Mr. Blue Sky 's thread on gum grafts reminded me of something I experienced a few years ago. I had had jaw surgery to correct some alignment problems. After the surgery numbness persisted in part of my chin and my lower lip on one side. The oral surgeon had warned me that long-term, or even permanent, numbness was possible. (Mild numbness persists to this day, but I’m so used to it I hardly notice.)
Anyway, several months after my jaw surgery I had a grafting procedure done where tissue from the roof of my mouth was grafted onto my lower gum. During the procedure my periodontist simply could not get one side of my gum to go completely numb – the side on which I was already partially numb. Over the course of the procedure he probably gave me at least a half dozen shots of Novocaine. Eventually I told him to just forget about it and finish the procedure. It wasn’t the most comfortable I’ve ever been in my life, but I survived.
My questions are these: Why couldn’t the periodontist get my gum completely numb? Did my nerves move or become damaged in such a way that they wouldn’t respond to Novocaine? Was my periodontist incompetent? How frequently does stuff like this happen? My periodontist was pretty frustrated by the whole affair. At first I think he thought I was just being oversensitive (i.e. reacting to anticipated pain, rather than actual pain), but it was eventually obvious that I really could feel what he was doing on that one side.
Add me to the list of people who have experienced. I now refuse to let dentists use it on me, and take the pain as it comes.
My experiences have been a little different than yours - fortunately without the long term consequences - but as I was a little kid at the time, I’m now panicky about dentists. I don’t feel the effects of it at all until several hours ( 6 - 8) after the injection, but then my mouth goes so numb I drool for a day or more. Because I was young, no one believed me when I’d tell them the drugs hadn’t taken effect yet, so they’d drill away and, much as your dentist did, to the expectation of pain rather than actual pain. Wrong!
I can’t do novacaine. Apparently they put adrenaline with it to make it work quick. My heart races and my breath gets really short. It feels like I’m having a heart attack and it’s really scary. They tried some stuff that does not have adrenaline. It works for like 15 to 20 minutes before they gotta shoot you up again. The pain from getting shots was worse than the pain from the procedure, I’m sure.
Some local anaesthetics work very poorly on me, but I don’t know which. I once had 8 injections into one side of my gum and it still didn’t go numb. The ensuing extraction was extremely painful.
Another dentist said he couldn’t give me any more as I might overdose, but when he started drilling I leaped off the chair and broke his drill bit. He gave me more then and eventually got it numb.
The above occasions were in the UK. I don’t know what anaesthetic was used. I have had no problem in the US where I believe I have had lidocaine.
Possibly related - I have never noticed any effect from over-the-counter pain-killers either: Tylenol, Advil etc. The only painkiller I can recall working was oxycontin - and I had to take two before I noticed anything. I’m not sure whether it actually reduced the pain, or whether I just didn’t care.
[QUOTE=PussyCow]
I can’t do novacaine. Apparently they put adrenaline with it to make it work quick. My heart races and my breath gets really short. It feels like I’m having a heart attack and it’s really scary.QUOTE]
I too have this problem with Novacaine (and Allocaine, and Zylocaine…sigh). I can only do Carbocaine. Actually, I sometimes have even worse reactions that you do to anasthetics/analgesics (like shortness of breath, rash, swelling…the whole hit parade).
And on a side note: a dermatologist friend of mine told me that the epenehrine is added to the analgesic to help reduce bleeding (not to make it work faster). If that’s true, and if excessive bleeding isn’t a concern with your procedure, you should have alternatives. Just food for thought.
As for the OP, my father (from whom I seem to have inherited my above problem, BTW) has had similar experiences. He says it takes TONS of whatever they try to use on him to have any effect, and once it does it takes an inordinate amount of time to wear off.
Actually, they mix epinephrine in with local anesthetics for a different reason. The anesthetics themselves are vasodilators and increase blood flow to the area, so they add epinephrine to constrict blood vessels again. This has the effect of reducing bleeding, but the actual reason is to help the anesthetic stay in the area for a much longer period of time and keep the numbness up. Otherwise, lidocaine and its ilk would not last very long at all.
As an aside, the above page helped me solve a mystery I had been wondering about for a long time. On one episode of ER, Dr. Benton got into a fight with a prosthetic limb salesman in the parking garage of his hospital, and he damages one of his fingers by punching the guy. Later on in the episode, he and Dr. Carter are hidden away in a small room in the ER while Carter sets the broken or sprained finger. As he is getting up to leave and go on his surgical rounds, Benton says to Carter, “You used the lidocaine without epi[nephrine], right?” and Carter pauses and says “Is there a difference?” When Benton looks up and starts to freak out, Carter says “I’m kidding! No epi!” and Benton leaves. I always wondered what that was all about. Now I realize that Benton wanted the lidocaine to wear off quickly, so he could perform his normal duties, and thus wanted Carter to use lidocaine with no epinephrine added.
