Expert: Frederick R. Liewehr DDS, MS, FICD - 10/21/2007

Question
Hi,
Just a little back story, I had my son July 2007, and I did receive dental care during, but I still received 10 cavities and one turned out to need a root canal.
I finally got it done three days ago, not expecting much pain from the procedure...well I was wrong!!
I think I've just been getting so many cavities filled that I'm building a tolerance to novacaine.
I told the endodontist that I usually need about 3 needles to get numb, sometimes more...and he gave me one and that was that. I trusted him though.
He started and all was well, then the burning began and I knew I'd start feeling it soon, I began to panic as I felt all the drilling...he said there was nothing he could do until he got in...
He finally got in, as I was sitting there crying out in pain during the drilling, and then he couldn't get a good hold of my open nerve, so after 4 tries he did something that made the pain go away...this was all quite traumatic, I must say.
The rest of the procedure wasn't that bad,  he seemed quite rough but everyone that had seen him before that I had talked to said he was the best.
Well, I'm still in severe pain. I keep taking advil and tylenol but its just not cutting it, and I can't take any narcotics...so I don't know what to do.
He didn't tell me how long this pain would last....but my jaw is throbbing!
And I think I bit my tongue, it's swollen, and raw on the side of my procedure (tooth #18)
Is this amount of pain normal? He showed me my xray after thr procedure and showd me that he had gotten everything, as it was all filled in with white.

Answer
People do not develop a tolerance to local anesthetic. It is possible that you have some anatomical variation that makes your more difficult than the average patient to anesthetize, but a skillful operator, particularly one who attempts to perform endodontic therapy, should be able to make you comfortable. If not, he should not continue with the procedure while you are having so much discomfort. This, in my opinion, indicates that he lacking in compassion as well as technical skill. Some soreness is common for a day or two, but it should be decreasing and manageable with the Advil (you should be taking 2 or 3 of the 200mg tablets at a time, not just one). If not, there is a problem, and your dentist should be able to manage it, or he should not be performing endodontic therapy. You may need to find an endodontist who can help you.