Apprehension due to local anesthetic resistance

[KittysKid]

I have a h/o not getting numb x 2 dental procedures & non dental biopsy. Which made a fear of dental procedure return. My primary care said this is related to Ph & this happens with some people. They have to use different anesthetic, My dentist is aware.

He prepped & placed a crown last year & I was completely numb.

#31 has older, superficial occlusal filling, one high cusp, tactile sensitivity occlusal surface cheek side & where that high cusp it. I have h/o grinding. It hurts the most with brushing teeth & occasionally when eating if I hit it the right way . No other heat, cold, pressure sensitivity.

The restoration was getting ratty around the edge, so dentist said they will fix that thinking that could be cause.

1st attempt at numbing, I could tell it wasn’t right. It could have been anxiety but my heart raced a little. He injected again adding injection gumline. Let me sit a while. I could tell I wasn’t numb as I should have been. Maybe he used something different last tie & forgot I had the issue with aesthetics. He attempted & I felt pain. I just pushed through. EFDA did the bonding & that was sensitive. On my way home I felt the numbing go to my temple & eye but my cheek, tongue, chin not numb like I am familiar with.

The sensitivity remains. I think my dentin is still exposed & it was not covered with the bonding or it was & not working.

We discussed possibility of crown.

Now I am extremely apprehensive. My anxiety for dental work had not been an issue for 30 yrs as long as I am numb, I am good. I fall asleep during long procedures. I know anxiety can affect getting numb but I have had several procedures without issue. I don’t know what happened this time. Type of anesthetic, technique. Any ideas or suggestions?

 

[Gordon]

Lower right molar?

It sounds like he managed to inject at least some of the local into a vein, so it was washed away quickly instead of working. It's unlucky but happens to the best of us occasionally.

Injection no 2 was a bit off target (placed a bit too high up) since (from your description) it got the facial nerve... usually down to trying not to inject in exactly the same place to minimise trauma to the soft tissues. You're now also a bit stressed, so your pulse is fast, your BP is elevated and the local is being washed away faster due to this.

So in short, the dentist has been a bit unlucky and hasn't quite hit the exact spot with the first one, then things have escalated a bit from there. It's not likely to happen again.

The type of local doesn't matter that much.

 

[KittysKid]

@Gordon I understand this could have been an issue with technique & these things can happen. I am still not convinced it wont happen again because it has happened 3 times now with 3 different dentists & a gyneocologist doing a biopsy. We have 4 different providers & 2 different anatomical areas affected.

 

[Gordon]

Doctors for some strange reason use 1% lignocaine for local, which is pretty weak, I'd discount that one!
You're still stressed before it starts though, due to previous failures, so my comments about fast pulse and high BP would still apply...