine and I tolerated it well. I mentioned the nerve being dead in relation to the numbing, as I won't need to worry about getting that numb at least. I am really hoping that a Lidocaine infiltration will be enough for me to tolerate the tooth extraction at least fairly comfortably. It's tooth #30 and I had fillings in tooth #31 and #32 without any numbing at all. Of course, I know that's a lot different procedure.