Expert: Dr Ian Jackson - please note UK based - 11/19/2008

Question
                    Dear Dr.Jackson,

  I am Tomas and I live in the Slovak Republic. Today,my dentist gave me intraligamentary anesthesia before drilling my tooth. After two or three minutes, she started to drill. In the first few seconds of drilling, I could only feel the pressure on my tooth with just slight pain I could tolerate. Afterward, I could feel the pain throughout the whole drilling procedure, as if there was no anesthesia in the first place. My dentist was repeatedly telling me: "I know your tooth is numb. I can tell by looking at the gum that it is numb ! You are just afraid !" Nevertheless, I was in such pain that my body was shaking like never before in my life. This was my first dental treatment in Slovakia. I lived in the United States for 11 years, and never had similar troubles after being administered anesthesia.  I can't understand how come I felt the raw pain after the anesthesia, as my dentist was telling me that she could see my tooth was "numb". Also, my lip never felt completely numb during the procedure. Every other time I had anesthesia before a dental procedure, my cheek felt as if it was swollen a little. After this procedure today, I touched my cheek and could hardly feel any numbness. What do you think was the problem with the anesthesia ? Is it really possible to tell whether a tooth is completely numb by looking at the gum, like my dentist says ? I can't understand how my dentist could have thought that my tooth was numbed just fine, as I was writhing in pain throughout the procedure.

Answer
Tomas
I do not bel;ieve it is possible to tell if a tooth is numb by looking at it - the thought is absurd. You felt pain because the local anaesthetic had not reached the nerves it needed to reach. Rule number one is to believe what the patient tells you that is happening, but then we live in the UK and if someone did what you describe - then they wouldn't stay in business for long.
I'm sorry to hear about your experience - I suggest you look for another dentist!
Kind regards
Dr Ian Jackson