fourth attempt at extraction anaesthetic doesn't work. Terrified

[dryad]

Hi, I've had a quick look at the forum (ok a long wide eyed shakey look) and haven't spotted a similar problem, but I may have missed it so please forgive me if I'm repeating a thread.

I've been phobic about dental treatment since before I can remember, and have had intermittent treatment over the years, and have only very rarely had a dentist that I could feel 'safe' with i.e. they treat me like a baby, go slow and gentle and have the pateince of a saint . During the last year I have undertaken a major course of treatment involving root canals, extractions, crowns and simple fillings, I was only able to get through the door of the surgery with the help of hypnosis, and because I was in such excruciating pain from so many teeth . The course of treatment was started with a trainee dentist, all uk nhs patients only ever seem to get to see the newbie dentists. However she was wonderful, gentle, reassuring and skilled, and although I did have some sticky moments we got through them, but always seems to happen with the nhs just as I think I have found my dental angel they have moved her to another practice to widen her experience . I can't 'follow' her as that practice is not taking on any more nhs patients.

Her replacement while very very nice, and I'm sure is talented, has been unlucky to have as my second treatment an extraction, which the previous dentist claimed would be simple compared to my others because of the straight roots. However we've had more trouble with this than anything else.

Tomorrow I have a fourth appointment to try and extract that tooth, and even after 3 different kinds of antibiotic to avoid 'hot tooth' my jaw just will not numb enough to pull the tooth, I have been passed to the more experienced practice partner now, and even he has not been able to numb me enough with a block that works on "everyone" and he uses for extraction and dental implant 'implantation'. Nhs dentists do not seem to offer conscious sedation, which would be of no use anyway as I may be woozy but would not be numb, or a general anaesthetic. This experience is breaking through my long and hard fought road to getting over my phobia, and I am terrified of my appointment tomorrow. Is it simply my jaw wiring that is unusual and that the dentists technique has not been able to hit the right spot yet, or are some people just not succeptible to local anaesthetics in some cases (they work on my upper jaw, but hardly at all on the lower). Any suggestions or reassurances would be very gratefuly received.

Thank for reading.

 

[Stress Doc]

Hi Dryad:

Welcome to the forum!
This is a great place of encouragement and advice.

You are doing the best thing by making the choice to deal with your dental fear. You ability to face this resides in you and not from the dentist. A caring compassionate dentist is great but know you have the power to control yourself and perceptions. I am not blaming or ridiculing you but pointing out you have far more power than you realize.

A far as getting numb. No one is immune to LA. However, there can be differences in anatomy but this problem is solvable. High anxiety can change the PH of oral tissues which can can the amount of LA needed but still this is doable. A different type of LA might work better as there are many different types and combinations. A different technique might also be in order. I am confident they will solve the problem.

You will do great and will not lose the progress you have made as long as you believe you will not. Remember, this is based upon perception. You can handle anything you encounter and will do great.

If I can be of any help, please let me know.

Blessings

 

[dsr]

Just a thought.

Did you feel pain when the dentist attempted to extract the tooth, or did you feel that the area was not numb and therefore stop the procedure from going ahead ?.

I only ask this because I had an extraction last week and it felt like the LA had not worked ( i.e I could still feel my lip, mouth etc ). Mine was an upper molar and I always know when my LA has worked, but this time it felt as if nothing had happened.

When my dentist carried out the usual prod around, I didn't feel a thing, seconds later the tooth was out. I can only imagine my dentist applied the LA with such skill it only numbed the area I needed.

 

[dryad]

Thank you for the welcome stress doc and thanks for the reassurance, and what you say backs up what I suspect is the problem I'm trying to think positive and stay calm today. Hi Dsr thanks for the response, it sounds as if your dentist was very skilled . The gum was pretty numb but an area of the gum margin at the bucal side and a little at the back abutting the wisdom tooth was still sensitive to sharp things when poked. On the first two appointments the dentist didn't even try very hard to remove the tooth and gave me antibiotics after each visit, the third time with the more experienced dentist had the same prob, but he managed to get it numb with a second round of shots. However as he got the tooth nearer to extraction it started to hurt, and then suddenly it was agony, so he stopped and asked a few questions (i think he thought because i was nervous i was perceiving pressure as pain, but i've had a few extractions and I know the difference ) it made me cry (and yelp) and I NEVER do that in public, I was so embarassed and ashamed. He had to stopped the extraction there as he wouldn't risk any more anaesthetic. He gave me another dose of different antibiotics (he says i have a dense jaw bone and have a little pocket of infection sitting happily at the tip of the root) if it doesn't work today he says he will refer me to a hospital where I can have general anaethesia although I would rather not have that if it can be avoided as I'm asthmatic and a little overweight, also he said there's a 3 month waiting list, and not looking forward to that with toothache!

The funny thing is that although the tooth is degraded and I had had some tooth ache with it, the original dentist had filled it and said it should last a year or two. I've only had problems with it again since the new trainee built up the tooth that meets it in the top jaw. She took ages to get it down to a size where my other teeth would meet, and it presses very firmly on this lower molar, a week after the top tooth was done the bucal filling in the bottom one popped out, which set off toothache again (after the filling had been out for a month) and that is when they decided it needed to come out. Do you think I should mention that to my dentist? maybe the tooth doesn't need to come out yet (it will eventually) just be refilled and the bite of the top tooth adjusted ??? or am I grasping at straws . Sorry this is so long!!

 

[brit]

Hi, I've had a quick look at the forum (ok a long wide eyed shakey look) and haven't spotted a similar problem, but I may have missed it so please forgive me if I'm repeating a thread.

I've been phobic about dental treatment since before I can remember, and have had intermittent treatment over the years, and have only very rarely had a dentist that I could feel 'safe' with i.e. they treat me like a baby, go slow and gentle and have the pateince of a saint . During the last year I have undertaken a major course of treatment involving root canals, extractions, crowns and simple fillings, I was only able to get through the door of the surgery with the help of hypnosis, and because I was in such excruciating pain from so many teeth . The course of treatment was started with a trainee dentist, all uk nhs patients only ever seem to get to see the newbie dentists. However she was wonderful, gentle, reassuring and skilled, and although I did have some sticky moments we got through them, but always seems to happen with the nhs just as I think I have found my dental angel they have moved her to another practice to widen her experience . I can't 'follow' her as that practice is not taking on any more nhs patients.

Her replacement while very very nice, and I'm sure is talented, has been unlucky to have as my second treatment an extraction, which the previous dentist claimed would be simple compared to my others because of the straight roots. However we've had more trouble with this than anything else.

Tomorrow I have a fourth appointment to try and extract that tooth, and even after 3 different kinds of antibiotic to avoid 'hot tooth' my jaw just will not numb enough to pull the tooth, I have been passed to the more experienced practice partner now, and even he has not been able to numb me enough with a block that works on "everyone" and he uses for extraction and dental implant 'implantation'. Nhs dentists do not seem to offer conscious sedation, which would be of no use anyway as I may be woozy but would not be numb, or a general anaesthetic. This experience is breaking through my long and hard fought road to getting over my phobia, and I am terrified of my appointment tomorrow. Is it simply my jaw wiring that is unusual and that the dentists technique has not been able to hit the right spot yet, or are some people just not succeptible to local anaesthetics in some cases (they work on my upper jaw, but hardly at all on the lower). Any suggestions or reassurances would be very gratefuly received.

Thank for reading.

I agree with everything you have said about the downsides and sometimes plusses of UK NHS newbie dentists. At the fourth attempt, they simply have to refer you to an oral surgeon at the hospital who will have access to nitrous/i/v sedation/ even GA if that's what it takes.....you are not expected to just put up with pain for a tooth extraction...they are supposed to provide adequate anaesthesia. It is also possible that another dentist/surgeon using a more advanced technique such as Cow Gates or Akinosi will be able to get the tooth fully numb with just local. If you are in pain you should be referred on an urgent basis and therefore not have to wait for 3 months.
So the way to kick your fear into touch is to say they can only extract if you give them the all clear...there are many stages as you must already know during an extraction where you stop to check adequate numbness...many people develop phobia when they encounter dentists who believe their only duty is to inject rather than to inject effectively.
Ask for a referral to an Oral surgeon if tomorrow fails as well.
You have certainly been very unlucky with this tooth.

Kudos to you for calling him on the 'pressure' v 'pain' thing.....

 

[dryad]

I agree with everything you have said about the downsides and sometimes plusses of UK NHS newbie dentists. At the fourth attempt, they simply have to refer you to an oral surgeon at the hospital who will have access to nitrous/i/v sedation/ even GA if that's what it takes.....you are not expected to just put up with pain for a tooth extraction...they are supposed to provide adequate anaesthesia. It is also possible that another dentist/surgeon using a more advanced technique such as Cow Gates or Akinosi will be able to get the tooth fully numb with just local.
So the way to kick your fear into touch is to say they can only extract if you give them the all clear...there are many stages as you must already know during an extraction where you stop to check adequate numbness...many people develop phobia when they encounter dentists who believe their only duty is to inject rather than to inject effectively.
Ask for a referral to an Oral surgeon if tomorrow fails as well.
You have certainly been very unlucky with this tooth.

Kudos to you for calling him on the 'pressure' v 'pain' thing.....

Thanks so much for that Brit, also the group hug helps for some reason it's made me feel less guilty (and less of a failure) for stopping the treatment to point out that it's become painful, and more confident about asking for/agreeing to a hospital referal. My dentist did seem quite shocked that I wasn't numb enough to continue - as was I to be honest, I had no reason to think it wouldn't work, I think he has been lucky not to encounter many people whos nerve wiring is as messed up as mine must be and couldn't quite believe it was really pain I was feeling, thanks for the kudos on that I felt at first that he thought I was exaggerating. I think he tried the akinosi 'technique?', unless there's a local anaesthetic that begins with A and I was numb but not enough (swears to self). I think it is down to bad luck, and I just have to see the next appointment as a new improved attempt, maybe he'll try something else, or these antibiotics will have helped. Will just have to keep my fingers crossed and have a large glass of something alcoholic

 

[dryad]

YAY!!!

My dreaded tooth is no more, it is an ex tooth. Thank you for your support and advice. I felt much more relaxed about my appointment this time, and the antibiotics seem to have done the trick, was a hell of a wrestle but it didn't hurt and it was out in a couple of minutes

It was well worth getting through the set back, and now I'm more confident than before that I can handle this phobia.

Thanks

 

[NotAloneISee]

Congratulations!

Isn't it a big relief? I think all of us who have come over to the other side know the feelings that you have.

 

[brit]

Really pleased to hear that..you must be relieved to have it behind you by Christmas.