need crown, implant ..don't get numb. nitrous?

[roy]

Need a crown on lower molar. Dentist warned it could require root canal. I endured an emergency pulpectomy about a dozen years ago and the pain was off the charts, so had it extracted. I expect i would do the same with this upcoming crown if it came to that. Would also like to get an implant for that empty spot (lower molar on opposite side that needs the crown). My problem is in my 50 years or so as a dental patient (half a dozen dentists), I have only been numb once ...during most recent crown when I went to a dentist that does IV sedation. I was completely awake during the procedure and only sensed the vibration of the drill and absolutely no pain. He claimed afterward that the sedation was only to relax and that the numbing was due to the local. I think he may also have been the only dentist I've ever went to that was familiar with some of the advanced local anesthetic techniques as described on this site. Unfortunately I am not currently near him or any dentist that does IV sedation. 2 questions:
1. What is the pain of an implant, relative to say a crown?
2. Would nitrous help in my case?
Thx

 

[FearfulInMA]

I'm sorry that I don't have an answer to either of your questions, but I'm wondering if the dentist who was able to numb you might be able to refer you to someone with similar skills where you are now?

 

[Shadsie]

I have no answer for this, but now want to watch this thread because it may help a friend of mine.

I have a friend that, due to her genetics, doesn't get numb. She has been able to get work done anyway because, as she puts it, she has the psychological reaction of "locking up" in the face of pain. As someone with a HIGH fight-or-flight trigger, I can't even imagine this - being able to lock up and let pain happen. Her teeth are currently healthy, but she has been looking into I.V. sedation if she can get it as a possibility for any future problems. I am interested in hearing how stories of that go for her sake, even though unlike me, this friend is brave as Hell and says "she'll deal with any pain when it comes."

 

[gentledental]

Getting numb for an implant is different versus a tooth. The bone has no nerve endings so you only numb the gum and you will not feel pain when the bone is being drilled.
When working with teeth only, some patients find it hard to numb up the lower back teeth and that is due to anatomical differences.

Again sedation does not knock you out. It is there to make you feel very relaxed, however the side effects makes you forget the experience and hence some people think they have been put to sleep.

Patients are not in pain during the procedure when they are fully numbed up. There might be some pain and discomfort after the numbness have worn off but it shouldn't be severe like toothache.

We normally perform this procedure under IV rather than nitrous purely because the nitrous mask gets in the way when we are performing surgery.

 

[roy]

Thanks for the info re no nerve endings in the jaw. I have not read that until now, despite several google attempts. You have given me the courage to try this! (the implant)

For the crown and its potential root canal, I am still looking for a dentist that can accommodate me so may have to travel a bit. After experiencing a pain-free crown a few years ago, I have decided I can't go back to the same-old same-old.

Thx for all replies...will keep everyone updated.

 

[roy]

Regarding previous suggestion to get referral from previous dentist ...he is in London Ontario Canada (Dr Gabriel Lacombe .. only had 1 full crown by him 6 years ago, but highly recommend). I am now in Chiang Mai Thailand.

So I went to see an implant dentist. I explained my history re anesthetic failure and was looking for his reassurance that this would be fairly painless as the jaw has no nerve endings, but he was not quite as confident as gentledental and would only say it was about the same as an extraction and would stop the procedure at no cost if needed. I recall my extraction was relatively uneventful so I went ahead and booked the appt.

Well I have to say I wish I had done this years ago. Absolutely no pain during or 24+ hours since the procedure, and no swelling to speak of. I have a palpable lump where he did the bone graft. Haven't touched the pain meds but taking anti-biotics and anti-inflammatories as prescribed. I should point out that I have never had a problem with soft tissues going numb, just upper and lower back teeth from pre-molars back (never had front teeth worked on). I suspect he gave me a lot of anesthetic since i couldn't sleep a wink last nite (adrenaline). Didn't help that I had a late day appt.

I go back to see him in a few days for a quick look-see...will also get his thoughts re the crown and possible root canal I need for my other lower molar.

 

[roy]

Finally got my full crown done and was lucky enough to avoid the root canal. Also got another molar fixed up with an on-lay. Went to a clinic that had IV sedation, but the German trained dentist suggested he try to numb me first and if unsuccessful, would re-book with the anesthetist. Well, he had no problem numbing me completely 4 times (2 teeth X 2 appts). I asked him how he did it and for any words of advice I could pass on to future dentists but he was not able to tell me anything specific. He does a lot of root canal work and so I wonder if in the future I should try to find someone who does a lot of RCT or a large practice with an endodontist on staff.