Bad experience today

[frase]

Hi all, was glad to stumble across this forum today and figured I'd share the experience I had today.

I haven't had a regular dentist since 2003, I'm embarrassed to admit that and sat back and watched/felt problems appear over the past 5 years while doing very little to sort them out.

My last experience of a dentist was a bad one, a large Danish lady in a private practice in Norway (I was living there at the time) basically drilled 4 pre-existing fillings I had done on the NHS as a child and refilled them with white fillings, criticising the existing work and being far more unsympathetic and painful than I can ever remember my NHS dentist as a child being.

I've never liked getting dental work done, don't get me wrong - I'd always hated it and found lidocaine never numbed me to the point of no pain like every dentist has claimed to me it does. I feel when the bit approaches the nerve and it's the worst pain I can imagine, far worse than dealing with toothache most of the time. I did however manage to handle it up until I was about 17 without the panic reactions I get now.

Having suffered from bad toothaches over the past few months I finally managed to secure an emergency appointment today through the NHS, left work and found my way to a very nice, modern little practice outside of the city - a world away from the dated 60s decor and feel of the NHS practice I had used up until the time I left to go to Norway. I was feeling ok, not great but in pain and wanted to get things sorted out. I was called in a little late, sat down and explained the couple of problems I had noticed myself to the young dentist who seemed like a nice guy. An x-ray was taken and then the news was broken that I would require a root canal today, at least 3 of the fillings my dentist in Norway had given replaced, a possible extraction or root canal on another tooth that was less urgent and that I had an impacted wisdom tooth.

At this point my heart started to jump and I explained to the dentist that I am not sure I can have this work done, I suffer from Generalised Anxiety Disorder and the panic reflex kicked in. Still, he hadn't got the tools out yet and after 5 minutes of talking it through in a relatively no-bullsh*t sort of way (which I appreciated) I agreed to the root canal.

I was getting worse as I laid down and the assistant obviously anticipated things could get worse and was trying her very best to keep me calm as the dentist drilled. The injections were fine, not comfortable but nothing I can't handle - I've never liked them but they are not my issue, my issue is drills. The noise, sensation and blinding pain as it approaches and breaches the nerve. Sure enough I handled the first 10 seconds of drilling but could feel the panic and fear rising, my heart rate rocketing and then when the pain hit I couldn't bear it and had to get him to stop. At this point I entered a full on panic attack like nothing I've experienced in years, suffering from anxiety and the occasional panic attack in the past I know the feeling and it was horrible for it to all come back. Hyperventilating, barely able to speak and feeling like a complete idiot I had to halt the procedure before the drilling of the damaged tooth had even been completed.

I do not know how I could have handled the actual removal of the nerves if this is anything to go by. I convinced myself that this was something I couldn't do today. The dentist seemed understanding and was trying his best to coax me back into the chair, speaking sense about avoiding my phobias being an unhealthy response etc. which I could understand completely, in theory but at this point not even Natalie Portman herself walking in and taking on the role of assistant would get me back in that chair. I had to get out. He patched up the work he had done and let me go.

Of course at this point I made an arse of myself in the waiting room trying to explain to the receptionist that I needed some fresh air (still half hyperventilating, face numb and tears streaming down my cheeks) who obviously thought I was trying to do a runner on the bill. Not good. Still, after 5 minutes standing outside I felt a bit better and got a chance to speak to the dentist in private. He explained that he could give me a referral to a consultant who could arrange for the work to be performed in the dental hospital either under sedation or general anaesthesia due to my inability to remain calm under local anaesthetic. Of course he would have liked to take me on as a private patient (considering the work I need done) and I don't blame him for that but this practice had no gas facilities and really nothing that would make me want to sign up there today. It would be even worse to be paying private rates and monthly fees etc. as I freak out and suffer.

Apparently I will hear from a consultant in a few weeks and be put on a waiting list. I realise this is the "easy" option and he's right, it is just avoiding my fear and phobia that I have developed along with my generalised anxiety but I really don't think I can have the work done with just local anaesthesia. It doesn't block out the sounds, the smells, the noise, the sensation and worst of all the pain. I am convinced that these days the only way I can have this work done is if I am completely out of it, I've never had gas but would be willing to try it but would jump at the chance of I.V sedation or general anaesthesia, I don't want to be aware of or remember a thing about it especially if I'm getting my gums cut up for the wisdom tooth extraction and nerves torn out in root canals.

I no longer take anti-anxiety medication believing I had better control of it these days, after today I'm less convinced of this however.

Sorry for the length, I just felt I'd share my experience today. I feel a bit of an arse and sorry for 'wasting' this dentists time today when he was good enough to let me come in for an emergency appointment, obviously a very busy man. I explained this to him but feel no better about it, worried that I'll see him in the street or his assistant and be reminded that on this day I broke down and cried, hyperventilated and generally freaked out - as a grown man - over a bit of dental work

 

[brit]

I am so sorry to hear what happened...it could be that you have anatomical variation or that your anxiety is so high the LA doesn't work......it is completely logical that you would be afraid if dental treatment has always been painful for you...it shouldn't be painful at all...pressure and pain are not the same thing...I think you did the right thing to halt proceedings. Because of childhood experiences where I was denied anaesthetic I know what the pain from drilling can be like and I can promise you that when you are properly numb, it is a piece of cake.

This is our page on numbing problems: https://www.dentalfearcentral.org/fears/not-numb/ - there are 4 main causes. You did not mention that your dentist tried to top up the LA at all either.

You need to work out what the cause is in your case and take it from there...if it is anatomical variation you need a dentist familiar with advanced techniques (oral surgeons would often fall into this category)..another option would be to consult a private endodontist (root canal specialist) they do exist in the UK: they often have nitrous as conscious sedation and could be expected to know more than the basic techniques for numbing taught at dental school since people seek them out for complex root canals.

The pain today could have been infection in the tooth but it could have been the other things too...there are advanced techniques for numbing hot teeth too.
The dentist could have just injected in the wrong place - you did not mention that he tried any follow-up anaesthesia and obviously as you feel pain, your anxiety level rises and this too interferes (or can do so) with the anaesthetic working properly.
If you'd like to avoid injection pain....even though it's not your main concern..TheWand can achieve comfortable anaesthesia for most people even in the more sensitive areas.

QUOTE OP 'I realise this is the "easy" option and he's right, it is just avoiding my fear and phobia that I have developed along with my generalised anxiety but I really don't think I can have the work done with just local anaesthesia. It doesn't block out the sounds, the smells, the noise, the sensation and worst of all the pain.'
I repeat it is not supposed to be painful..all teeth can be got numb but not all dentists can get all teeth numb if you get my drift.
Are you convinced your dentist today knew you were in pain and did not just think you were having a panic attack?

 

[frase]

I don't experience pain as the outer tooth is drilled, never have done - don't like it but it is and was pain free. It's when the bit breaks that surface and nears/breaches that fleshy inner core that it becomes a blinding pain, it's a pain like no other i've ever experienced and one that's very hard to describe other than the pain that is felt when nerves are being drilled through.

I've never had a dentist convinced that I'm feeling this pain, it certainly isn't what I'd describe as pressure or anything - I've never had a shot that removes it and every deep filling I've had in my lifetime has felt the same as it did yesterday. I've always resented the assertion from dentists that a procedure would be painless, it's never been the case

 

[brit]

The outer section is often painfree even with no numbing hence why so many (Dumb?) dentists still try to fix kids' teeth with no numbing. It may just be that you need more LA than the average patient everyone metabolises drugs at different rates...the maximum dose is sth like 8-10 syringes (standard UK carpule is more generous than a USA one I understand - I wonder if that's because they want to make more money out of their patients?) so if you had only a couple you were nowhere near the maximum...some dentists are just not that good at LA.

Anatomic variation would normally only apply on lower teeth I think. Which area of the mouth was being worked on? I don't for a moment dispute that you felt real pain..I have been there myself.....what I am trying to say is that you have not yet found a dentist with good enough LA technique to treat you comfortably (even without sedation) but they do exist.
Treatment under sedation could work particularly if anxiety is the cause. The downside to NHS treatment under GA apart from maybe a long waiting list is that they tend to only do the most basic stuff under GA so you'd end up losing teeth which could be saved with root canals etc.
Have you looked on our Dentistfinder for a dentist near you who has been recommended by a fellow-phobic. It is very common for people to post on here that dentists disbelieve that they are still feeling pain during procedures but it is common knowledge that everyone is different as to LA dosage required and some poor souls (very rare - usually LA failure is because the correct spot has been missed by dentist) do have their nerves in a slightly diffrent place and therefore require different techniques (suvh as Akinosa or Cow-Gates blocks).
As to no longer being on your anti-anxiety meds, please do not see this as your fault, it is down to the dentist's abilities to deal effectively with a hard to numb patient (for whatever reason - there may be more than one in play on this occasion).