dentist trouble with numbing injections--- do you get this?

Question

when i have a tooth out or filling and the dentist numbs my mouth, it never numbs straight away even after 15 to 20 mins waiting and sometimes the dentist has to stop and give me more numbing injections.

does anyone else have a high tolerance like this? im starting to dread the dentist because i know these injections have trouble working on me.

why does it do this and can i ask to be put to sleep in future?

Answer 1

I had 3 fillings yesterday and was in the chair a whole hour waiting for the numbing and after about 7 injections I was shaking cos of the pain. I know you can have anaesthetic if you have a tooth out, but I'm not sure about fillings. But I sympathise with you about the pain and dread!!!

Answer 2

Some people just take longer to get numb. If it is a lower block injection, I admit that I may not have found the landmark, which is extremely well-hidden in some people. We jus tgo for a second shot and it is easier to probe for theproper landmarks when you are numb back at the injection site.

I've got some patients who take extra long to get numb with the "easy" shots also, so I concluded that some people just take longer.

There are some modern concepts about the anatomy of the innervation of the lower jaw that your dentist might not be up on. How can you tell him to take a class on injections, though?

Answer 3

It is not due to a "high tolerance" to local anaesthetic (LA). You are no different to anyone else. You don't need to be put to sleep.
Most upper injections work very easily. It is usually the lower injections (a "block") where there can be failures. If the dentist has injected well, then you should have an effect coming on within 3 minutes in your lower lip. A 2nd dose of LA before starting is not uncommon, but more than this becomes questionable. There is a limit to the amount of LA that can be given, as there are toxic effects at high levels.
Most dentists use lignocaine with adrenaline. I don't know brand names in the US, so will talk generically. This has been the "gold standard" for many years, and works very well.
Another LA is articaine, which supposedly works better, but in my experience there is no difference in overall effect. Part of its alleged better effects are probably due to its concentration - it is a 4% solution, twice that of lignocaine at 2%. Therefore a cartridge of articaine is a double cartridge of lignocaine. So you have to halve the maximum dose allowable.
Personally, I would change dentists. He seems to need a refresher course in anatomy. Ask friends and relatives for recommendations.
P.S. Thank you Dr Sam (below). In Australia "lignocaine" is the generic name. Our available brand names are Xylocaine, Nurocaine, or Lignospan. This prompted me to look up on the web, where according to Wikipedia, lignocaine is the British Approved Name which has passed to Oz as part of our historical connections, whereas lidocaine is the International Name. Another bit of trivia I now know. Cheers!

Answer 4

this can be because the dentist doesn't reach the "longbuckle nerve" initially. This nerve can be difficult to find sometimes and can be the reason for multiple injections. If the nerve agent is injected around this nerve, instead of into it, it can result in no numbing at all or only partial numbing. It is often very common for there to be a need for additional injections as the procedure goes on. You can be asked to be put to sleep but your health insurance may not cover this.

Answer 5

Hi - I had a similar problem a few months ago. Basically there are two nerves in your mouth - the main one, which is numbed by and injection under your tongue, and another one which needs to injected on the outside of your gums - near your cheek. Make sure the dentist injects both of these nerves and you shouldn't feel a thing!

Answer 6

Some people need more Novocain inj. Some dentists don't get it in the right spot. I have a Friend who goes on Valium a half hour before every dental appt. You need to speak up because I avoid the dentist because of the pain. It does not need to be painful. Not in this day and age. Some dentists I think, think if it is painful you will take better care of your teeth. Well I can tell you from experience it works just the opposite with me.

Answer 7

Yes have this problem all the time and have been in agony on a few occassions.
Have recently found a new dentist who said my body metabolizes it faster than normal so wears off quickly or needs more to numb it up speak to your dentist about this.

Answer 8

I do. I sometimes take two or three injections to get numb. The nice thing is I'm partially numb already, so I don't feel them as much. The numbing shots are the worst part of the dental experience for me.

You can ask to be knocked out, but it's very dangerous and expensive. They normally don't do it for general dentistry, just extractions. You can also ask for nitrous, which is *very* relaxing and not as expensive.

Answer 9

Sometimes people just need more and it has nothing to do with your dentist. If you know that you take more to get numb, tell them that! When I have a patient that says that they have trouble getting numb, we ALWAYS give an extra dose right away. No biggie.

Answer 10

ask for septocaine. i never, ever have to give a second injection. it costs the dentist a little less to use the cheap stuff that doesn't always work the first time. it has nothing to do with tolerance. either it's cheap anesthetic or your dentist needs to do a little head and neck anatomy review.

going to sleep for procedures cost a minimum of $400 so i wouldn't advise that.