Terrified, bottom molar won’t numb for extraction

[Audreyteddy]

I’m so anxious, I wanted to ask about iv sedation for tooth extraction. Molar 6 I believe. I’m due to go to Liverpool Dental hospital for extraction as the tooth won’t numb for root canal treatment. They said they wouldn’t do General A without trying iv sedation first. The thing is, the local anaesthetic hasn’t worked in the past hense the situation I’m in so I’m terrified that I’m going to feel the extraction, even if I’m drowsy, surely that pain would be felt?. If the area would numb I would be ok but knowing they’re relying on the sedation for the procedure to go ahead is worrying me. I’m sure they’ll try to numb it but that’s failed previously. I had to have the same tooth on the opposite side extracted under GA as a private patient last year. I have mild pain in the tooth now, worse lately, so don’t want to leave things too long. Can you tell me if the iv sedation will block the pain? Genuinely terrified here

 

[Dr. Daniel]

Hi,

It is a known clinical problem: difficulty numbing lower molars for root canal treatments (there are ways to overcome this problem). Surprisingly, there is no problem numbing these teeth for a tooth extraction.

 

[Gordon]

In addition, Local anaesthetic works much better with IV sedation. It's because you're relaxed, your BP is right down and the pulse is slow, so the anaesthetic has a chance to work before it's flushed away by the blood stream.

 

[comfortdentist]

and I third the above by adding those dentists who offer IV sedation generally are among the best in obtaining excellent anesthesia as they are accustom to patients who are more sensitive often because they are harder to get numb.

 

[Aurora10]

Hi,

It is a known clinical problem: difficulty numbing lower molars for root canal treatments (there are ways to overcome this problem). Surprisingly, there is no problem numbing these teeth for a tooth extraction.

That’s very interesting as I had the same issue while having a lower molar root-filled, in fact I lost the sight in one of my eyes for a few minutes after the LA was given, which made my dentist shake and offer to stop treatment but I just wanted to get it over with so he went ahead. I now have to have it removed and have an implanted placed so we are doing that under IV and I was really worried that I would feel it so your post really reassured me, thanks!

 

[Aurora10]

In addition, Local anaesthetic works much better with IV sedation. It's because you're relaxed, your BP is right down and the pulse is slow, so the anaesthetic has a chance to work before it's flushed away by the blood stream.

Gordon,
Can you please tell me why I felt the LA going in when under IV sedation last year? I don’t numb up easily and my dentist and I agreed that sedation was the way to go. Over here in Canada they use fetanyl and midazolam and they say you don’t feel a thing and I didn’t-apart from the needle when the LA went in. Usually my dentist puts the numbing gel on before he starts but he wanted to make sure I wasn’t too far ‘under’ sedation so he omitted to use the gel.
I may be missing something obvious here?
Thank you!

 

[Gordon]

Yes you probably weren't sedated enough if you actually remember it. I'm not sure about the rationale for avoiding the surface anaesthetic either, which leads back to my first point...