Why couldn’t my dentist get me numb?

Dear Dr Hall,
I have a peculiar problem which my dentist could not solve even after 11 sittings. My front lower teeth (two of them, I think they are called central incisors) are partially dead (injury from football during college) now half of it is infected and half of the nerves are still alive. I have got 5 injections and a paste on the tooth to numb it, it simply does not numb enough for a root canal. My dentist returned my fee, I am virtually living on ultraset since last 2 weeks now. your view and guidance would be a blessing.
Best regards,
Ankur from India.

Dear Ankur,
I’m confident I know precisely the answer to your problem, because the same thing has happened to me, when I had a root canal treatment done.

There is always a certain amount of anxiety when you’re having dental work done. And especially after trying and failing to get a tooth numb for dental work (you said 11 times), the amount of anxiety is going to increase dramatically. A lot of dentists don’t understand the connection between this anxiety and the novocain that they depend on to get you numb, but the anxiety counteracts the novocain and can even make it impossible to get you completely numb.

This happens with me, and once I understood this, I saw this in many of my patients who were difficult to get numb. What you need is some type of anti-anxiety medication. Taking 10 or 20 milligrams of Valium could do the job. Or, if you can find a dentist who uses nitrous oxide gas, that could do it also. If it’s Valium, take that at least 30 or 40 minutes prior to your appointment. But be sure you have someone who can take you to the appointment and take you home, as you will not be fit to drive probably the rest of the day. There are other good anti-anxiety medications that are useful for dentistry also, such as Halcion.

Dr. Hall