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Terrified of being numbed up and getting a crown

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silvercat

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Hi I'm new here and really really need some adivce. I have a right 2nd back molar with a large silver filling taking up the back thrid of the tooth the tooth has also been filled on both sides. 4 years ago the inside back corner broke off when I bit something hard my dentist just smoothed the sharp edge and said it was ok. All X rays that have been taken have always shown the tooth to be ok and Ive never suffered any major pain from it just some sensitivity. Then last week I bit a bone and a tiny piece on the front right edge broke off. Again I went to the dentist and she smoothed the sharp edge down but this time she just sprang it on me that I needed a crown.

I suffer from extreme anxiety and this has set me off on a total panic for the last four days (so bad I can't sleep properly and am anxious constantly). I am absolutely terrified and I mean terrified of having to go through this procedure. I hate being numbed up don't know why as Im not scared of needles (at the doc I watch them put the needle into my arm and draw the blood) it's the numb feeling freaks me out. For the last 20 years all fillings etc I have had done have been done without being numbed up I prefer to have the pain than being numbed up but I fear this procedure may require me to be numbed. I am also terrified of having medications put into me for fear of a reaction or side effects. Dr goggle has made this a horror story for me as I have read on google reports of people getting occular complications from local anaesthetics and even loosing their sight so this has got me even more uptight. I am also on fluoxetine proprananol and valium for my anxiety and depression so this is also concerning me (worried about drug interactions).

The tooth is intact apart from the two bits that have broken off and has no visable cracks in it what Im wondering is do I really need a crown or not. Im feared that when the dentist drills it it causes irepearable damage to the tooth or may cause me to need a root canal at some point. Im basicallly virtuallly suicidal with the stress the whole situation is causing me I've had a very bad year with many up and down spells of increased anxiety and depression and this has sent me over the edge again.

Any advice about my fears of the anaesthetic and the procedures invloved will be greatly appreciated as I have literally never been so scared of anything in my life before. I cannot over empahsize how terrified I am of the whole thing the anaesthetic the procedure etc
Thanks Owain
 
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letsconnect

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Hi Owain,

so sorry to hear about the horror stories that Dr Google throws up! I'm sure our own forum is not entirely innocent - after all, this is where people come to post when things go wrong for them. So you get to hear the rare freak occurrences and horror stories that might happen to a dentist once in a lifetime (or never), but not the positive everyday stories!

In reality, local anaesthetics nowadays are really safe (otherwise, they'd make you sign a disclaimer before having local anaesthesia :)). Just think of how many people have local anaesthetics at the dentist's each day, and how exceedingly rare the freak occurrences are...

I'm not a dentist, so I can't tell you about drug interactions, but maybe one of our dentists can answer your question about fluoxetine propranolol! Valium certainly doesn't interact with local anaesthesia - in fact, it's routinely used as a premedication (even though temazepam is a much better choice for that purpose due to its short half-life and fast onset).

You're also not alone in your fear of feeling numb. We've got a whole page dedicated to that very topic, in case you haven't come across it yet:


Is there anything in particular about the numb sensation that terrifies you?
 
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S

silvercat

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Thanks for the reply I can't put my finger on it. I can only put it down to a horrendous wisdom tooth . extraction I had done when I was 24. It was done while I was awake and it was a absolute nightmare I just have vivid memories of this huge needle being stuck in the back of my mouth which was very painful then the actual extraction took ages the dentist ended up needing to put his knee on my chest to get enough force to pull it out. Needless to say the other wisdom teeth were done under a general. Ever since that experience Ive opted for fillings without numbing and to be honest the few mins of pain for me is far preferable to the felling of being numb for ages.

I don't have a fear of the dentist I go regulary and as said get fillings without being numbed. So I can't say I have a dental phobia it is more a phobia of taking medications I have thats why im so worried about the anaesthestic. Also because of my mental state at the moment Im more susceptible to worry and stress which is not helping. Im just scared Im going to freak out and feared of worrying about any side effects after Ive left the dentist as I know my mind will be in overdrive and Im scared of it triggering another severe anxious episode.
 
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letsconnect

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Hopefully a dentist will be along over the next couple of days to address your concerns (I've merged your original thread in the Support section with the one you posted here, to make things a bit easier with all the additional info you've provided)...

Not sure if you've had a chance to look at the link I posted yet, but I'd guess that the numbing needed for a crown on an upper molar is quite different from the wisdom tooth you had removed. There's probably no comparison. Perhaps a dentist can chime in on this one :) .

I see from your profile that you're in Edinburgh... just in case you're interested, Fraser Hendrie has helped some other people here who had very similar fears, he's at Craigentinny Dental Care and by all accounts he's really excellent in such situations. I think he's private only though. Here's a link: https://www.craigentinny.co.uk/meet-the-team/
 
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silvercat

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Hi thanks again it is a lower molar not upper molar the crown has been suggested for. I have no idea if this will make any difference to the numbing process.
 
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letsconnect

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I've heard that there are some ways of only numbing a small area even when it's lower molars by using different techniques and/or equipment, so it's something that you could talk about with your dentist in case they can offer this.

Have you had side effects from the local anaesthetic on previous occasions (apart from the numbness of course)?
 
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silvercat

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Hi No I've never had any side effects from a local but am on a small dose of proprananol 20mg a day so I maybe need an adrenaline free one. I had my appointment today with my dentist today she has been my dentisit for over 6 years. I thought she was nice unitl today she was rude abnoxious and had zero time for trying to calm my nerves or explain anything to me. She just wanted to rush into the procedure and had no time to allow me to ask questions or talk about the procedure. Then she said to me that she would refuse to give me another appointment on the same tooth as I had refused her advice then basicallly told me to leave. It was my worse experience with a dentist ever. I left the surgery in a completley stunned state at how I was treated.
 
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letsconnect

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Yeah, using a local anaesthetic without epi sounds like a good idea, just to be on the safe side? I can't really see that being a problem (maybe @Gordon or @drhirst or someone else in the know might be able to confirm).

So, so sorry to hear about your appointment yesterday, that sounds awful, made even worse by the fact that it was so unexpected :(. Have you thought about switching dentists? We have a section with dentist recommendations for Scotland here:

 
Gordon

Gordon

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No, you don't need an adrenaline free local because of the Propranolol, having said that, it's easy enough to use an adr. free local if you asked for it but you don't need to.
 
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silvercat

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@letsconnect Hi thanks I have tried Craigentinny but they are so popular Fraser is booked until October so no good for me. My Girlfreind and kids recently changed to Slateford dental practice (who also get great reviews) I phoned them today and despite not having any free slots the Dentist that sees them has agreed to see me tomorrow. Initialy they booked me with a different dentist but phoned me back to say they had had a chat with my Familys dentist and he said wanted to see me. Pretty good level of service from a surgery Ive never even been to before I reckon. My old dentisit has recently become the sole director of the surgery they use agency dental nurses who are diff every time you go, she got rid of the hygenist. Its like she is trying to cut costs everywhere and run a solo ship. I'm not confident that she has gone in the right direction.
 
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letsconnect

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@silvercat that's great news (not about Fraser being booked until October, but about your girlfriend's dentist agreeing to see you at such short notice!).

Please let us know how it goes tomorrow?
 
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silvercat

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Not so well its left me even more confused. According to the new detist I need £2000 worth of work done. This dentist has a fancy camera that takes pics of your teeth so he showed me the areas of concern and I could clearly see the areas that need the work. The problem is my old detist has constantly said for years that my teeth are fine apart from the one that needs the crown. 4 of the teeth in question are teeth that I had fillings in that then fell out. They had been refilled twice by my old dentist and kept falling out, she said it was down to the way I was brushing my teeth and that there was no point refilling them. She now says the have reminerlised and don't need filling although they are very very dark brown (they are on the outside roots below a normal gum line I have receding gums) I mean is this true can previously filled teeth not need filling and reminerlise. She said that refilling them weakens the tooth every time it is done so its best to not to refill them? He also showed me two other areas of concern that he said need filled my old dentist has never even mentioned them to me again though he showed me them clearly on the pics. Im just so confused now I dont know if this new dentist is just trying to get cash out of me by suggesting work that my old dentist has said does not need done. My head is a mess Im just super stressed now and don't know what to do
 
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silvercat

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@Gordon Hi thanks for the reply can you explain why I dont need an adrenaline free local as I have read that a local with adrenaline in it is dangerous for peolpe on proprananol as it can cause high blood pressure and bradycardia. I am very very concerned about this it is my main cause of concern.

I am also concerned about the possibilty of occular side effects of locals (Dr google Im afraid it has scared me witless) there are stories of people loosing their vision temporarily and even permanently after having dental locals. Im reallly really stressed about these two isssues, they are entirely preventing me from getting the treatment I know I need the teeth will just get worse.
 
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Thanks for reporting back! Sorry to hear that today's visit has left you even more confused :( . From your description, the dentist today sounds a lot more credible than your previous dentist (probably not what you wanted to hear!). I doubt that he's just trying to get cash out of you.

If you are in any doubt though and you'd like a third opinion, maybe you could ask the new dentist for the photos he was showing you and post them here (or pm @Gordon with them if you don't want to make them public). Hopefully, Gordon will also be able to answer your other questions regarding proporananol and ocular side effects :)!

How did you get on with the new dentist apart from that? Did you get a chance to voice your concerns today? Must have been quite difficult with all those unexpected things being sprung on you.
 
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silvercat

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I was there for a full hour which is much much longer than my old dentist ever gave me. He also recommended that I see the hygenist every 3 months. Now I thought my previous dentisist was doing that Job as she got rid of her hygenist and the surgery no longer has one. However on investigation online as to what a proper scale and polish involves she never even came close to providing that. She would pick for a few sceonds around the gums then polish my teeth for prob no longer than a few seconds that was it. A full check up and her scale and polish would last 10-15 mins at most.
 
Gordon

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@Gordon Hi thanks for the reply can you explain why I dont need an adrenaline free local as I have read that a local with adrenaline in it is dangerous for peolpe on proprananol as it can cause high blood pressure and bradycardia. I am very very concerned about this it is my main cause of concern.

Can I ask where you're finding this? It's very, very out of date information. As in, I was taught it as a student back in the 70s but it's not applied since at least the late 80s.

Basically the quantity of adrenaline in the local is so small that it's irrelevant compared to the amount that your own adrenal glands can pump out.

I think I've answered the point about occular issues in the other thread you've started.
 
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silvercat

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This article also scared me It would be great if you could offer some comment after reading it thanks

Unilateral Vision Loss after a Dental Visit on karger.com​

 
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silvercat

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Hi sorry Gordon I forgot to ask do you think a crown prep can be done without local my old dentist was willing to try it without the new one I went to see said he would feel uneasy about doing it this way. Thanks
 
Gordon

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I really don't like doing precise work like a crown prep on a patient who might "jump" at the worst possible time and wreck my work :(
I've done it a few times and it's very stressful (on me!). It's something you and your dentist would need to agree together.
This article also scared me It would be great if you could offer some comment after reading it thanks
Sounds like the dentist managed to inject some local very near to the eye's blood supply and the resulting spasm in the artery has caused the problem. You'll have read that it cleared spontaneously fairly quickly afterwards.
Most likely thing is that the dentist was trying to do a fairly tricky advanced LA technique called an infra-orbital block, your average GP dentist will NOT be attempting one of those!
 
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