April 2021 - Kentucky Dental Group

Can you help me? I have never had a dental procedure where Novocain worked for me. This is true no matter how many shots they give me. Because of this, all my dental procedures have been excruciating. It is to the point where I only go if there is no other choice because of a tooth infection. My mouth is a wreck as a result. Is there any hope I can have a healthy smile?

Mandy

Dear Mandy,

I am so sorry for all you have been through. The fact that you are trying to get to the dentist again says a lot about your courage. I also feel confident I can help you.

There is a phenomenon that many dentists are still unaware of that pertains to this very issue. We have found there is a connection between dental anxiety and Novocaine resistance. In other words, the more anxious a patient is going in to a procedure, the higher the likelihood the Novocaine will not work for them. We’re not certain as to why. Some speculate it is a metabolism issue, meaning that your metabolism jumps up during anxiety which in turn burns off the numbing medication too quickly for it to be effective.

The solution is to go to a dentist who is willing to use a relaxant, such as you’d find with dental sedation. I suggest you do an internet search for a sedation dentist. In your case, I would specifically look for one who offers oral conscious sedation.

This is so strong that most patients sleep through their procedures. The only real downside is you will need someone to drive you to and from your appointment as well as stay with you at home for a few hours until you are lucid and steady on your feet again.

In addition to giving you a completely relaxed experience at the dentist, it will also allow you to catch up on your needed dental work much faster because you are able to have more procedures done at each appointment. Before you know it, you will have a healthy, beautiful smile once more with no more dental emergencies.

This blog is brought to you by Lexington, KY Dentist Dr. Weaver.

My six year old daughter has decay on two of her back molars. The dentist is being a bit rude and wants them extracted immediately, but they are baby teeth. Why is that the right choice? Won’t they just come out? Why pay to pull it?

Sara

Dear Sara,

There are a few things going on here. First, I will say I am sorry your daughter’s dentist was rude. I wasn’t there and don’t know your dentist, but is it possible it was more urgency that came across as rude? It is unusual for a children’s dentist to recommend that a back molar be extracted on a child that age. You mention decay. I wonder if that decay had turned into an infection. I know it is a baby tooth and they do come out, however back teeth are different for reasons we’ll go over in a moment.

Bear in mind, I have not examined your daughter, but here are some possibilities and what to do about them.

1. The teeth are deeply decayed and they going to break and lead to infection. If there is enough of the tooth left to save some of it, you could do a pulpotomy and place a dental crown on it. A pulpotomy is simply a child’s version of a root canal treatment.

You mentioned that their teeth come out. So you are likely now wondering why do a pulpotomy when you can just get rid of the tooth? While it is fine for most baby teeth to be removed prematurely, the back molars need to stay in place until she is twelve years old, when her next set of molars typically come in. In a six year span, her other teeth will drift toward the empty space, then when her adult molars finally do come in, there will not be space for them and it will turn into a crowding problem that needs orthodontics to fix. Getting the crown, will preserve that position so the adult teeth can come into the right place.

2. The tooth is already infected beyond what a pulpotomy can help. Tooth infections are considered dental emergencies. This is because the antibiotics cannot “treat” the infection only hold it back temporarily. If a dentist doesn’t get in there and remove the infected pulp, the infection will spread. Think about how close your daughter’s jaw is to her heart, lungs, and brain. Sadly, people still die of tooth infections, even though it is completely treatable.

If her decay and infection have progressed, then even though it is a molar the tooth will have to be extracted. If that happens, make sure to get a space maintainer. This is a device they can place which will keep the space protected so there won’t be crowding.

Because your daughter is likely already in some pain and you don’t want it to be a traumatic situation for her that makes her afraid of dentists for the remainder of her life, I recommend you go to someone who uses dental sedation. This way it will be an anxiety-free/pain-free experience for her.

This blog is brought to you by Lexington, KY Dentist Dr. Weaver.

Novocaine Doesn’t Work for Me

Why Extract Baby Teeth

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