Earlier this week, I fielded a question from Gail from California who told me that it took twelve shots of novocain to get her numb for her tooth extraction. I explained some about dental anxiety, and she followed up with these comments and a question:

Dr. Hall,
1st let me say I “liked” you on Facebook and wrote a comment recommending your site.

Thanks for responding so quickly. Sorry I wasn’t more detailed.

As for the 12 shots of novacaine – all but one tiny spot was very numb. Everytime the dentist would apply pressure to the area pain would shot up the side of my face. The dentist said she was having a hard time getting that tiny area numb. When I went back for the removal of the bone spur, the dentist said the spur was probably the reason for the sensitivity experienced during the extraction done the previous week. This time 3 shots numbed the area great. The dentist said that one of her other patients had been in the morning with the same problem (bone spur) from her extraction the previous week too. The dentist said she couldn’t figure out what would have caused the spur to work itself to the surface.

Now the area where the bone spur was removed is VERY sensitive and this is the area where the ridge of bone is sticking thru the gum line. Whenever my tongue hits a spot on this “boney” ridge, pain shots thru my entire left side of my gum line. It also feels like the outside of my face is bruised along the same location. The dentist and her staff are very kind and caring. I just don’t know if I should go back to give them a chance to get it right.

Have a great one,
Gail from California

Gail,
Thanks for your kind comments.

There’s nothing really unusual about your experience, and it sounds like your dentist is doing a good enough job. And this will heal by itself given time, it’s just a matter of whether or not you’re comfortable in the meantime. I think you’d be fine going back to her for help.

But this idea that it was the dentist that just had trouble getting one spot numb – that is the anxiety, totally. This tooth that was extracted was a lower left second molar. There is one nerve that goes to the entire lower jaw on that entire left side, and it’s either completely numb or it’s not completely numb. It’s not possible to get one spot numb without numbing the entire side. It will FEEL like that, but it’s the anxiety. I know. As I said, not only did I treat a lot of patients with this problem, but I myself am one of those patients. The dentist pokes the tissue all around the tooth and you can’t feel it because it’s numb, but they go to extract the tooth and try to separate the tooth from its socket and it hurts. That’s how this works. The novocain is strong enough to block the very mild pain of poking the gum but because of the anxiety it isn’t strong enough to block the intense pain of the extraction.

You were fine for the loose bone spur because that requires a less profound anesthesia than the extraction.

And if a bone spur is loose, it will likely work its way to the surface. But, as I implied, this is no big deal and it just needs to be removed – if not by the dentist then by the patient at home – either way is fine.

Dr. Hall