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Root Canal - profound anesthesia

F

Fonsini

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Dec 16, 2018
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Usa
I have always been dentist phobic - the problem for many of us is that this leads to more dental problems simply because we don’t go to the dentist, and to some extent that’s me.

I had my first crown 18 months ago after a tooth cracked, and it was a living nightmare for 3 months afterwards with extreme sensitivity to hot and cold, but I lived with it and eventually it settled down. Happy life - until 4 weeks ago when it cracked right down the middle. I went to a new dentist (having recently moved) and when she popped off the old crown she said the tooth “stub” had a cavity and that I should have a root canal as she may expose the nerve when drilling it out. I had an immediate panic attack and nearly vomited, after calming down she told me she would try and just recrown it - which she did. At first it was fine, but now after 3 weeks the tooth has started aching (occasionally) and will throb for an hour after any hot/cold sensation - so a root canal seems likely as I have a hot tooth. The problem is anesthesia, I simply can’t get numb even under normal circumstances, but with a hot tooth and the prospect of something as invasive as a root canal extreme pain seems inevitable. Ideally I would like to be completely unconscious, I know that I will feel this no matter what they do - what are my anesthesia options under these circumstances - please help, I’m terrified and not sure I can face this.
 
Enarete

Enarete

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Hi Fonsini,

sorry to read about your situation. Being properly numb should be the first thing provided for any treatment, no matter if someone is anxious or not. If you are phobic then this is even more important. You might or might not have read it already, but here is a link to an article from our common fears section which you might find helpful: https://www.dentalfearcentral.org/fears/not-numb/
Hope it helps for now until you get a reply from one of our dentists.

All the best wishes
 
Dr. Daniel

Dr. Daniel

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Hi,

Part of clinical excellence is making sure there is no pain for the patient.
Can you tell us: which tooth is it? (upper/lower, front/back)
 
F

Fonsini

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Usa
Hi Dr.

The tooth is one of the larger molars on the lower set on the left side of my mouth, one tooth from the rear of my mouth if that makes sense. Any advice appreciated.
 
Dr. Daniel

Dr. Daniel

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Back lower molars can be more difficult to sufficiently numb for a root canal treatment. A way to avoid pain with these teeth is by search for a dentist who has special technologies for numbing a tooth. Technologies like WAND, Quicksleeper, STA should be provide a completely pain free root canal treatment.
There are other ways to deal with these "difficult" teeth, every dentist has a protocol. You can ask about it.


Hope it helped.
 
Enarete

Enarete

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Fonsini, I am wondering how supportive and mindful your dentist is - would it be possible and helpful for you to have a profound chat with your dentist about your numbing issue and let her explain to you which precautions she will take to make sure you will be really numb and also, what would you do if you find out that the treatment is not painfree? Rereading your post I feel it might help and reassure you. Also noticing pain during a treatment (and using a stop sign to have the dentist stop immediately) is one thing but in the end it's all about how will your dentist react if this happens. Just going on with the treatment certainly wouldn't be an option so having a real 'plan' of action for every case might be a good idea. Another option would be to find a dentist who has experiences with hard-to-numb patients or as Dr.Daniel suggests, uses special tools. If I were in your shoes, I wouldn't go into any treatment before feeling absolutely confident about what exactly is planned.
 
M

MountainMama

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I hope your dentist can help you find a solution. Have you ever been able to get numb at all? I have always had difficulty getting numb, and had some terrible eperiences with tooth extractions as a child, and a few fillings as an adult that were painful.

I had my first root canal this summer, and I was terrified! I made sure the endodontist knew I had a history of difficulty getting numb. She gave me extra anesthesia, and I also opted for laughing gas, which helps you relax so that the anesthetic can work.

She did end up having to give me twice as many shots, but thoroughly tested my tooth before drilling. She also said that if I felt anything when drilling, she could give me a shot directly into the nerve, which would completely numb it.

It went better than I thought. The laughing gas helped a lot!
 
F

Fonsini

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Thanks all - you guys are very supportive. As of right now the inflamed (newly crowned) tooth has calmed down, and I’m confident that the immediate problem has passed, but I know that I will need a root canal eventually so I am still preparing. I have never been fully numb, numb enough to be comfortable yes, but any drilling directly into the center of a rear molar inevitably causes me pain even after 3 novacaine injections and has given me a severe dental phobia. Some of the numbing procedures mentioned above involve injections directly into the jawbone which itself sounds nightmarish. When I was a child they used to put me completely under with some type of gas, and I would come around with no memory of the procedure and zero pain - my manager at work claims that nitrous oxide knocks him completely unconscious so maybe it’s that ? This always worked perfectly for me, and I think the best option for me personally is a combination of Vicodin and nitrous oxide (sedation therapy) and a lot of Novacaine at least that’s my plan. But general anesthesia is my goal. To make matters worse one of my female colleagues had dental implants one morning this week, and was in the office working by 11am, albeit with swollen cheeks packed with gauze. I had always hoped that modern dentistry and analgesia would have advanced by the time I reached my current age, but for me at least it seems to have gone backwards.

Thank you all so much for your kindness, it means a lot.
 
M

MountainMama

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Thanks all - you guys are very supportive. As of right now the inflamed (newly crowned) tooth has calmed down, and I’m confident that the immediate problem has passed, but I know that I will need a root canal eventually so I am still preparing. I have never been fully numb, numb enough to be comfortable yes, but any drilling directly into the center of a rear molar inevitably causes me pain even after 3 novacaine injections and has given me a severe dental phobia. Some of the numbing procedures mentioned above involve injections directly into the jawbone which itself sounds nightmarish. When I was a child they used to put me completely under with some type of gas, and I would come around with no memory of the procedure and zero pain - my manager at work claims that nitrous oxide knocks him completely unconscious so maybe it’s that ? This always worked perfectly for me, and I think the best option for me personally is a combination of Vicodin and nitrous oxide (sedation therapy) and a lot of Novacaine at least that’s my plan. But general anesthesia is my goal. To make matters worse one of my female colleagues had dental implants one morning this week, and was in the office working by 11am, albeit with swollen cheeks packed with gauze. I had always hoped that modern dentistry and analgesia would have advanced by the time I reached my current age, but for me at least it seems to have gone backwards.

Thank you all so much for your kindness, it means a lot.
Nitrous oxide (laughing gas) can be turned up or down. When I had the first part of my root canal, they put me on a higher titration, and I was out of it completely. I don't remember much other than the endodontist saying that she was into the nerve. Then she turned it down to where I was aware but loopy feeling.

I had to have a total of 5 shots to get numb. She did 3 originally, then tapped on my tooth. I had delayed pain, after a few seconds, so she gave me 2 more, then turned up the nitrous and told me to raise my hand if I felt any pain and she would stop.
 
F

Fonsini

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Thanks MountainMama that’s where I am at as well in terms of my “pain plan”.
 
M

MountainMama

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Thanks MountainMama that’s where I am at as well in terms of my “pain plan”.
I hope you don't need the root canal for awhile, but I am glad you have a plan. It is awful not being able to get numb. Especially when it feels like you are numb, but when they start working and you feel it!
 
K

Kns

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I have had similar experiences not getting fully numb suring work on my lower back teeth. Amd staying numb. I had three root canals in the past year and a half on lower molars. The two lower second molars were hard to numb. I was completely fat-lipped numb everywhere but the tooth. However, both endodontists I went to then used an intraosseous injection (xtip and stabident?). It sounds worse than it is. They drill into the side of your bone by the tooth and put in a catheter to place lidocaine. It helped tremendously and they could add more easily (without more needles), if I needed it. It saved me from having a terrible experience! I would highly recommend it. If you’re honest and upfront with the endodontist they will be able to help and make sure you are profoundly numb. I have always heard anxiety works against the numbing, so maybe that Vicodin will help too. I have been too afraid to try nitrous or oral or IV sedation. I would recommend mot delaying treatment (even though the instinct, being scared, is to avoid it as long as possible) because if your tooth is calm, it will be easier to numb. Good luck! You can do this! I know from experience how terrifying it feels. Take care!
 
Dr. Daniel

Dr. Daniel

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Some of the numbing procedures mentioned above involve injections directly into the jawbone which itself sounds nightmarish.
I know, it sounds scary but in fact there are no nerves in the bone so there is no issue from that sense.

As of right now the inflamed (newly crowned) tooth has calmed down, and I’m confident that the immediate problem has passed, but I know that I will need a root canal eventually so I am still preparing.
If the tooth is now no longer alive (necrotic) then numbing it well is much much easier.
 
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F

Fonsini

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Usa
Resolution !!

I switched dentists and my new dentist is not a believer in unnecessary root canals. He diagnosed a loose fitting crown and sure enough it popped right off. He advised me that any crown which moves under bite pressure will typically cause tooth pain.

He tried me with a temporary bonding agent first and there was zero pain after 4 months of agony, yesterday the crown was re-bonded permanently and it is PERFECT - I could chew on a rock without any pain whatsoever. Crisis averted and a pain free life has been restored, I am literally doing backflips. The best part - after the nightmare I have been through with the other dentist he refused to charge me !!
 
Enarete

Enarete

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Wow, this is amazing to read! :jump::jump::jump:
Congrats on having found a dentist who can help you.

Another story that confirms that having the right dentist is everything.
 
krlovesherkids777

krlovesherkids777

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:wow:Wow. Fonsini this is SO great to hear, this new dentist sounds great! like a keeper for sure! Amazing what a difference it can make to be with the right dentist ! So happy for you!!
 
F

Fonsini

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Usa
You guys are the best, you were all very supportive through this nightmare and for that I thank you. I’m sure I will still face other dental challenges as I grow older and things start wearing out, but for now I’m just taking a moment to realize how precious life is especially when it is lived without pain. Champagne is being opened tonight - seriously, you have no idea the difference this has made to me and my quality of life.
 
C

comfortdentist

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Okay Now don't change dentists. You have found an exceptional one so stay faithful even if there is an insurance issue as doing the right thing is always cheaper in the long run
 
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