Failed Appointment, Need Support Before Next Try

[dokidoki]

Hello everyone!

So I had a failed dental appointment for a crown today. I broke a back left molar, and need to have a crown done. I've researched the procedure and I went to the dentist I've had good luck with in the past -- he's the first dentist I've ever gone to more than once, and I allowed him to extract all 4 of my wisdom teeth under regular dental anesthetic (Carbocaine with no epinephrine -- I have an adverse reaction including hives to anything else) and was feeling fairly good about letting him do the procedure this time around. I was anxious this morning, but made it in for my appointment at 3.

Fast forward to 6pm, where I'm still sitting in the chair, terrified and three anxiety attacks later. I wound up just rescheduling the appointment for next week. Everyone at the office was really understanding -- some of the employees were clearly more annoyed with me than others, but ... largely everyone was pretty cool about it. I'm pretty sure I can handle it next time, but ... I think I worked out a little bit more about my dental anxiety today which is great on the one hand, but is ... also intimidating. Because I NEED this procedure done but now I have a hurdle to get over.

Apparently, I am HORRIFIED by anesthetic. I CANNOT have IV sedation in any setting other than a proper hospital under close monitoring due to a heart condition, and I have found that things like Xanax or Valium and also "laughing gas" make my anxiety MUCH worse. I can't afford to see a different sort of dentist -- and my dentist IS perfectly well trained and experienced. I am not interested in another dentist, really -- I like this office and I've already paid for the procedure, lol. Mostly, I'm interested in ways to help myself cope with the anesthetic anxiety. It's really terrible, and to make matters worse -- the dentist this time nicked a blood vessel and aggravated a nerve(? so he said?) and I swelled up like a balloon. It was HORRIBLE and it hurts, and I left with a still-numb and very swollen mouth and a good deal of embarrassment after sitting in a dental chair sobbing as a 30 year old woman.

Can anyone point me to some literature about why we swell after dental injections, maybe some more information on dental anesthetics so I can arm myself with facts to use as a weapon against my anxiety? Anyone have some tips on dealing with the pain of injecting anesthetic and the numbness? How GROSS the topical is and how to avoid swallowing it? Anyone want to help soothe my embarrassment at taking up 3 hours of time and completely failing to actually have any work done and inconveniencing everyone around me, including the friend I brought for moral support? I go back next Tuesday and I don't want to fail again! I have a TON of work that needs to be done, and I want to have a pretty and pain-free, cavity-free smile!

 

[brit]

Hello everyone!

1. Can anyone point me to some literature about why we swell after dental injections, maybe some more information on dental anesthetics so I can arm myself with facts to use as a weapon against my anxiety?


2. Anyone have some tips on dealing with the pain of injecting anesthetic and the numbness?

3. How GROSS the topical is and how to avoid swallowing it?

4. Anyone want to help soothe my embarrassment at taking up 3 hours of time and completely failing to actually have any work done and inconveniencing everyone around me, including the friend I brought for moral support?

1. I have had numerous local anaesthetic injections and not aware of ever having swollen. It sounds like sth went wrong with your dentist's injection technique last time and hopefully if will go better next week. It feels numb, so you might interpret this as being swollen but to the naked eye the area should not look any different, I wouldn't have thought.

2. It doesn't have to hurt. See these links: https://www.dentalfearcentral.org/fears/needle-phobia/ and https://www.dentalfearcentral.org/fears/feeling-numb/

3. Different flavours? It is not essential if slow injection technique is used although you might be best to have it if it is your dentist's preference for a good experience.

4. You are the paying customer - I doubt 3 hours was your fault. Whatever it takes to get through your treatment.

 

[dokidoki]

1. I have had numerous local anaesthetic injections and not aware of ever having swollen. It sounds like sth went wrong with your dentist's injection technique last time and hopefully if will go better next week. It feels numb, so you might interpret this as being swollen but to the naked eye the area should not look any different, I wouldn't have thought.

Interesting! No, I've actually swollen. There's an area of swelling in my cheek, which the dentist said can be normal if you're very tense during the injection (which I absolutely was) and, in my own research, seems to be indicative that either a blood vessel or nerve got hit. Which ... I wasn't being super cooperative, so this would make sense to me?

2. It doesn't have to hurt.

I mean ... I don't know that I can reasonably expect no pain during a dental procedure. I've never dealt well with injections and my body has always reacted negatively to them. I appreciate the links though -- some of the anxieties are definitely addressed there. However, reasonably assuming that some pain is going to be involved seems more realistic.

4. You are the paying customer - I doubt 3 hours was your fault. Whatever it takes to get through your treatment.

Thank you for saying this. The 3 hours was DEFINITELY "my fault" -- I was the one with the anxiety, and they let me sit there as long as they literally could before I made the call to reschedule and try again. But it does help to remember that I'm the customer and it's okay to need extra accomodation.

 

[Enarete]

Hi dokidoki,

sorry to hear about your experience and I can relate to the feeling of having failed. At the same time I admire your determination to take control, get some information and arm yourself for the next visit.

I cannot tell you much about the medical side of things, like why exactly your face got swollen (which is not normal, but you seem to know it and also have some explanation abotu why this happened), but I can tell you something about the 'feeling numb' which for me was a huge trigger and took me several visits to overcome.

When we get numbed, what we feel ist that we feel nothing and it feels weird because it's not natural. Naturally, the only situation where we feel like this is when we have a swelling. And a swelling out of sudden would often naturally occure if we got poisoned, for exampl. So as soon as your brain notices the numbness, it may start to panick because it looks like 'my face is swollen, so I'm poisoned, I may die'. My dentist always asks me to keep in mind that what we are doing is shutting off the nerves around the tooth to do the work and we do it intentionally and just for a short window of time in which we do the work.

As brit pointed out, an injection should not be painful. Again, if you had pain it might have been because of something went wrong and if I were you I would ask the dentist about some background information to this and how he can make sure to make it painless this time.

The topical. I talked to my dentist about this point back then and he explained that topical was only one step for making sure the injection was painless. Stretching of the tissue is an another action. He said the stretching would be sufficient so we wouldn't have to use the numbing gel. After all I decided for the numbing gel because I wanted to make the experience, but if it worries you too much, you might try to go without. It doesn't taste too great, but you have it in your cheek and not on your tongue so it's not that bad. And I never swallowed any of it. (By the way, I had anxiety when thinking of swallowing the gel so I got some throat lozenges that contain anesthetics and would make my throat numb with it few times at home to feel how 'bad' it would be if that happened).

During a dental injection, you can try to totally and to 100% concentrate on your feet. I sometimes even move my toes or do circles with my feet (keeping the rest of the body calm) to get as much of my attention as far away from the numbing as possible.

Having an appointment only for the injection, without any further treatment might be helpful too if this would be managable with you and your dentist. It is good to have to deal with only one trigger at a time. I had one appointment just for the injection, a second one where the treatment should have taken place but I was such a wreck that we only did the injection and finally, on the third appointment I was able to cope with an injection and a treatment. Again, you may or may not have this option, just sharing what was helped me.

To your embarassment. I can understand it and would feel the same. It seems to me that you, on a logical level, know, that it was not too bad, but the emotions of embarassement are still there. Here is something to reframe: your dentist has a practice and is the boss there (if not in the whole practice, then at least in his surgery). He can decide what he will do and how long it will take. He decided to give you the time. He could have suggest you to re-schedule any time. So the fact he didn't do it means that it was ok for him. I am sure he doesn't see it as failing but as 'this patient needed the time and as a responsible health care professional I tried my best to comfort her'. You won't be the first nor the last who wasn't able to get through treatment and you will find posts about interrupted treatments also here on the forum a lot. I am sure that as soon as you have seen your dental team next time, all your worries will wanish.

Remember that progress takes time and is not linear, there are visits that go well and other that don't and that's fine. You will eventually get all needed treatment and have a beautiful smile

All the best wishes for Tuesday, keeping my fingers crossed for you and look forward to your updates.

 

[letsconnect]

The swelling sounds like a hematoma, this can happen if a blood vessel is accidentally nicked during an injection or when withdrawing the needle. It could happen to any dentist (though it's a rare occurrence and unlikely to ever happen to you again)!

How is it now? Normally, it will go away without any intervention, but occasionally, you may need painkillers and antibiotics.

 

[dokidoki]

The swelling sounds like a hematoma, this can happen if a blood vessel is accidentally nicked during an injection or when withdrawing the needle. It could happen to any dentist (though it's a rare occurrence and unlikely to ever happen to you again)! How is it now? Normally, it will go away without any intervention, but occasionally, you may need painkillers and antibiotics.

I'm basically POSITIVE this is what happened. I even have a little ... hard area I can feel if I poke my cheek area (down near where he injected) with my tongue. I'm not terribly surprised, I was REALLY tense and I jerked around a little bit, soooooo. Maybe my fault a little, too? Something someone pointed out to me was that the best thing we can do is give a dentist our cooperation so that things run smoothly and without complication, and I did the OPPOSITE of that. lol

It's better now, though. The swelling has gone down a lot over the last 36 hours or so, so I'm pretty sure it'll be good by next week and I doubt it will happen again if I can stay calm. It also doesn't hurt unless I poke at it too much or stretch my mouth out. If it doesn't, though -- I'll call the dentist and go get some antibiotics, if necessary!