Advice on Incomplete Numbness

[Carrie0930]

I recently had two dentist appointments where I had trouble getting numb. One deep filling on the top right and one on the bottom right. The first time I didn't complain until the very end and the second time, it hurt the instant they started drilling and sometimes was okay and sometimes was kind of painful. The dentist said I probably had trouble because it was so close to the nerve and the tooth was irritated.

I have been reading the reasons why people don't get completely numb and am perplexed.

The first reason is anatomical variation, which at first I thought might be a cause because my mother said that it happens from time to time that it's painful and that was normal, but I think probably not, because I haven't really had this in the past and it's in two locations.

The second reason is poor technique. That is certainly possible, but I don't know how to approach this with the dentist. Also, he comes pretty highly recommended and I have never heard of anyone having this problem. Another thing with that is on the tooth on the bottom, my entire mouth was numb but not my tooth, and I don't understand why this would be with a block.

The third is anxiety and I'm pretty sure that's not the case as I was pretty confident the anesthesia would work.

And the last is a hot tooth. I thought this might be possible that the tooth could have a bacterial infection that hadn't turned into an absess yet and could still be filled. Is this possible? Since my dentist didn't use more than one injection of lidocaine?

I have another filling next week and am terrified I'm going to have another problem. I am just not sure how to bring it up to the dentist especially without offending him. I would just be terrified now to have a root canal or something with incomplete anesthesia.

My dentist uses the wand and I've never had a dentist who uses that before so I hope that doesn't have anything to do with it.

 

[Gordon]

You need to tell the dentist that you weren't numb enough and you're worried about it. Actually you shouldn't really need to mention it, since it should have been obvious when you jumped as soon as they started working on your tooth.
The other thing that could be a factor is simple biological variation between different people's reaction to LA, you may need a bit more LA than average and the dentist may need to put in a bit more for you.

The Wand may be a factor, since it's designed for a 1.8ml anaesthetic vial and most dentists routinely use 2.2ml, so you're probably getting about 1.7ml rather than 2.1 or so...

 

[brit]

Waiting long enough before starting is also another factor in many cases - some people take longer to become numb from the same amount of LA and how relaxed you are could influence this.

Interesting comment from Gordon about TheWand dosage, I think i've read before that UK LA vials contain more than USA ones - that must also make it more likely that you might get underdosed in USA.

Hope you find a solution...for someone to be lucky enough to stay as my dentist , they have to be willing to do something if I am insufficiently numb, excuses about things being close to the nerve don't cut it with me - they have to take professional pride in not causing unnecessary pain during treatment.

It can always be possible that LA needs to be topped up during a procedure and it is of concern to me that you only ever received the one dosage in both instances. My dentist always tells me to raise my hand before drilling if I feel anything...which makes it easier for me to feel I have the right to stop proceedings.....I have had inadequate numbing issues myself and also complete lack of LA issues so as you can probably tell, I am advising you to be proactive in finding a solution. Trying a much bigger LA dose, would be a good first option..if he's not willing to do this or to halt treatment and rethink if you are not numb, then you need to go elsewhere Wand or no Wand.

 

[Carrie0930]

Waiting long enough before starting is also another factor in many cases - some people take longer to become numb from the same amount of LA and how relaxed you are could influence this.

Interesting comment from Gordon about TheWand dosage, I think i've read before that UK LA vials contain more than USA ones - that must also make it more likely that you might get underdosed in USA.

Hope you find a solution...for someone to be lucky enough to stay as my dentist , they have to be willing to do something if I am insufficiently numb, excuses about things being close to the nerve don't cut it with me - they have to take professional pride in not causing unnecessary pain during treatment.

It can always be possible that LA needs to be topped up during a procedure and it is of concern to me that you only ever received the one dosage in both instances. My dentist always tells me to raise my hand before drilling if I feel anything...which makes it easier for me to feel I have the right to stop proceedings.....I have had inadequate numbing issues myself and also complete lack of LA issues so as you can probably tell, I am advising you to be proactive in finding a solution. Trying a much bigger LA dose, would be a good first option..if he's not willing to do this or to halt treatment and rethink if you are not numb, then you need to go elsewhere Wand or no Wand.

Thanks for the input!

I think it's pretty unlikely that the dentist didn't wait long enough. He waited a few minutes before starting and when I said it hurt immediately, he waited some more. But then I didn't say anything else because it was okay for a few minutes. I think I really need to learn to speak up and I'm going to speak to the dentist about this before we start tomorrow. It felt like it was more like the anesthetic worked on some areas of the tooth but not others because it was fine in some areas, but hurt in others. I think it's pretty interesting about the wand's smaller dosage, especially where I was partially numb, that seems like that could be a likely solution.