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Palatal Block

L

LFDucky007

Junior member
Joined
Feb 20, 2008
Messages
4
I have had difficulty getting numb for dental work for as long as I can remember. My childhood dentist tried many methods: nitrous oxide, multiple Novocaine shots, sand and water abrasions, and even a stabident intraosseous block (NOT recommended!). Obviously, this led to pain, anxiety, fear, panic attacks and avoiding dentists for years. Because of a toothache, I recently went to a dentist for the first time in 6 years, who referred me to a laser dentist. Today, I agreed to a filling on my smallest cavity today using nitrous, novacaine, and the laser (no drill!). He is very familiar with dental fears and did his best to keep me calm, but I was still extremely panicked (shaking, sweating, crying, etc) and was unable to get numb- using the laser instead of the drill was not as painful as before but I still felt everything he was doing and had to endure that 'nails on chalkboard' feeling in my mouth. He thinks my anxiety is metabolizing the anesthetic too quickly and that I have sensitive gums and other areas that are just not getting numb. I have to go back in 2 days for 2 more (deeper) cavities. This time, he wants to try an additional injection in my hard palate to help numb the whole area. Does any one have any comments or advice on this? have you tried this? It sounds like the injection itself can be quite painful and I am worried it won't actually work. As I am sure many of you know, these visits are exhausting and embarrassing, but I can't seem to stop the panic feelings! He even suggest I have a beer (or 2) before the next visit. Thanks for any responses and I will be happy to share more information the laser versus the drill.
 
A dentist will no doubt be along to answer this shortly..in the meantime you may want to browse this link on difficulties with numbing: https://www.dentalfearcentral.org/fears/not-numb/
It covers the main causes and you've already homed in on one of them.

I'm pleased to hear that the dentists you have seen, have tried to solve your problem to some extent and not just suggested you grin and bear it.

It sounds to me that if it is anxiety causing the problem, you'd probably benefit from deeper sedation of some kind; or hypnosis or some other way of training yourself to relax sufficiently for the LA to work.
 
That's the "V2 block". It isn't necessarily more painful than a regular injection and it sounds like your new dentist knows what he's doing. It's not Ashley in San Diego is it?
 
My current (laser) dentist is Dr. Luther in Pittsburgh, PA. My former dentist was Dr. Simpson in Charleston, WV.

Why have none of these techniques worked on me? I think I am going to capable dentist trying many options. Is it just the anxiety?
 
Are you finding it happening with specific teeth or all your teeth in general whether they be top or bottom ones? Some people are more difficult to numb, but usually it's the bottom posterior teeth which are the culprits. Some top posterior molars have very splayed palatal roots from the buccal (outer) ones requiring that the palate be numbed up as well for basic restorative work.

I've also found that people who drink a lot of alcohol have a resistence to anesthetic for some reason. That plus certain drug users/abusers seem to have higher tolerance to anesthetics as well. In other cases, there's no apparent reason why some people have difficulty that I can determine. It might be variance in bone density or accessory innervation or abberant nerve morphology / physiology that could be the cause. :confused:
 
Thanks for your response. I like to have as much information as possible.

I managed to get my final 2 cavities filled! My new dentist does not believe in heavy sedation medications (i.e. valium, halcion) and I don't believe in drinking beer for sedation at 10am.

Our plan of attack was my boyfriend in the room for moral support and comfort, 0.5mg klonopin for anxiety, 1 lortab for pain, and nitrous oxide to the point of the dentist stating "if I turn it any higher, you will stop breathing". I told him this option was acceptable to me, but he was determined to show me I could get numb. Both remaining cavities were between molars. For the top, he used a regular xylocaine injection in the cheek and one one in the hard palate. It did seem to hurt more than other injections, and the feeling of the needle being pushed in was nauseating. But. I was numb! And with the laser on the slower setting, I was able to handle that cavity with minimal sensation. The bottom cavity (again, between two molars), he used another regular placed xylocaine shot and one behind the teeth- he called this a buckle?. I did not get quite as numb as the top, but with focus on staying calm the pain/shaking/sweating/panic was greatly improved. I was even able to sit still and allow the dentist to re-smooth a previous filling.

My jaw hurt last night and today and I am sore at each of the injection sites, but this is normal for me. This week's visits were exhausting and embarrassing, but it was a huge sucess for me to get that numb and make it through the appointment with out crying and wishing awful things on the entire dental office staff. I guess I must be one of those with odd anatomy or extra nerve innervation??
 
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You did it-- way to go!! :jump:

I'm glad to hear that you were able to be made comfortable despite all your past problems with getting numb! Who knows what the reason might be... but regardless, you've made it through it, and now you also know that it's at least possible for a dentist to get you there with the right techniques.

Wishing you a speedy recovery and happy teeth forever!:grouphug:
 
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