Anaesthetic for Crown replacement

[SallyUK]

hello - I have ongoing fear of dental work, about things going wrong during the procedure mainly, panicking and ultimately losing all my teeth! I have overcome my fears a lot through the help of this forum but a new anxiety is starting and thought I would try getting some information clear before my head runs away with itself.

Unfortunately I have some decay between two crowned molars in my upper left and the dentist will replace the back one and improve the margin on the second one.

I have a slightly lazy top lip on oneside which is sometimes noticeable when I speak or smile as it doesnt lift the same as the other side - slightly Elvis like (funny but not) and I am sure I remember this was due to some dental work years ago, before I had this fear and probably let it go. I have now become worried about facial injuries!

I have freaked out in the past when parts of my face felt numb when I wasn't expecting it. Is this a 'simple' place to have an injection and I wanted to know which parts of my face will go numb for this.

can anyone explain a little bit about the risks of things like this happening (slightly drooping lip other things like this) and the area which will be numbed.

Many thanks

 

[Gordon]

The upper molar area is the easiest place to get local anaesthetic done, there will be a bit of numb feeling in your cheek but it isn't likely to affect your lip.

Since local anaesthetic works on sensory nerves and not on motor nerves, it's unlikely that it will be that which caused your droopy lip.

 

[hartsada]

Is the upper molar a wisdom tooth? IF so why don't they refer it to that. So you are saying that on Tuesday when I have my wisdom tooth removed (molar or 3rd molar) that the numbing will only effect the upper part and not my lip?? THanks!!!

The upper molar area is the easiest place to get local anaesthetic done, there will be a bit of numb feeling in your cheek but it isn't likely to affect your lip.

Since local anaesthetic works on sensory nerves and not on motor nerves, it's unlikely that it will be that which caused your droopy lip.

 

[SallyUK]

Thank you very much Gordon - it helps me no end to have clear information, I shall stop expanding my thoughts into playing dentist and diagnostic! I shall get back to managing the anxiety, appointment is not until mid June, so I shall try and lay it to side for now.

 

[hartsada]

Sally if you figure that out, please let me know as I am scheduled this Tuesday!!

 

[SallyUK]

Sally if you figure that out, please let me know as I am scheduled this Tuesday!![/QUOTE

Do you mean figure out the anxiety? I guess you do, well, it has been a while since I have been working on this and different things will work for different people. For me, I like to know what the procedure is expected to be, the length of time etc, and then I sort of prepare myself and praise myself at each step, taking it bit by bit. All the while focussing on the reason why I want the work done, think of a reason that means something to you. It might be that you will prevent further work being done, it will improve your health, you want to overcome your fears etc. Then I have to go with the anxiety if and when it comes but committ to continuing to step forward - there was a point where I was avoiding, stopping this behaviour was a big breakthrough. I wish you luck managing your worries

 

[Gordon]

Is the upper molar a wisdom tooth? IF so why don't they refer it to that. So you are saying that on Tuesday when I have my wisdom tooth removed (molar or 3rd molar) that the numbing will only effect the upper part and not my lip?? THanks!!!

Wisdom teeth are the third molars. You have upper and lower ones. If you're getting upper ones out then what I said holds true, if you're getting lower ones out then it doesn't and your lower lip will most certainly be affected by the anaesthetic.

 

[SallyUK]

Crown replacement

Hello - I went for my check up today and thankfully there is no more work to be done except the replacement of the crown.

I did talk it through with my dentist but wanted to ask some questions here:

- the dentist was keeping an eye on the space between these two crowns (upper left molars) and when I had toothache 3 weeks ago was when he decided on the plan to replace the back crown and try to fill the decay in the neighbouring one (both are crowned)

- I have had extensive work on my teeth over the years and he wants to take a conservative approach, today he took another xray and the decay between the two crowns was more visible - he said the angle of the x-ray can make a difference.

- I talked through my fears of the worst case scenario and although he cant guarantee there wont be massive decay under the tooth meaning it needs to be extracted, he said unlikely.

I guess I am worried - it has happened to me before that a crown had a lot of decay underneath and needed extracting, well, it almost broke off actually. Admittedly this was before I got on top of cleaning and after a good few years of stable teeth, the restorations all seemed to fail at the same time.

Anyhow, I am now imagining the decay between the teeth will mean there is nothing left to crown - would the dentist be able to tell this from xrays and his probe (he said he could feel the decay) I am upset as I clean well, hygenist every 3 months, no sugary foods etc. This gap has always been quite wide between the teeth and food recently getting stuck.

Can anyone reassure me that the replacement of the crown is more than likely possible. I can never understand the talk of margins and how much tooth needs to be left etc. These teeth are not root filled and on the xray the roots look fine, the slightly grey shadow on the xray is between the teeth and a little bit under the crown on the back one. Plan is to fill one, once the back crown is removed and to replace this crown. Also do you have anaesthetic for the crown fitting (its been 20 yrs since I had these)

Thank you.

 

[Gordon]

The person with the most information is your dentist, anybody on here has to guess with no useful information at all... so since he thinks it'll be OK then I think that it'll be OK too.

Sometimes you need anaesthetic to fit a crown sometimes not, I usually give a patient the choice between a wee bit of sensitivity for a minute or two or a numb face for a couple of hours. I may not phrase it quite like that!

 

[SallyUK]

Thanks for your reply Gordon, I really really am trying really hard to get to grips with the uncertainty of things. It's just I dont want to lose anymore teeth and am really a bit upset that this bit of decay has happened. Of course with it being a crown it has to come off to repair it, and I DO know that things can go on underneath and not be aware. The dentist does tell me that with regular check ups etc, things should never get really surprisingly bad ever again - I need to trust and it's no-ones problem but mine.

1970's child, susceptible to decay, cleaned well, not much sugar and filling after filling, crowns in my 20's.........it's really hard to get over the psychological 'out of control' feeling let alone the reality of having less than great teeth. He said I can live without that tooth in worst case scenario, which he didnt suggest, I mentioned it! But....have gaps on other side and cant imagine chewing ok without this one, but I guess I would

I will take no anaesthetic if he offers, I don't think he will - fitting is without one I am guessing (no drills!)

However hard I try, I just cant come to terms with all this maintenance of restorations - however hard I try, they eventually need something grrrrr

 

[brit]

I will take no anaesthetic if he offers, I don't think he will - fitting is without one I am guessing (no drills!)

I don't know if Gordon is talking about a crown fitting appointment - the final stage?
As I understand it you are having a old crown taken off on a tooth which has not had a root canal with a view to removing any decay which is found, restoring it and fitting another crown. It would be normal and desirable in that situation to be numbed up.

If a tooth has already had a root canal, it is possible to do crown prep with no LA but I prefer to use LA (have tried it both ways with same dentist) and then the fitting(seating) appt can be done with no LA easily but both mine had had rcts so no nerve left.
I think to seat a crown where the nerve was still alive, I would likely opt for LA.

 

[SallyUK]

Thank you Brit - I made a typing error, I meant to say I think my dentist will offer me anaesthetic for the prep, as far as I know the root and nerve are fine, no root canal on this tooth. I am paranoid there will need to be one though! Its' good to know the second appointment won't need one, yes the first is him removing the crown and sorting the decay and impressions, the tooth is a tiny bit sensitive when poked about, so I guess it's alive and will hurt. Thank you.

 

[carole]

In that case then you will be very numbed up for it