What Are the Reasons for Dental Anesthesia Not Working?

According to SAEDNEWS, thanks to local anesthesia, pain in the gums and teeth is not felt during treatment, allowing the dentist to work easily. Anesthesia is performed in two ways: topical and injectable. Topical anesthesia is used only when the dentist intends to treat a small area of the tooth, using sprays, liquids, or gels. In addition, anesthetic fluid is applied to the gum using a needle and a swab is used to spread it over the area.

In injectable anesthesia, which is used for more essential treatments, the injection in the upper jaw is administered near the treatment area, while in the lower jaw it is injected at the lower part of the jaw to create a nerve block.

One of the main fears people have about dental anesthesia is the inability to control pain in the face or the possibility that the tooth may not become numb. Patients are usually assured that if they feel severe pain during treatment, they can signal the dentist (e.g., by raising their hand or changing facial expression) so that treatment can be paused and more anesthetic can be administered.

Dental anesthesia is generally used for more complex procedures. The anesthetic is injected and within minutes the patient should feel complete numbness in the treatment area. However, sometimes even with the best anesthetic, numbness may not occur properly.

Causes of Failure of Dental Numbness

Inexperienced dentists

Not all dentists are skilled in administering dental anesthesia. If you have experienced poor performance in local anesthesia, it may be better to visit another dentist. Dental anesthesia requires a specific technique. Some types also require a very slow and steady injection process; if injected too quickly, effectiveness may decrease.

The dentist may also miss the exact area that needs to be numbed, which often happens when trying to numb the lower back teeth. In such cases, even the lips may become numb. This occurs when the dentist attempts to block the nerve that supplies sensation to the teeth. If standard methods fail, experienced dentists may use the “Akinosi” technique (closed-mouth mandibular anesthesia) or the “Gow-Gates” method (mandibular nerve block). However, both techniques require a highly skilled dentist and are usually used only when the inferior alveolar nerve block fails.

Anxiety and stress

Stress and anxiety can cause failure of dental anesthesia. Discussing the procedure beforehand can help reduce patient anxiety. New techniques and modern anesthetic agents, especially for lower molars, have significantly improved results.

Addiction and failure of anesthesia

Dental anesthesia failure is more common in individuals who use drugs or alcohol. Cocaine, by affecting the central nervous system (CNS), alters pain perception; therefore, these patients often require stronger or multiple anesthesia techniques, along with medical management before and after treatment.

Solutions for achieving complete numbness

• Get enough rest the day before treatment

• Avoid scheduling dental work during stressful times

• Inform your dentist about any anxiety before treatment

• Take a mild painkiller such as 400 mg ibuprofen one hour before treatment

  

When are special anesthetic injections used?

There are two types of dental anesthetic cartridges: one with lidocaine plus vasoconstrictor (epinephrine), and one without epinephrine. In some cases, anesthetics containing vasoconstrictors should be avoided or minimized, such as:

1. Patients with systolic blood pressure over 200 mmHg or diastolic over 115 mmHg

2. Patients with uncontrolled hyperthyroidism

3. Patients who had a stroke or heart attack within the past 6 months, unstable angina, irregular heartbeat, or recent coronary bypass surgery (less than 6 months ago)

4. Patients undergoing general anesthesia with halogenated compounds