My wife has just returned from a second unsuccessful attempt at a root canal. Both attempts were stymied by either (a) the dentist’s inability to “find a nerve”, or (b) my wife’s preternatural resistance to novocaine and nitrous oxide.
The first thing our dentist office does after this second failed attempt was to refer us to an expensive endodontist. When I called the endodontist’s office to inquire about just what service they provided above and beyond what a dentist provides, the best the staff could do was to assure me that they “specialize in root canals” and that they “use novocaine and nitrous, plus two other things (?) to numb patients”. I was also told that back teeth can be hard to numb … the nerve is hard to locate (IIRC?).
OK. So we’re asking ourselves: do we really need to spend double (and pay upfront to boot – no copays accepted) for endodontic services that might be reliably performed by another dentist (to whom we can pay a copay)? Is it worth is to shop around and consult with other dentists until we find one that has the chops to pull this off? The talk with the endodontist’s staff really led me to believe that successful numbing of back teeth was something that some dentists could pull off, and that many could not – much like how in nursing, starting an IV is more art than science.
I am generally very resilient to local. Lidocaine, novocaine or whatever they use. In fact, I’ve never had a numb dentist experience. I get numb 4-6 hours after the visit, however. I’ve had a dedicated dentist try, and I just gave up after 6 shots and said “Yeah I guess I’m numb”, even though I wasn’t. My strategy now is to ask the dentist to work as quickly as possible and just tough it out. I don’t know, never had a dentist who did nitrous but I’m frankly scared to try. One time I was in so much pain 20 minutes after leaving the dentist office I couldn’t remember my last name nor which key opened my front door(I managed to drive myself home fine, though, luckily).
You’ve probably already thought of this, but does your insurance plan have a list of doctors? Perhaps there’s an endodontist who is in their list so you can avoid the large bill.
Sometimes – and I’m neither a dentist nor an insurance agent – complex dental work counts as surgery and is covered under one’s medical, not dental, insurance. I’ve also heard of people getting general anaesthesia, beyond the nitrous oxide stuff, for dental surgery.
I do know first hand that it is possible to have nerves in a part of the jaw that are especially deep and/or difficult to hit with local anaesthetic. My dentist, who is a sweetheart and absolutely hates to cause anyone the slightest pain, loathes having to do anything to my lower back teeth for that reason.
I was knocked out for the extraction of wisdom teeth, so I know they can do this. You just need to find the right guy to perform it. They need a degree in anesthesiology, and not all of them care to bother with that. But they’re out there!
I am very resistant to pain-killers of any sort. I went to one dentist and had 8 injections and the dental work was still the most painful experience of my life. At the next dentist I tried, I still wasn’t numb by the time he said he needed to stop or he might overdose me. When he started drilling, I leaped out of the chair and broke his drill bit. He gave me more anesthetic.
I explained all this to my next dentist. I do not know what he did as a result, but I have never had any problems with him. So you may be able to find other dentists who can provide effective anesthesia.
Just out of curiosity: Is your wife a natural redhead? It has been shown in studies that redheads have a higher pain threshhold than the general population, and that they are resistant to painkillers and anesthesia.
My family is full of redheads, and while I am not one of them, I did inherit some of this trait. I’ve often had procedures with a ridiculous amount of lidocaine injected, but with me feeling most of the pain anyway.
No, they don’t, if they only do “conscious sedation” as opposed to “general anaesthesia.” In conscious sedation the patient is entirely concious through the procedure, but through the use of IV sedatives a)they feel nothing b)they retain no memory of the experience.
I had my wisdom teeth out under conscious sedation (IV Demerol) at an Oral Surgeon (I am under the impression that some use IV Valium). My subjective experience is that I went to sleep in one room, and woke up in another with four fewer teeth (an ideal dental experience in my view). However, objectively speaking I was actually awake and answering questions through the whole procedure.
I do recommend it, although they won’t let you operate a vehicle after the procedure – you have to have someone to drive you home.
I myself am very very hard to numb (I am a natural redhead, BTW) and once had a rather upsetting root canal experience – the numbness wore off halfway through the procedure. For my second root canal, they used about 6 shots of novocaine, spaced out every 5 minutes, plus nitrous for the anxiety I was feeling after the first experience. It went pretty smoothly. I used a endodontist for both root canals.
Well, how can you call it “conscious” if you don’t know you’re doing it and have no memory of it (which was my experience)? If I don’t know it’s happening, I call it “knocked out”. I had mine done in 1978. Maybe it’s different now.
About eight years ago, I had the periodontal surgery (whole mouth at one shot) and I had an IV and novocaine. I also remember nothing of that procedure.
I’m a redhead, and it takes horse portions to knock me out. One time, an ER doc thought I was on drugs because I was so resistant to the numbing agent he gave me to stitch up my hand…I also WOKE UP during an endoscopy and tore out my IV and had to be restrained by 4 people (I have absolutely no memory of it, strangely). I later saw an article about redheads being more resistant to anesthesia and it all started to make sense.
Yep, first thing I thought of. Turns out that no endodontist anywhere in the world belongs to my insurance company’s dental plan. My insurance company will pay some portion of the endodontist’s bill (60-80%) … but only as a reimbursement 4-8 weeks after we shell out for the procedure in full. Having to come out of pocket up front is the problem.
My wife has already visited another dentist who expressed confidence that he could pull off successful numbing and the subsequent root canal. This new dentist took an X-ray (or something?) to determine exactly where her back-mouth nerves were and how they were situated. IIRC, the first dentist didn’t do this … he just applied Novocaine more or less blindly.
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Saltire, my wife has some red hair here and there in her extended family tree. Maybe she has the pain-sensitivity gene.