I’m with you, Rachellelogram. My last four dentists have all been women, as have my last two doctors. So far, I have loved all of them. I do think women dentists in general are more attuned to the notion of pain as an avoidable thing and I appreciate that.
ETA: I just realized it sounds like I change dentists a lot. Well, I moved, then one retired, then I moved again.
I’m also “hard-to-freeze”, but only on the bottom. Top is fine because they can actually do a localized numbing for the quadrants they need. Bottom is different because they have to do a block to numb the entire bottom. Apparently due to my wisdom teeth being extracted, the spot that needs to be full of novocaine isn’t in it’s normal location, so I usually have to get two shots. The second one is only bad when they hit a nerve, and then it’s BAD!
I also have an extremely sensitive mouth so stuff that shouldn’t hurt, does. I usually cry at least once during routine cleanings.
Like Cat above, I’ve also not really liked nitrous. It does nothing to calm my anxiety and just makes me feel like I can’t breathe properly. I like valium before hand (2 blues), but that doesn’t really ease my anxiety either. The dental assistant always holds my hand while I’m getting the shot (I’m 43, by the way). I would call around find a dentist that is comfortable working with dental chickens. It really does take a special dentist to work through this type of fear.
Once I’m numb, the rest is a breeze. I just got a crown on my lower right molar.
I started doing sedation dentistry after a particularly bad session with a new dentist (new to me, and I suspect new to the profession). I lost count of how many times he injected my mouth, trying to freeze me - around six, I figure. I could see the fear in his eyes - he didn’t know what the hell to do except keep on jabbing needles in my mouth. I finally told him to just do the filling with me only partially frozen - I was used to getting fillings that way, after all (I was well into adulthood before I found out that fillings weren’t supposed to hurt!). Sedation’s better for everyone involved in my case, I figure. 
My old dentists (hey, one retired back when I still couldn’t vote, the other one two years ago) were male. The one who’s been treating me for the last couple of months is female. The one who had to do an emergency root canal after one tooth where the female dentist had “updated” a filling went nasty and her clinic wasn’t able to fit me in is male, and compared with her he’s got hands like all-cotton gloves.
Hey XT, dentist here. Most of the info already posted is spot on. Crowns are a fairly routine thing. A couple of things though. Generally you don’t need to be told that you have a cracked tooth they are almost always symptomatic. Spontainious pain or pain on biting. Sometimes a tooth gets craze lines. Similar to cracks in the glaze of an old fine china plate. Doesn’t look good but doesn’t affect strength of the plate, same things happen to teeth. Usually dark thin vertical lines on the tooth. I’m not implying anything since I don’t know your teeth or dentist.
Five hours is quite long for one dental session. Probably they will break it into several shorter sessions. A bite block can help with holding your mouth open. Gag reflex isn’t usually a problem they shouldn’t be in the throat/back of tongue area.
Take the nitrous, it calms you down and also makes you unaware of the time. As for the local anesthetic not working, that is usually a placement issue not a case of it not working on you. Usually this is on the bottem not the top due to the anatomy. your nerve may be in a less than ideal spot and the dentists in the past missed the block. If your aren’t numb tell them they should adjust the injection area. A panoramic x-ray can help the dentist see where your foramen (hole in jaw where the nerve goes) is located and adjust.
If you have any questions or fears let the dentist know. They should be happy to answer and explain.
I forgot to add that I also have a hair trigger gag reflex and really the only thing that I don’t like is the saliva/water sucker. They always want to put it where it causes issues, so I usually take control of it and make sure it doesn’t get too far back. My dentist if fine with this.
Mine also uses the bite block. I hate it, but it does help keep my mouth open with less effort on my part, but I have to do a few deep calm breaths when it’s first put in.
One of the biggest little known facts about dentists is they don’t use novocaine. They have not used it for decades , too many people were allergic to it. They use lidocaine now.
If having crown work done, consider looking for a dentist that can make the final crown on-site, vs making castings and outsourcing.
The stub and mating teeth are sprayed with a contrast enhancing paint and measured via digital photography. The crown is then designed in a CAD system and machined from solid porcelain on a purpose designed CNC diamond abrasive milling machine. I got to watch, it was really cool.
My only crown was done this way, and when I have told people about it, (not that many) I have heard a couple horror stories of multiple tries and the crowns still not being quite right.
This process removes several sources of error, (castings) and eliminates the need for temporary crowns, and also makes it much easier and quicker to re-do the crown if the fit is found to be off.
Under nitrous, I had a root canal followed by a crown on one molar. Slept pretty much through the whole thing, though I tend to do that anyway when sufficiently bored.
Correct but everyone still calls it that. IIRC about a little under half of the anesthetic used in the U.S. is lidocaine. Another big portion is septocaine which is something like 90% in Europe.
Exactly.
When we were kids, apparently some dentists DID use nitrous alone. My husband had an unfortunate experience with a dentist who subscribed to that theory :(.
From what others have said on the board, the amount of nitrous they use nowadays isn’t enough to offer much analgesia. BUT - it is enough to get you very relaxed, which allows the local anesthetic to work better. There’s a lot of strong anecdotal evidence (and I imagine quite a few studies) that anxiety makes local anesthetics less effective in some people. Plus, it’s got to be a lot harder to administer if the patient is tense and/or jumping in terror and pain.
I’m echoing Cat, here. I didn’t used to be afraid, either, but after a botched root canal job, I developed a raging case of dentist phobia whenever I have to have something more than a filling done.
I learned the hard way that novacaine doesn’t work well on infected tissue - something us lay people generally ARE NOT aware of - hence the root canal job from hell even tho I was on NO, too. If I’d had access to a blunt instrument I probably would have murdered that butcher… Never, ever again.
Point being, as mentioned earlier, there is absolutely no excuse for ANY dentistry to cause pain to a patient. If your dentist seems unwilling to make it work for you - find another one. Too often we take a back seat to our concerns when it comes to any branch of the medical profession. I’m long past that. I argue and question my docs whenever a detail doesn’t strike me as right.
I opted for sedation dentistry when they replaced an implant last year. It was smooth sailing the whole way. Big-time procedures like that will be done from now on with me unconscious. 
Appreciate all the responses. Tomorrow is the big day. I have to admit, seeing everyone’s experience here has helped calm me down a bit. I’m still more than a little apprehensive, but I feel better about it now than I did. If anyone is interested, I’ll let you all know how it turns out. So far the doc is still sticking with the 5 hour plan…I told him about what rsat3acr said about breaking it up into multiple sessions but he still seems to think he can get it all done tomorrow.
Thanks everyone for your thoughts on this…it’s really, really helped.
If you do nitrous you will not know it’s 5 hours, believe me.
Good luck and don’t worry; this time tomorrow you’ll be telling us all what a breeze it was!
Well, I survived fwiw. The NO helped, though I kept going through periods of crystal lucid and almost psychedelic hallucination (I assume because they were switching off the NO for pure oxygen). There was still pain, but as others said I didn’t care so much, though when they gave me the injections into my lower jaw THAT still hurt quite a bit. I was there almost 7 hours, so it went over even the 5 hour estimate I was originally given.
Last night I was in quite a bit of pain, and my upper jaw especially was very temperature sensitive (which it wasn’t before). Today the pain is manageable though my lower jaw is sore and my teeth still seem to be temperature sensitive. I think it’s manageable though since these things are only temporary and I don’t get the permanent ones for a few weeks.
At any rate, thanks everyone for giving me the heads up…it helped a LOT, to be honest, in calming me down and giving me some idea what to expect. In some ways it wasn’t as bad as I thought, though if I had it to do over again I would have never agreed to getting all the stuff that needed to be done in one sitting.
Glad you made it through. And although you may wish you had not done it all at once, look on the bright side: it’s OVER.
I wouldn’t do seven hours (or even the original five hours) at one time either without sedation, even to get it all over with. I don’t know if I mentioned it earlier, but sedation really makes the time go by - it seems like you get in the chair and the next thing you know it’s over and you’re heading off for home to sleep it off.
ETA: Glad to hear it’s all done anyway, XT.
XT glad you made it. The temp sensitivity is usually a function of cutting on the teeth, for all practical purposes the nerve is now closer to the outdide of the tooth so reacts to temps more. Usually gets better by itself although sometimes slowly.
I doubt they were turning the nitrous of and on probably just how you reacted. FWIIS a nitpick but it is N2O not NO.
keep us posted.
Very true on the sedation. Well, in my case I was reasonably aware of the time going by, I just really didn’t care. I was in the chair for 5 hours instead of the 3ish I’d expected, but hey, that was… um… wait… wow… :D. This was with nitrous on top of the oral sedative as well, of course. I’ve found that with just the sedative, it doesn’t make as big a difference (as I found one time when the work they were doing apparently couldn’t be done with the nitrous mask in place - surgery on the base of the root of an upper molar.
Just a quick update for anyone interested. I still haven’t gotten the permanent crowns in. I’ve had to go back twice now to get the temps adjusted. They still aren’t right and it hurts to bite down on my right side, as well as low level constant pain. The last adjustment helped cut down on both things somewhat, but it’s still there. I’m hoping that the permanent ones will be a lot better on both aspects. Some of the people in my office who have gotten something similar done say it should be.