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#1
Old 02-22-2015, 02:33 AM
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Join Date: Jun 2003
Location: Indiana
Posts: 1,197
So...how many shots of novocaine?

All right, so this past Thursday I finally went in to get this lost filling in a molar tended to. Turns out I waited a leetle too long and I now need a crown. Of course, that's a send-out and I will just get prepped and a temporary crown installed till next month....

It took (I believe) 6 shots of Novocaine to numb me up sufficiently, over the course of an hour and a half. Plus, apparently they are now putting epinephrine in those shots (thanks for not warning me thought I was having a heart attack). Still hurt for the drillings a bit and I ended up getting another two shots before we were through. Now, a few days later, I have an ear infection (the earliest shots inflamed my ear and my eye on that side), and my jaw is so swollen I have a weird underbite. Additionally, I'm afraid that the crown will be as ill-formed as the temporary, since I was (eventually) so numb I couldn't tell if she had shaved down enough for a proper bite--that's the worst part of this. I'll get the real crown on in a few weeks.

Also, probably unrelated...probably...I've been vomiting and haven't kept anything but a solitary bowl of soup (and a couple toddies) down since then. Urgh.

Sigh. So is this par for the course for modern dentistry, or are my nerves in the wrong place for normal anesthesia, or...what? This is totally outside my experience.

Or, if you just have some fun rants about the dentist, I'm all ears.
#2
Old 02-22-2015, 08:56 AM
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Location: Back in the South, y'all
Posts: 6,947
It depends what tooth they're working on for me. A year and a half ago, I had a cracked tooth crowned (though not root canaled), and that sucker was tough to numb. It took:

3 regular shots. Not numbed. At all.
1 or 2 where they went into a specific spot in my jar. Lightly numbed.
What they called an "intraligamental block" where he had to put something at the 4 corners of my tooth. I felt nothing. For quite some time.

Back in November, same tooth was root canaled because the nerve went necrotic. I had far less numbing for that - I think it was 3 shots total (and I hate the epinephrine too - endodontist used it while my regular dentist didn't. I think it's supposed to cut down on blood flow in the area. It makes me super shaky and heart racy).

For a regular filing on a non-molar tooth? One, maybe two shots. On a molar, two, maybe three.
#3
Old 02-22-2015, 09:34 AM
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Location: I am Queens Boulevard
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I'm very hard to numb. Six shots of novocaine wouldn't be unusual for me at all. It's also true that the back is harder to numb. I think the nerves are in there deeper.

And it's not just dentistry. I cut two fingers requiring a total of six stitches. Three shots of lidocaine for each finger. Each of which hurt like a motherfucker going in. The doctor kept saying, "no, really, you can FEEL that?" while I'm going "YES. YES I CAN. OUCH".

They're putting adrenalin in local now? At least one dentist has previously told me adrenalin makes your body clear numbing agents faster (he was explaining why numbing wore off halfway into a procedure).
#4
Old 02-22-2015, 10:14 AM
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Join Date: Jul 2007
Location: Southwestern PA
Posts: 12,976
I had to have one of the more front teeth worked on and I was 4 shots in before the doc even started. He had to add another. Back teeth its hard to say; me being me he usually goes straight to IV sedation for anything extensive back there.
#5
Old 02-22-2015, 10:19 AM
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Join Date: May 2000
Location: SW Side, Chicago
Posts: 44,458
I'm visiting my dentist for the third time this week for a crown since they can't get me lidocained up enough to do work. even brought in an endodontist for my last visit and there's just a rogue nerve he can't freeze. Except for my wisdom tooth in the same area, I've never had this problem before (though that time the oral surgeon did manage to get me numb enough.) It's really annoying. They're having me take some steroids the day of my appointment, hoping it will help. It's not like I'm particularly nervous or have any fear of dentistry (although these experiences are starting to.) I was perfectly relaxed the last appointment and at least this time they did a cold swab test on my tooth to see if the nerve was number instead of drilling into it like they did last time. (Not that the pain is much better, but it's more comforting not to suddenly twitch when a drill is in your mouth.) And it's not just a little pain that I could power through. It's deep into the core of the jaw, into the ears sort of violent pain. Not sharp, but cold and dull and through the bone. Ugh.

Last edited by pulykamell; 02-22-2015 at 10:23 AM.
#6
Old 02-22-2015, 02:31 PM
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Join Date: Mar 2012
Posts: 1,401
Dentist here. A couple of things, no one uses novocaine anymore, it is still referred to as that but it is most likely lidocaine or septocain. As for the epinephrine, it is been there years and is in most local anesthetics. It doesn't speed up the removal of the anesthetic. It acts as a vasoconstrictor so the anesthetic remains in the area longer for better anesthesia. All injected dental anesthetics are vasodilators.

As a general rule six injections for one tooth would be a lot. For uppers one can usually get the tooth numb with one carpule every time. May put it on both the cheek and roof of mouth sides. Some might think of that as two injections.

Lowers can be tougher. It is a function of variability of where the nerve is. Most of the time(something like 90%) dentists get it in one injection. Some times takes two. For me only go a third time about once ever couple of months. A fourth time maybe once a year. Six times is usually too much medication. All cases vary. Lack of anesthesia is never due to not enough anesthetic but due to not being in the right place. With very bad infections the pus may prevent the anesthetic from reaching the nerve but not often.

I tell folks it is like when they take blood from your arm. They can see the vein and yet still sometimes miss. We only know about where the nerve should be and can't see it so missing occasionally is to be expected. Human variation and all.

Last edited by rsat3acr; 02-22-2015 at 02:32 PM.
#7
Old 02-22-2015, 02:36 PM
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My dentist told me no one even use Novacaine anymore. They use something else nowadays.
#8
Old 02-22-2015, 02:56 PM
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Join Date: Mar 1999
Location: N/W Arkansas
Posts: 8,416
I don't do pain quietly. one dentist I went to for over 30 years, put several of his kids through college and bought several motorcycles for him.

First visit I told him, if he did not want bruises, his assistant knocked into a wall or his tools bitten in half, to be free with the shots and turn the gas full on.

He did not believe me. Buy the end of the visit he did.
For 30 years I got gas at wide open, 12+ on the meter, as soon as I sat down.

We had signals for "you better go slower." And "Get out now if you value your life."

Always go it done with having to be put under. He was great.

Feds seem to have changed the rules lately as I can't get any docs to make it OK. They tell me I will die. Which means the Feds or the insurance companies have them by the short hair. IMO

I am kind of big and what works for a 120# woman does not make a dent in my pain levels.

A good dentist is worth their weight in gold. In my later years I have travel 30 miles & past 10 dentist to get to the good one.

After my latest move in 2012, I am still looking.

Last edited by GusNSpot; 02-22-2015 at 02:56 PM. Reason: :: cause it needed it ::::::::::::::
#9
Old 02-22-2015, 04:59 PM
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Join Date: Nov 2006
Location: By the fjords
Posts: 374
I numb pretty easily - and I insist on getting anesthesia even for the smallest things.

Many years ago I had a horrible school dentist who apparently hated kids (over here, kids get free dental care until the age of 18). Frau Mengele* was a really unpleasant woman, who would yell at you if you dared to show up with cavities. At one occasion I had a cavity that she deemed was so small that she didn't think I should have any anesthesia. I didn't dare to protest, and I remember the process was pretty damn painful.

So now that I can pay civilized people to work on my teeth, I'll have that lidocaine thank you.

*Not her real name. As far as we know.

Last edited by Archeonomist; 02-22-2015 at 05:01 PM.
#10
Old 02-22-2015, 05:03 PM
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Join Date: Dec 2005
Location: Van Nuys, CA
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Had my first root canal last year and it took a total of 11 shots to finish the job.
#11
Old 02-22-2015, 05:10 PM
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Location: Florida, USA
Posts: 20,191
Had a filling last week, it took two shots. It was a lower tooth.
#12
Old 02-22-2015, 06:13 PM
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Location: Frogstar World B
Posts: 14,102
I had my only wisdom tooth pulled, and the dentist did a prime job with the anesthesic, all I got was sound effects (it was a one-root tooth, so not that difficult). A few years later, I went to have a bad molar dealt with, and that dentist ended up giving me seven shots because I thought I could still feel something. After number six, I asked what that little crunch noise was – she said she put the needle in till she felt bone, then backed off a bit. I was very sore for a couple days but it went away.

A few years later, I was on the last quarter of a deep cleaning and she came over to look at my teeth. Said that one should get a little bit of a filling, since I was numbed up – but I had told the hygienist earlier that I wanted to try it straight, and that went ok. So I told the dentist to give it a try. She drilled for about a minute, and it was a bit unpleasant, but I got through it fine.

I will only go to a woman dentist, because I expect pain from women.

Last edited by eschereal; 02-22-2015 at 06:15 PM.
#13
Old 02-23-2015, 01:02 AM
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Join Date: Sep 2011
Location: Sunny California
Posts: 14,840
I had a root canal once, where there was also an abscess down in there somewhere, and the anesthetic didn't work well. We discovered this when he drilled into the nerve area inside the tooth.

After the dentist scraped me off the ceiling, he was able to numb the tooth completely and immediately -- but squirting the anesthetic directly into the hole he had just drilled into the tooth.
#14
Old 02-23-2015, 01:07 AM
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Question for rsat3acr: I have a long history of heart palpitations (diagnosed as PAC's -- very minor and not particularly bothersome) -- but because of this, my current dentist insists on using an anesthetic without a vasoconstrictor mixed with it. Prior dentists over the years have never made an issue of this (that I know of), and I haven't dropped dead from it yet.

Is there any difference I need to worry about, using anesthetic without vasoconstrictor? What if I'm getting an extraction, or an abscess chopped out, or any such thing that would typically be bloody? You suggested above that the purpose of the vasoconstrictor is to keep the 'caine in the region longer. I didn't know that. I thought it was just to reduce bleeding. Am I likely to have problems with that?
#15
Old 02-23-2015, 02:06 PM
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Join Date: Jun 2003
Location: Indiana
Posts: 1,197
Quote:
Originally Posted by rsat3acr View Post
Dentist here. A couple of things, no one uses novocaine anymore, it is still referred to as that but it is most likely lidocaine or septocain. As for the epinephrine, it is been there years and is in most local anesthetics. It doesn't speed up the removal of the anesthetic. It acts as a vasoconstrictor so the anesthetic remains in the area longer for better anesthesia. All injected dental anesthetics are vasodilators.
Thanks for all the info! Sorry, I just called it novocaine...I didn't really know what was in it except they switched to a different kind for the last couple of injections. I'd never had a racing-heart reaction to anesthetic before, so it really threw me off. I'm also taking a small amount of Vyvanse (a stimulant) and have a high baseline pulse rate due to autoimmune crap, so I got pretty nervous about the whole thing...especially having it happen over and over.

Oh, and it was a lower jaw molar.

I had pretty good teeth till a few years ago. Not sure what happened.

Antinor01--Dang! But I'm glad to know I'm not the only one with weird nerves.

Gus--I feel about my eyes the way you do about teeth--hope I never have to have work done. Way too chicken for Lasik. I've got to go soon to get a special retina evaluation done soon, because of this new medicine I'm on, and I'm going to have to beg somebody for Valium first.

Last edited by Elemenopy; 02-23-2015 at 02:06 PM.
#16
Old 02-23-2015, 02:21 PM
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Join Date: Jul 2014
Location: behind the sofa
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Quote:
Originally Posted by GusNSpot View Post
I don't do pain quietly. one dentist I went to for over 30 years, put several of his kids through college and bought several motorcycles for him.

First visit I told him, if he did not want bruises, his assistant knocked into a wall or his tools bitten in half, to be free with the shots and turn the gas full on.

He did not believe me. Buy the end of the visit he did.
For 30 years I got gas at wide open, 12+ on the meter, as soon as I sat down.

We had signals for "you better go slower." And "Get out now if you value your life."

Always go it done with having to be put under. He was great.

Feds seem to have changed the rules lately as I can't get any docs to make it OK. They tell me I will die. Which means the Feds or the insurance companies have them by the short hair. IMO

I am kind of big and what works for a 120# woman does not make a dent in my pain levels.

A good dentist is worth their weight in gold. In my later years I have travel 30 miles & past 10 dentist to get to the good one.

After my latest move in 2012, I am still looking.
My dentist in Florida is an angel and brilliant and kind and can actually get me numb and uses enough nitrous so I don't want to run screaming from the room before he's halfway done. (Bonus: he also knows my family -- my uncle owns the dental lab the dentist uses.)

The dentists I've seen in my new state are...ugh. And they're damn stingy with the nitrous. I'm a redhead who takes opiates AND has dental anxiety. Don't be stingy. I also am not a tiny delicate thing. Between the opiates, the redhead-pain issue, and not being 120#, it will take more to calm me down and numb me. I can and have punched a dentist in the stomach (he deserved it; didn't believe me when I said the tooth wasn't numb).

I should've let my Florida dentist pull the tooth when the root canal failed (while I was visiting at Christmas). The "oral surgeon" I saw here was obviously just some bozo with a lab coat and some pliers.

Anyway, I'm seriously considering having all of my future dental care done in Florida when I go home for the annual family visit.
#17
Old 02-23-2015, 02:55 PM
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Location: N/W Arkansas
Posts: 8,416
Quote:
Originally Posted by GrumpyBunny View Post

::: snip :::::

I should've let my Florida dentist pull the tooth when the root canal failed (while I was visiting at Christmas). The "oral surgeon" I saw here was obviously just some bozo with a lab coat and some pliers.

Anyway, I'm seriously considering having all of my future dental care done in Florida when I go home for the annual family visit.
I have thought about doing similar to see my last dentist. I sympathize & empathize...
#18
Old 02-23-2015, 02:58 PM
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Join Date: Nov 2001
Location: Upstate NY
Posts: 31,112
Jesus H Christ.

I am lucky to be numb after one shot. Now admittedly I have never had anything major done. I had all four of my wisdom teeth removed at once and a few fillings is all. But the standard shot works with no problems at all./

I feel for you guys.
#19
Old 02-23-2015, 03:01 PM
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Location: N/W Arkansas
Posts: 8,416
Quote:
Originally Posted by Elemenopy View Post

::: snip ::::

Gus--I feel about my eyes the way you do about teeth--hope I never have to have work done. Way too chicken for Lasik. I've got to go soon to get a special retina evaluation done soon, because of this new medicine I'm on, and I'm going to have to beg somebody for Valium first.
Yepper, never could do contacts, just not worth the ******** for me.
I am old so I have had to have cataract surgery on both eyes. Needed new lenses.

The eye is not feeling anything but they do not put a person all the way out. Just enough that I did not go into heart failure or hit the pretty Doctor.

Watching a scalpel come at my eye was not my favorite thing.....

Was worth doing though.
#20
Old 02-23-2015, 09:10 PM
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Join Date: Mar 2012
Posts: 1,401
Quote:
Originally Posted by Senegoid View Post
Question for rsat3acr: I have a long history of heart palpitations (diagnosed as PAC's -- very minor and not particularly bothersome) -- but because of this, my current dentist insists on using an anesthetic without a vasoconstrictor mixed with it. Prior dentists over the years have never made an issue of this (that I know of), and I haven't dropped dead from it yet.

Is there any difference I need to worry about, using anesthetic without vasoconstrictor? What if I'm getting an extraction, or an abscess chopped out, or any such thing that would typically be bloody? You suggested above that the purpose of the vasoconstrictor is to keep the 'caine in the region longer. I didn't know that. I thought it was just to reduce bleeding. Am I likely to have problems with that?
Sorry to take so long to respond.

I'd say talk to your GP or cardiologist. I'd always rather use a vasoconstrictor. One can get profound anesthesia without it but it is easier to achieve anesthesia with it. Most of the time it is fine to use the constrictor.

It isn't of a concentration to effect bleeding. Also it isn't placed at the bleeding site. Most dental bleeding is very easy to control with direct pressure. Unless you have bleeding problems don't worry about that.
#21
Old 02-23-2015, 09:16 PM
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Join Date: Dec 2005
Location: Van Nuys, CA
Posts: 11,663
Quote:
Originally Posted by Elemenopy View Post
Antinor01--Dang! But I'm glad to know I'm not the only one with weird nerves.

Gus--I feel about my eyes the way you do about teeth--hope I never have to have work done. Way too chicken for Lasik. I've got to go soon to get a special retina evaluation done soon, because of this new medicine I'm on, and I'm going to have to beg somebody for Valium first.
Yea it sucked. Took 6 or 7 to totally numb me originally. Then he realized half way through that I could feel again even though it didn't hurt. Told me not to be a hero and gave me the rest.

Seems that it runs in the family, I told my mom about it and she said she's the same way. Takes a lot to numb and we seem to burn through it quickly.
#22
Old 02-23-2015, 09:53 PM
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Quote:
Originally Posted by HeXen View Post
My dentist told me no one even use Novacaine anymore. They use something else nowadays.
"Novocaine" has become like "Kleenex" - a brand name used for a general product. Dentists may use any of several local anesthetics, depending on what kind of procedure they're doing. Lidocaine will usually suffice, but a few years ago, I had some fillings replaced and that dentist used a long-acting local anesthetic I had never heard of, and when she said it was long-acting, she wasn't kidding; I had the procedure in the early morning and the numbness didn't wear off until well in the afternoon. That was almost as unpleasant as the procedure itself!

Novocaine is a brand for procaine, which is rarely used any more. It's most commonly found in long-acting penicillin injections; not only does it reduce the pain at the injection site, it attaches to the penicillin molecule and makes the drug stay in the body for days instead of (no, I'm not kidding here) minutes. If anyone here has ever had one of those humongous shots for syphilis, that's what's in it, and there are other, less powerful preparations out there too.
#23
Old 02-23-2015, 11:14 PM
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Join Date: Oct 2008
Location: San Jose, CA
Posts: 3,828
Everyone is different.
My dentist had to use the maximum amount of Novocain when working on my teeth. And is surprised that I can still fill his working on me.

I had a prostrate biopsy and by the time the doctor finished poking me I was considering poking him with any sharp instrument. And do not get me started on oxycodone or morphine, I can not believe anyone would take that crap voluntarily.

But everyone is different.
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