Anesthesiology/Life long issues getting properly numbed
I will try and keep this as short as possible without leaving out details. My first experience not getting numb at the dentist was at age 6, got the shot started to drill, it hurt and I reflexed and smacked the dentist arm who yelled at me. This has continued to be an issue for the next 30 years, and not just with dental work. I have been to several dentists in my lifetime trying to find one who can help me and tell me what the problem is and I have yet to find one. I have done sedation dentistry, which was great until they actually got into the tooth and I immediately was jolted wide awake, shaking and hyperventilating. I've been given oral anxiety meds prior to appointments and all goes well until they get in and hit those spots and its all gone. I have been yelled at, told that I've been given too much medicine already and I'm just afraid of the drill noise, they've stopped and told me they cant get me numb and help me, I've been mis-injected, where half my face turned red the other mottled and burning pain and swelling in my nose (which I was told at the time was an allergic reaction) all types of unnecessary rude treatment. I actually have a very high tolerance for pain, so for me to have this reaction, its 100% real. I've wondered my whole life why I have these issues at the dentist. Then I had two children, 5 years apart, two different hospitals and neither epidural worked. On the second child I told the anesthesiologist my prior didn't work, he said he'd try a cocktail but when that one failed he removed it, and gave me a shot of marcaine (spinal) which worked for 20 min.
After this, I was dumbfounded as to what in the world my issue is, so was he. I ended up needing to have two root canals a few years ago and because of the issues Ive had, I paid $5k out of pocket and found a dentist with hospital privileges to be able to be under general anesthesia and have it all done at once (cash and dental/med insurance $30k - which shows how real of a problem this is for me).
I had my third child last year, who was breech, and had to have a C section. I was in complete panic that I would feel it. I met with anesthesiologist 3 times before to discuss, he said it seems as though the block worked for you before and we will be using a spinal for this too so you should be fine, I will make sure you are. I was so grateful for his attention, caring and concern and relieved when the block took effect. Ive tried researching on my own, and thought anatomy (dental) originally but would that also explain why an epidural wouldnt work twice but a spinal would? Any dental locals Ive ever gotten seem to numb only superficially if at all, lip, cheek, gum but once the tooth is penetrated I feel it all. Lidocaine injections Ive gotten in hand didnt numb me at all (this is every single time for 30 years)
Locals and Epidurals dont work, but Spinals and General do.
Sorry it was so long, but I would really appreciate your opinion as to what the problem could be. I recently had a filling fall out and Im scared to death to go get it fixed due to my prior history and experiences.
I would recommend having your procedures done by an oro-maxilofacial dentist. They are often certified to administer (in office) general anesthetics. I have never heard of anyone completely insensitive to local anesthetics but if it is really a problem for you then you may have to have all your procedures under general or spinal.
Ronald Levy, MD
Professor of Anesthesiology