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Medical Forum / General / Dentistry / August 2006IV-based anesthetic for root canal?
Any comments would be greatly appreciated! The history -- A month ago, my wife visited our dentist regarding some pain in one of her lower molars. Her pain is not acute, but does bother her when she chews. Our dentist took some x-rays, prescribed 500 MG of Keflex (3x per day), and suggested she visit an endodontist. On the first visit to the endodntist, he evaluated her and suggested a root canal. At the root canal appointment, he attempted to numb her tooth with a local anesthetic but the tooth would not go numb. He prescribed 500 MG of Amoxicillin (3x per day) and told her to come back in a week. This last week he again tried to numb her tooth but it *still* wouldn't go numb. He is now suggesting an IV-based anesthetic. My questions -- Is this normal for a tooth to be so difficult to numb (even with the antibiotics)? Should we see a endodontist with better anesthetic skills? Thank you! > Any comments would be greatly appreciated! > [quoted text clipped - 16 lines] > Is this normal for a tooth to be so difficult to numb (even with the > antibiotics)? Not too unusual, unfortunately. It's tough to numb a hot tooth. > Should we see a endodontist with better anesthetic skills? There's no way to tell that lack of skill is the problem. I can say that an endodontist with poor anesthetic skills is in trouble big. I assume he is suggesting sedation or general anesthesia? I'd sooner try a third time with local. Steve > Thank you! Achieving profound anesthesia with a local anesthetic can be very difficult for a tooth that has an infection. In a nutshell, the infection can make it difficult for the anesthetic to work. However, a lower tooth is usually anesthetized with a nerve block [inferior alveolar nerve block] and it usually can be anesthetized at a distance far enough from the tooth so that even if there were an active infection, the nerve block would be successful. But, it could be that in your wife's situation, the infection has gone further. As the other responder said, I would agree and try to use the local again. Most endodontists should be very skilled in achieving profound anesthesia. As the dentist about this and see what he thinks. > Any comments would be greatly appreciated! > [quoted text clipped - 20 lines] > > Thank you! I liken a hot tooth to a sun burned arm: If I slap my normal arm, it hurts a little but not much; however, if the arm is sun burned, the slap will KILL me. Same thing with a tooth...a hot tooth when drilled upon will elicit a greater degree of pain sensation not necessarily locally but also via the pathways in the brain. Try looking up the following terms: Allodynia Hyperalgesia > Achieving profound anesthesia with a local anesthetic can be very > difficult for a tooth that has an infection. In a nutshell, the infection [quoted text clipped - 32 lines] >> >> Thank you! |
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