I just don't get numb

[PRW]

Hi, I'm glad I found this forum through a Google search. I have a dental appointment to get a broken filling repaired the day after tomorrow, and as usual I'm dreading the dental chair like a condemned man would dread the gallows.

The problem is that local anesthesia simply doesn't get my teeth ... any of my teeth, upper or lower ... completely numb anymore. And the problem seems to get worse as I get older. I didn't have this problem when I was younger, but I'm pushing 50 now and it seems like every time I have to undergo it, local anesthesia works with less and less effectiveness.

My dentist, who I've been using for nearly 30 years, understands my problems here and has gone out of his way to work with me. He'll give the anesthesia time to take effect before working on me. He'll give me another shot or two if it takes it. He'll do the deal where he injects right into the area behind the tooth in question. He's also used a stronger, longer-lasting anesthetic on me. But nothing gets my teeth totally numb to where I don't eventually feel the electric jolt of pain when he drills.

I've tried not to be a "clincher" in the chair, I've tried my best to take deep breaths and relax and not be nervous, but when the electric jolt happens as it always does, I end up going to pieces and gripping the chair with a death grip and I usually come out of the dentist's office bathed in sweat.

I would probably do better with nitrous, but my dentist, who has a small practice and office and doesn't really have the setup to do the oxygen and stuff that you have to have while using nitrous, does not use it. I had to have a root canal last year and my first one of those a few years earlier was a bad experience ... the endodontist finally took his drill and drilled into my gum underneath the tooth and shot anesthesia directly into the root which got me through it ... but I asked for nitrous this time and it got me through it although I still felt the pain, I just was so relaxed (it felt like I was tucked in under a warm blanket) that I didn't care.

Here's my problem. The injections don't bother me. A dentist could stick me 25 times in my mouth and it wouldn't bother me one iota. I can handle it. And I know there are some people who don't like having their mouth numb (I know a couple who refuse to take the shots and let their dentists drill with no anesthesia). Again, it doesn't bother me one iota. I don't care if my mouth is so numb that my lower lip is hanging down to my ankles. I don't want to feel anything.

And I especially can't handle feeling the drill. I simply have zero tolerance for it, my pain threshold as far as having my teeth drilled on is zero. I'm not proud of that because I ought to be a big boy, but I simply can't handle feeling my teeth being drilled on. When I was younger and anesthesia worked better on me, it wasn't a problem because I got totally numb and didn't feel the drill. Now, as I get older and the anesthesia is less effective, as I said eventually, at some point during the procedure, I'm going to feel the electric jolt of pain.

Is there anything that I could be doing, or my dentist could be doing, to try to help alleviate this a little better? I don't let these fears keep me from going to the dentist when I need to go to the dentist, but as I said, it's like preparing to face the gallows and it shouldn't be like that.

 

[letsconnect]

Hi there ,

there could be several reasons as to why the local anaesthetic might not work as well as it should. You mentioned that you've got the same problem in the upper and lower jaw, which might suggest that anatomic variation is not to blame. Has your dentist tried different local anaesthetics? For some people, certain anesthetics seem to be more effective than others.

 

[Carol_P]

Hi PRW

I have exactly the same problem as you. I joined here specifically to look into my problem and yours is the third post I found with the same broblem. I like you am not scared of the needles, its that feeling when the drill gets down, and you accurate description of the electric jolt of pain. Its horrific, truly horrific and I am now terrified of the dentist and have never been previously.

I got goose bumps thinking about it!

 

[letsconnect]

Carol, if your dentist has problems numbing you in the lower jaw only, it's most likely due to anatomic variation and your dentist will need to inject higher up, using a Gow-Gates or Akinosi block, maybe supplemented with other injections. It can also help to have nitrous oxide (makes the anaesthetic work more effectively, especially if you're nervous). The problem is that not all dentists are familiar enough with advanced local anaesthesia techniques, so you may have to look around and find someone else who is. We've also got a page on difficulties with numbing here, but it's going to get an overhaul soon (https://www.dentalfearcentral.org/fears/not-numb/). If anatomic variation is the cause, a panoramic x-ray can help identify where the nerve most likely runs.
From what you said in your other post, your last dentist didn't have a problem numbing you, maybe he used a higher block on you? Or there can be secondary innervation, which requires infiltration around the tooth.
When your dentist numbed you the two times it didn't work, was your lip numb right to the midline?

 

[Carol_P]

Hi thanks for the swift response!!!!!

My lips used to go numb but they dont so much now. I was not sure if it was an age thing with me maturing or what. Is it possible my new dentist uses different anaestetic from the previous one? Lots of things have crossed my mind... different medication as times change, my own body maturing? Who knows. I am so tempted to tell him if I ever need this done again I will go to the dental hospital and be put to sleep. I really am scared!!!

 

[Carol_P]

Also.... (I have had 2 of these horrific experiences) the dentist inserted further injections around the actual tooth as well as at the back of the jaw. I had 4 injections both times.

 

[letsconnect]

It's very very unlikely that this happens because your "body is maturing". It's far more likely that either your last dentist used a different anesthetic, or else that your last dentist used a different anesthetic technique on you, like a Gow-Gates or Akinosi nerve block. Your dentist shouldn't proceed unless your lip is numb to the midline.

Is your dentist fully aware of the fact that you're not numb before he begins? If he's kind and understanding as you say, it would be a good idea to make him fully aware of this problem .

 

[BlueStringPudding]

Wow - and I thought it was just me. Like some of the people commenting here, I don't get numb. I've gone to the dentist every six months all my life with no fear and no problems.

Then the first time I needed treatment involving anaesthetic it only partially numbed the tooth and almost completely wore off before the end of the precedure. The nerve trauma from that first filling led to my needing a root canal. That was the most horrendously painful experience I've ever had - I kept telling the dentist I could feel pain, she kept injecting me. Eventually she went ahead anyway and drilled right into the nerve cavity with the nerve still "live". I can't begin to explain the pain - I screamed and jumped! (and I'm quite a quiet kind of a person!) It was awful, and she had to inject directly into the top of the open tooth (which was unbeleiably painful) and has made me petrified of the dentist ever since.

Needless to say I changed dentist after that - and although he was very understanding of my past experience - he has had to repeatedly inject me when giving me fillings - and I still don't get fully numb (and whatever numbness there is wears off well before the procedure's finished). Once even with him, although my tongue and lip was numb, the tooth wasn't and again he had to inject into the "live" nerve part way through drilling to numb it.

Now I live in another part of the country I have to find another dentist - tomorrow to be precise as I broke a tooth at the weekend. The best bet I can see from my research is finding a pratise that provides IV sedation but I am scared senseless because no amount of "conscious" seation is going to stop pain if the anesthetics don't work. What can I do?

 

[vicki]

Hi &

Sorry to hear you've had such bad experiences . There are others on here who are or have been in a similar position so they may also be able to share their experiences with you.

I don't know whether you've seen it or not, but there's a page all about not being able to get numb here: https://www.dentalfearcentral.org/fears/not-numb/

Have you contacted any places yet? If you're stuck for ideas you can always check out our database (click on DentistFinder at the top of this page).

You can also post a question in the dentistry questions section and I'm sure Gordon will answer when he's around, or we can move this thread if you like?

Hope this helps

 

[BlueStringPudding]

Hi and thanks for the welcome, Vicki.

I will post a question to the wise Gordon - thanks. Just reading that link you showed me now. It's interesting to hear the suggested cause of "no-numbness". I suspect that as I've experienced the same problem with two very different dentists that I just ain't wired the same as many people (plus newly-acquired nervousness don't help)!

I've found a dentist listed in my hometown that apparently offers IV sedation, so hopefully if they can fit me in they might discuss some of anaesthesia problems with me. I don't know if different anaesthetics are available privately as I've always gone NHS before. However there are no dentists in my area taking on NHS patients any more (that old story!) so it seems as good a time as any to try the debt approach and go private!

I'll post again when I see how it goes tomorrow.

Thanks again.

 

[BlueStringPudding]

In response to my rather worried posting about having to fix my broken tooth when anaesthetic doesn't seem to work on me, I went to the dentist yesterday and didn't have a great time. It wasn't as painful as some experiences I've had but it was by no means pain free. I had hope to have a "success story" to share but unfortunately that wasn't to be the case... again.

I copied my original anaesthesia post over to the Dental Questions section of this forum and am now in discussion with Gordon about my less than successful experience at the dentist yesterday.

 

[janey]

also don't take any form of vitamin C. this makes the novacaine not work. it's happened to me.
janey

 

[BlueStringPudding]

Really? That's interesting - I take high strength multivitamins and have done for years. That's probably not helped at all.

On the plus side, my new dentist found an anaesthetic and means of administering it that does work (viatmin C or no!). I posted it a couple of months ago on the Success Stories part of this forum - for anyone who's experienced similar problems. There is hope!

 

[brit]

Don't see how someone could know for sure that vitamin C was the cause of their problem in not getting numb. Gordon, presumably there's no scientific basis for this suggestion?

 

[Gordon]

Nope, none that I've seen.

 

[brit]

The problem is that local anesthesia simply doesn't get my teeth ...
I would probably do better with nitrous, but my dentist, who has a small practice and office and doesn't really have the setup to do the oxygen and stuff that you have to have while using nitrous, does not use it. ...........

I don't let these fears keep me from going to the dentist when I need to go to the dentist, but as I said, it's like preparing to face the gallows and it shouldn't be like that.

I know this is an old post recently revived but you are quite right it simply shouldn't be like that. I don't understand why you wouldn't immediately seek a different dentist given the problems. A lot has changed in 30 years, he has tried but doesn't have a solution for you....so you owe it to yourself to go elsewhere. Your fear of the pain involved is entirely rational rather than phobic in my view, but I can only imagine you have stayed put out of loyalty...whereas really this dentist of 30 years should have been trying to refer you to someone who could help you more effectively.