Medical Forum / General / Dentistry / October 2004
Halcion! A Godsend!!!
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Synergie - 30 Sep 2004 02:02 GMT Well, today I finally had my appointment. At 8am I took two little blue pills .25mg each of Halcion. About 45 mins later, I walked in the the detal office feeling like what at the time I thought was completely conscious and aware, albeit a bit drunk-like. I couldn't walk straight!!!
Anyway, this was the very first time i 'allowed' a dentist to use local anesthetic, only if they agrees to give me something for pain after since I have a history of injections causing pain afterward. This time was no different... I have the same residual pain from the injection site, but she gave me percocet! :)
Anyway the Halcion is wierd, at the time I thought I was completely awake and even thought it didn't work on me. But after I came home and slept for most of the day, I can't seem to recall most of the appointment! Very wierd. The parts that I do remember, I recall just as if I was not on anything at all. Unfortunately, the needle was one of those times. I made sure she used topical at first, but I still felt it. I know I am a wimp... it stung like hell for a few seconds. I wish that had been one of the points where the Halcion blurred my memory... but ohwell a bit of a dose increase might fix that for next time... hopefully a long time away!
Point of this post is that, even when I thought I was completely aware of evertying and thought the drug wasn't woprking, I was really less apprehensive about being there,... and I have a severe dental anxiety problem! I think maybe if the dose was tweaked a bit more for me it would be perfect. I recommend it to anyone who wasnts to 'be somewhere else... anywhere else than the chair' I also added the benefit of music since I brought my cd player, and since I was a bit cold they covered me in blankets :) so I think I really did 'sleep' for most of it.
When I got home, and sleot for most of the day I woke up and for a moment thought that I hadn't even gone to the appt!
More dentists should advertise that they can offer this! Its amazing!!!!
W_B - 30 Sep 2004 06:24 GMT >More dentists should advertise that they can offer this! Its amazing!!!! We offer it in my office but do not advertise it for obvious reasons.
-- W_B
wubbabubbazG@RBAGEyahoo.com Take out the G'RBAGE
Stormin Mormon - 30 Sep 2004 23:37 GMT HEY EVERYBODY!!!! W_B HAS HALCION AT THE OFFICE!!!!!!!!!!!!!!!!!!!!!
(like that?)
 Signature Christopher A. Young Learn more about Jesus www.lds.org www.mormons.com
On Wed, 29 Sep 2004 22:02:00 -0300, Synergie <wlmcdonald@accesswave.ca> wrote:
>More dentists should advertise that they can offer this! Its amazing!!!! We offer it in my office but do not advertise it for obvious reasons.
-- W_B
wubbabubbazG@RBAGEyahoo.com Take out the G'RBAGE
StovePipe - 02 Oct 2004 21:03 GMT > HEY EVERYBODY!!!! W_B HAS HALCION AT THE OFFICE!!!!!!!!!!!!!!!!!!!!! > > (like that?) .... Good thing that W_B is W_B and not a real person. Gawd what ah's can do here sometimes.... This is one of the reasons I'm SP instead of my real name (Dr. SPDork)....opps! There.... I've done it now... SP
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Synergie - 30 Sep 2004 11:53 GMT update: Oh crap, I woke up this morning, and my jaw is killing me! Same thing that always used to happen. The needle spot hurts. The dentist gave me percocet but all its doing it making me feel 'drugged up'. I can't open my mouth very much at all. The tooth worked on was the back top on the right side, and it felt like she stuck the thing right in my jaw joint. What I am scared of is that my jaw will lock like last time I tried local. I really dont want that to happen again.. it wasn't fun having tongue depressors shoved one by one between my front teeth to force my jaw open! It hurts too much to try and stretch it out, and I havn't eaten anything or talked much at all since yesterday. I've pretty much kept my jaw stationary since the appt for this reason. Should I go back and possibly get some different pain meds?? Is there anything else I can try that will lessen the needle spot pain??
> Well, today I finally had my appointment. At 8am I took two little blue > pills .25mg each of Halcion. About 45 mins later, I walked in the the [quoted text clipped - 31 lines] > > More dentists should advertise that they can offer this! Its amazing!!!! Dr Steve - 30 Sep 2004 12:23 GMT Sounds more like muscle spasm than needle injection pain.
Parafunction (Joel should make some wise-crack now)
www.headacheprevention.com
 Signature ~+--~+--~+--~+--~+-- Stephen Mancuso, D.D.S. Troy, Michigan, USA ....................................................
This posting is intended for informational or conversational purposes only. Always seek the opinion of a licensed dental professional before acting on the advice or opinion expressed here. Only a dentist who has examined you in person can diagnose your problems and make decisions which will affect your health. ......................
> update: Oh crap, I woke up this morning, and my jaw is killing me! Same > thing that always used to happen. The needle spot hurts. The dentist [quoted text clipped - 46 lines] >> >> More dentists should advertise that they can offer this! Its amazing!!!! Joel M. Eichen - 30 Sep 2004 16:26 GMT >Sounds more like muscle spasm than needle injection pain. > >Parafunction (Joel should make some wise-crack now) I was just thinking that ..........
>www.headacheprevention.com Synergie - 30 Sep 2004 16:41 GMT Nope, its from the injection.... I never used to get it when I refused freezing. I ALWAYS got it when I got the needle. It's always right where the needle was put in.
Unless its a muscle spasm 'caused' by the injection??? Either way, how do I get rid of it??? It's a good thing I am off work anyway, because I'd be asking for time off because of it. All I have been doing is sleeping since yesterday morning.
> Sounds more like muscle spasm than needle injection pain. > > Parafunction (Joel should make some wise-crack now) > > www.headacheprevention.com Joel M. Eichen - 30 Sep 2004 17:31 GMT >Nope, its from the injection.... I never used to get it when I refused >freezing. I ALWAYS got it when I got the needle. It's always right [quoted text clipped - 4 lines] >I'd be asking for time off because of it. All I have been doing is >sleeping since yesterday morning. I say parafunction ......
Joel
>> Sounds more like muscle spasm than needle injection pain. >> >> Parafunction (Joel should make some wise-crack now) >> >> www.headacheprevention.com Synergie - 30 Sep 2004 17:52 GMT Do you mean parafunction as like 'bruxism' like TMJ probs? Because I do actually have tmj problems. I have a splint. (I guess my stress levels are just too high and I clench alot lol) But how would a freezing injection near that area cause so much pain (are the mucsles in that area already so irritated that the injection just makes it worse?), and is there a way to avoid injecting in areas close to my joint, and still have the tooth in question frozen?
I really want to find an answer to this... at the very least so I can tell the dentist the next time I need to have any work done, so that maybe they can find some other way to deal with things and hopefully not cause me this much pain afterward.
>>Nope, its from the injection.... I never used to get it when I refused >>freezing. I ALWAYS got it when I got the needle. It's always right [quoted text clipped - 14 lines] >>> >>>www.headacheprevention.com Joel M. Eichen - 30 Sep 2004 18:12 GMT JUST PARAFUNCTION.
Perhaps some of the other guys can take over from here .....
JOEL
>Do you mean parafunction as like 'bruxism' like TMJ probs? Because I do >actually have tmj problems. I have a splint. (I guess my stress levels [quoted text clipped - 27 lines] >>>> >>>>www.headacheprevention.com Synergie - 30 Sep 2004 18:15 GMT If its just parafunction though, why would it not bother me on all of the times I refused local?? No needle = no pain! Its the same type of pain that occurrs when I get say an IM needle in my arm. I cant move my arm for awhile because the muscle is very sore. Same thing with freezing. The pain I have right now, occurrs ONLY when there was an injection. If it were 'just parafunction' wouldn't the other times that I refused the needle, have the same outcome?
> JUST PARAFUNCTION. > [quoted text clipped - 33 lines] >>>>> >>>>>www.headacheprevention.com Joel M. Eichen - 30 Sep 2004 18:34 GMT >If its just parafunction though, why would it not bother me on all of >the times I refused local?? No needle = no pain! Its the same type of [quoted text clipped - 3 lines] >injection. If it were 'just parafunction' wouldn't the other times that >I refused the needle, have the same outcome? No you are right, skip the PARAFUNCTION .....
Joel
>> JUST PARAFUNCTION. >> [quoted text clipped - 33 lines] >>>>>> >>>>>>www.headacheprevention.com Joel M. Eichen - 30 Sep 2004 18:35 GMT >>If its just parafunction though, why would it not bother me on all of >>the times I refused local?? No needle = no pain! Its the same type of [quoted text clipped - 5 lines] > >No you are right, skip the PARAFUNCTION ..... Errr, the PARAFUNCTION too ......
Jeez, that's what I said!
Joel
>Joel > [quoted text clipped - 35 lines] >>>>>>> >>>>>>>www.headacheprevention.com Dr Steve - 30 Sep 2004 18:42 GMT If so you would be the only person I know of who has this problem, and I don't know you face to face.
Muscle spasms lead to swollen hard painful muscles. Put a few cc of fluid into these muscles to create numbness, and it may hurt.
 Signature ~+--~+--~+--~+--~+-- Stephen Mancuso, D.D.S. Troy, Michigan, USA ....................................................
This posting is intended for informational or conversational purposes only. Always seek the opinion of a licensed dental professional before acting on the advice or opinion expressed here. Only a dentist who has examined you in person can diagnose your problems and make decisions which will affect your health. ......................
> If its just parafunction though, why would it not bother me on all of the > times I refused local?? No needle = no pain! Its the same type of pain [quoted text clipped - 41 lines] >>>>>> >>>>>>www.headacheprevention.com Dr Steve - 30 Sep 2004 18:41 GMT I have not seen you in person, so I could be all wet, but your description sounds like a person who clenches a fair amount during the day, and most of night while sleeping. This leads to muscle spasm. Muscle spasm leads to decreased opening and pain. TMJ refers to the joint, not to any problems with it. Bruxism refers to grinding back and forth. You do not sound like you have either bruxism nor TMJ problems. You are describing the typical clencher who gets muscle problems. A full mouth splint which looks like a horse-shoe will often make your problems worse. You need an NTI.
For the third time www.headacheprevention.com
 Signature ~+--~+--~+--~+--~+-- Stephen Mancuso, D.D.S. Troy, Michigan, USA ....................................................
This posting is intended for informational or conversational purposes only. Always seek the opinion of a licensed dental professional before acting on the advice or opinion expressed here. Only a dentist who has examined you in person can diagnose your problems and make decisions which will affect your health. ......................
> Do you mean parafunction as like 'bruxism' like TMJ probs? Because I do > actually have tmj problems. I have a splint. (I guess my stress levels [quoted text clipped - 27 lines] >>>> >>>>www.headacheprevention.com Synergie - 30 Sep 2004 18:52 GMT Wow you got me pegged! I do clench alot including day time. As far as TMJ probs, every time I open too wide I get clicking and popping, banging, and sometimes it kind of locks so that I have to close and open again to release it. I did not thik this was related to my probs with local though. But i can see how that if my myucles are always tensed, any needle invading them would cause alot more pain afterward. Same as if you tense your arm muscle when getting an immunization.... it will be alot more sore after. So, since I now know why I get more pain than others after freezing needles, how can I stop it? Should I just keep avoiding the needle and suffer through the drilling? At least I wont have any pain after the appt. If I do get the freezing, I need pain killers and at least a few days off work. I don't know which is worse.
> I have not seen you in person, so I could be all wet, but your description > sounds like a person who clenches a fair amount during the day, and most of [quoted text clipped - 6 lines] > > For the third time www.headacheprevention.com Dr Steve - 30 Sep 2004 20:04 GMT Fourth time www.headacheprevention.com
 Signature ~+--~+--~+--~+--~+-- Stephen Mancuso, D.D.S. Troy, Michigan, USA ....................................................
This posting is intended for informational or conversational purposes only. Always seek the opinion of a licensed dental professional before acting on the advice or opinion expressed here. Only a dentist who has examined you in person can diagnose your problems and make decisions which will affect your health. ......................
> > Wow you got me pegged! I do clench alot including day time. As far as [quoted text clipped - 21 lines] >> >> For the third time www.headacheprevention.com Synergie - 30 Sep 2004 20:14 GMT yes I read about the device! I dont think that we have it here yet though. And how will that help with the needle prob?? Will it make the needles not be sore anymore after?
> Fourth time www.headacheprevention.com Dr Steve - 30 Sep 2004 20:24 GMT Its in Canada
Trust me on the pain.
 Signature ~+--~+--~+--~+--~+-- Stephen Mancuso, D.D.S. Troy, Michigan, USA ....................................................
This posting is intended for informational or conversational purposes only. Always seek the opinion of a licensed dental professional before acting on the advice or opinion expressed here. Only a dentist who has examined you in person can diagnose your problems and make decisions which will affect your health. ......................
> yes I read about the device! I dont think that we have it here yet > though. And how will that help with the needle prob?? Will it make the > needles not be sore anymore after? > >> Fourth time www.headacheprevention.com The Real Paul - 30 Sep 2004 20:34 GMT You could ask for intraosseous injections which do not penetrate muscle tissue...
Google x-tip and/or stabident
Not all docs use this
> yes I read about the device! I dont think that we have it here yet > though. And how will that help with the needle prob?? Will it make the > needles not be sore anymore after? > > > Fourth time www.headacheprevention.com Synergie - 30 Sep 2004 23:44 GMT Hmmm I just read about that..... it sais that there is drilling right through the tooth and the anesthetic is injected through the hole?? How is this not painful? I'm not sure I understand how this is done.... But if it doesn't involve muscle tissue being all sore after, I'm all for it. That's of course if they even do it where I go. I've never heard of it before. On the site where I looked it up it also sais that its only good for bottom teeth and not top... is this true?? I'd like to know more if you can share!
> You could ask for intraosseous injections which do not penetrate muscle > tissue... [quoted text clipped - 8 lines] >> >>>Fourth time www.headacheprevention.com StovePipe - 02 Oct 2004 21:03 GMT > yes I read about the device! I dont think that we have it here yet > though. And how will that help with the needle prob?? Will it make the > needles not be sore anymore after? Of course we have it here, mon vieux.... look at the nti-tss.com web site and find an Kaannnaadian practitioner near you who prescribes it. You can phone Alpha Dental in Toronto and they will refer you to a dentist in your area.
IMVHO, I think you have needle-induced reflex contraction of hyperactive/irritable muscles, and this is why it hurts. The muscles contract and the joint is stressed. Your regular splint will NOT prevent reflex or sub-voluntary muscle contractions. If anything it will allow them to be even more forceful. Put your hands on your cheeks and clench down on your teeth. Feel the muscles contract. Now do the same with a pencil held between your front upper and lower teeth. You will feel that you cannot voluntarily contract as hard, as this will injure your muscles and teeth. This is how the NTI works. Your splint is even worse, IMO, because under the influence of Halcion, your sleep is NOT normal, and so involuntary muscle contraction with or without a splint would be given full reign.
I change my advice:
*Get an NTI
* DON'T augment your Halcion dose. It will allow too much uninhibited muscle activity around your machoire after the proceedure, as you sleep. Instead, ask your dentist to inject using her operating magnifiers, and do it SLOWLY... Touch the tissue, wait, inject a picoliter, wait.... Should take at least four or five minutes to do this.
*Ask your dentist to change the product she uses for your anesthesia.
*DO use osseous anesthesia after a local infiltration. There will be less product, and it won't be injected where the needle goes through a muscle. It goes straight into the bone above the muscle attachments.
*Have some prescription opthalmic steroid cream or liquid rubbed onto the injection site(s) and APPLY AN ICE PACK as soon as she redressed the chair. This is reflex iduced spasm and inflammation, and the ice should help.
*If your dentist has a LaserSmile, Twilite Laser or other dental Laser, that she irradiate the area at low levels to stimulate healing.
* Before going to sleep, do some slow stretches of the muscles and take some Robaxacet to help relax your muscles.
Hope this helps SP
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W_B - 02 Oct 2004 21:29 GMT Dear SP,
Looks like that I may have to buy you an airplane ticket to SM's place.
If I do this, you should be informed that I will collect the money out of your hide. Are you up for this ?
Just wondering, ;0)
>> yes I read about the device! I dont think that we have it here yet >> though. And how will that help with the needle prob?? Will it make the [quoted text clipped - 47 lines] >Hope this helps >SP -- W_B
wubbabubbazG@RBAGEyahoo.com Take out the G'RBAGE
Synergie - 02 Oct 2004 23:23 GMT >>* DON'T augment your Halcion dose. It will allow too much uninhibited >>muscle activity around your machoire after the proceedure, as you sleep. >>Instead, ask your dentist to inject using her operating magnifiers, and >>do it SLOWLY... Touch the tissue, wait, inject a picoliter, wait.... >>Should take at least four or five minutes to do this. The rest sounded good, but I absolutely HAVE to be sedated at the dentist. Not for the needle/pain reasons, but for anxiety. If I was not sedated, no wok would get done between my (sorry to be blunt) puking from bad nerves. Therefore, the more sedated I am, the better the appt will go.
BTW its been over 36 hours now and I still can't open past about a centimeter, and my jaw still hurts at the injection site. I hope this goes away soon, and I am going back to NO local again... ever! I did WAY betetr by *suffering* for an hour than I did by having a relatively painless appt but then *suffering* this long after... all because of the needle, which is supposed stop pain not induce it!
I will ask about the intraosseus injections for anesthetic (actually already did) but she asked me to print off what I could find on the net, because she wasn't sure exactly what I was talking about. All I know is that I can't have regular local anesthetic injections anywhere near muscle tissue... just a personal prob with me... oh well. They will have to deal with it and find other means. Maybe TENS?? How well does that work anyway as an alternative to the (dreaded) needle??
W_B - 03 Oct 2004 00:18 GMT > If I was >not sedated, no wok Perhaps a Chinese dentist would make you dinner.
-- W_B
wubbabubbazG@RBAGEyahoo.com Take out the G'RBAGE
StovePipe - 03 Oct 2004 04:43 GMT > Dear SP, > [quoted text clipped - 6 lines] > Just wondering, > ;0) That would be great, but unnecessary, and I'm wondering for what reason is this coming up here??????
Is there something particularly repulsive about what I said here that is making you want to vommmmit???? I DID think long and hard about what's happening in this lady's mouth before answering... Jes' Wonderin', an' thanks for the offer to get my a.s kicked... SP
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Steven Fawks - 30 Sep 2004 23:44 GMT Get an NTI and things may get better (IOW's I agree with Steve, even though I am also Steve <G>).
Watch the Halcion dosage and I hope your blood oxygen levels are being monitored.
Fawks
> Wow you got me pegged! I do clench alot including day time. As far as > TMJ probs, every time I open too wide I get clicking and popping, [quoted text clipped - 20 lines] >> >> For the third time www.headacheprevention.com StovePipe - 03 Oct 2004 04:43 GMT > Get an NTI and things may get better (IOW's I agree with Steve, even > though I am also Steve <G>). [quoted text clipped - 3 lines] > > Fawks How-do, SF.... Are you doing this with a pulse oximeter or what? Thanks SP
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Steven Fawks - 04 Oct 2004 15:24 GMT That would be the method of choice.
:-) Fawks
> How-do, SF.... Are you doing this with a pulse oximeter or what? > Thanks > SP Synergie - 04 Oct 2004 15:52 GMT Ummm where I go, the dental clinic is inside the base hospital (military). I remember they hooked me up to a bunch of stuff when I had my wisdom teeth out and was on IV sedation but not this time. Halcion is often taken by people to sleep at night and even at higher doses than I took for the appt. There is I believe a .5 mg pill. I had the .25 (though I took 2) anyway... they didn't monitor oxygen levels, but if something did happen where I didnt reapond or something, they could have a crash cart there in about 30 seconds. The OR is actually just around the corner on the same floor and the ER is one floor up. Is it the norm to monitor someone on oral sedation??
> That would be the method of choice. > [quoted text clipped - 4 lines] >> Thanks >> SP Joel M. Eichen - 04 Oct 2004 17:10 GMT >Ummm where I go, the dental clinic is inside the base hospital >(military). I remember they hooked me up to a bunch of stuff when I had [quoted text clipped - 6 lines] >the corner on the same floor and the ER is one floor up. Is it the norm >to monitor someone on oral sedation?? Yup, even worse, many people tell secrets while under and then end up getting blackmailed!
Joel
>> That would be the method of choice. >> [quoted text clipped - 4 lines] >>> Thanks >>> SP Joel M. Eichen - 04 Oct 2004 17:54 GMT >>Ummm where I go, the dental clinic is inside the base hospital >>(military). I remember they hooked me up to a bunch of stuff when I had [quoted text clipped - 11 lines] > >Joel Canadian Navy is concerned over this .......
Joel
>>> That would be the method of choice. >>> [quoted text clipped - 4 lines] >>>> Thanks >>>> SP Dr Steve - 30 Sep 2004 17:48 GMT If the needle hit a blood vessel (happens a lot), you could get some blood accumulation in the tissues which makes the area sore and hard to open widely for a day or two. Otherwise, pain from the injection (after the first 5 seconds) is not really something we see.
Patients with parafunctional muscle activity get pain and limited opening like you describe a lot, though.
again www.headacheprevention.com
 Signature ~+--~+--~+--~+--~+-- Stephen Mancuso, D.D.S. Troy, Michigan, USA ....................................................
This posting is intended for informational or conversational purposes only. Always seek the opinion of a licensed dental professional before acting on the advice or opinion expressed here. Only a dentist who has examined you in person can diagnose your problems and make decisions which will affect your health. ......................
> Nope, its from the injection.... I never used to get it when I refused > freezing. I ALWAYS got it when I got the needle. It's always right where [quoted text clipped - 10 lines] >> >> www.headacheprevention.com Joel M. Eichen - 30 Sep 2004 18:13 GMT >If the needle hit a blood vessel (happens a lot), you could get some blood >accumulation in the tissues which makes the area sore and hard to open [quoted text clipped - 3 lines] >Patients with parafunctional muscle activity get pain and limited opening >like you describe a lot, though. THANKS (whew - you saved me)
Joel
>again www.headacheprevention.com W_B - 01 Oct 2004 21:05 GMT >Sounds more like muscle spasm than needle injection pain. > >Parafunction (Joel should make some wise-crack now) > >www.headacheprevention.com Needle should *never* penetrate muscle tissue in the oral cavity.
Poor technic is to blame in most instances.
-- W_B
wubbabubbazG@RBAGEyahoo.com Take out the G'RBAGE
Dr. Steve - 01 Oct 2004 21:16 GMT >>Sounds more like muscle spasm than needle injection pain. >> [quoted text clipped - 3 lines] > >Needle should *never* penetrate muscle tissue in the oral cavity. ???
>Poor technic is to blame in most instances. Synergie - 01 Oct 2004 21:33 GMT I asked today about intraosseus (sp?) anesthetic, and she wanted me to get some more information for her. I think I now know more about it than she does! I watched a short video on it online last night. Since it doesn't go near muscles, and is supposed to be virtually painless, almost instantaneous, no lingering numbness, and no soreness after I want it next time. Thankfully, I only needed one old filling replaced, and have a full bill of health otherwise. But for future reference.
And btw she agreed that my probs with the needle could be caused by my TMJ probs and because my muscles are always tensed. She gave me a scrip for Flerxeril (muscle relaxant) today, to try and prevent my jaw from becomming stuck shut again. I still can't open more than a few millimeters....prooving good for the diet but I am so hungry I could eat an entire cow! Still have the pain from the needle and its been over 48 hours. So I guess this time I just have to 'suffer' it out. I should have just did the appt without local... I did it before. Suffering through 20 mins or so of drilling to me is way better than 3-4 days of not being able to eat, chew, talk etc... oh well... I tried.
>>>Sounds more like muscle spasm than needle injection pain. >>> [quoted text clipped - 7 lines] > >>Poor technic is to blame in most instances. Steven Fawks - 04 Oct 2004 15:21 GMT Lasers can come in handy too.
;-) Fawks
Suffering
> through 20 mins or so of drilling to me is way better than 3-4 days of > not being able to eat, chew, talk etc... oh well... I tried. StovePipe - 02 Oct 2004 21:03 GMT > Needle should *never* penetrate muscle tissue in the oral cavity. > > Poor technic is to blame in most instances. > > -- > W_B ????? 3rd division block (mandibular block) will penetrate the buccinator... don't see how it can be done otherwise. The internal pterygoid will be pierced with a high mandibular block (as in Gow Gates) as well, I think. Also the fibers from the masseter and lateral pterygoid up top in the posterior, and of course, the frenum insertions.... Might just be enough to induce reflex contractions of hyperirritable muscles. Just thinkin' SP
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W_B - 02 Oct 2004 21:21 GMT >> Needle should *never* penetrate muscle tissue in the oral cavity. >> [quoted text clipped - 12 lines] >Just thinkin' >SP Have been giving a Gow-Gates mandibular block for twenty years, son. A few Akinosi's on the side never hurt.
Long buccal is just distal to the DB cusp of 17 or 32. Right at the depression of the ramus.
Learn the anatomy and you will be more precise with your injections.
If you penetrate muscular tissue, at any time, you are doing it wrong.
Giving a Lingual N. block takes significant talent. I do it quite often. But I am talented.
FO, B
-- W_B
wubbabubbazG@RBAGEyahoo.com Take out the G'RBAGE
StovePipe - 03 Oct 2004 04:43 GMT > Have been giving a Gow-Gates mandibular block for twenty years, son. > A few Akinosi's on the side never hurt. Cool, Daddy-O
> Long buccal is just distal to the DB cusp of 17 or 32. > Right at the depression of the ramus. Oh Kay, but the buccinator is a sheet muscle, not a fascicle. Long, ribbon like insertion.
> Learn the anatomy and you will be more precise with your injections. Will do, but have to admit.... I've asked three different Anatomy Profs (two of them Oral Surgeons) and I've gotten three different answers as to injection techniques.
> If you penetrate muscular tissue, at any time, you are doing it wrong. Will honestly check, but I think you are wrong. (Admittedly, this doesn't happen very often...)
> Giving a Lingual N. block takes significant talent. > I do it quite often. > But I am talented. As FDR used to say... BULLEY!!! I'll settle for safely competent. That way I sleep at night.
> FO, B TMS&ISTI SP
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Joel M. Eichen - 30 Sep 2004 16:25 GMT >update: Oh crap, I woke up this morning, and my jaw is killing me! SEE???
Reading too much reading SMD and thinking about teeth proves painful (and good for the dental business).
Malocchia!
(evil eye thinggie)
> Same >thing that always used to happen. The needle spot hurts. The dentist [quoted text clipped - 3 lines] >jaw joint. What I am scared of is that my jaw will lock like last time >I tried local. I really dont want that to happen again.. MY TRICK:
Tell the dentist you WILL BE stopping every five minutes to rest and rotate your jaw a bit .......
DENTISTS hate me for this advice!
> it wasn't fun >having tongue depressors shoved one by one between my front teeth to >force my jaw open! Wait until they get out the Jaws Of Life apparatus ......
> It hurts too much to try and stretch it out, and I >havn't eaten anything or talked much at all since yesterday. I've [quoted text clipped - 37 lines] >> >> More dentists should advertise that they can offer this! Its amazing!!!! W_B - 01 Oct 2004 18:27 GMT Orudis KT 25mg q4h prn pain.
>update: Oh crap, I woke up this morning, and my jaw is killing me! Same >thing that always used to happen. The needle spot hurts. The dentist [quoted text clipped - 9 lines] >Should I go back and possibly get some different pain meds?? Is there >anything else I can try that will lessen the needle spot pain?? --
W_B
Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com
StovePipe - 02 Oct 2004 21:03 GMT > having tongue depressors shoved one by one between my front teeth to > force my jaw open! It hurts too much to try and stretch it out, and I > havn't eaten anything or talked much at all since yesterday. I've > pretty much kept my jaw stationary since the appt for this reason. > Should I go back and possibly get some different pain meds?? Is there > anything else I can try that will lessen the needle spot pain?? try moving the machoire from side to side instead of up and down. This will stretch the pterygoid muscles somewhat... do it SLOWLY, so you don't aggravate the muscle spasm.. Also try Robaxacet... it will relax the muscles. I think you may have an allergie to local anesthetics. Ask your dentist to use another product next time, and to use her loopes to better see what she is doing. I don't think you're a candidate for intraosseous anesthesia. I would also suggest using some good old aspirin, and rubbing the injection site with some topical cortisone solution next time around. HTH SP
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