Infected tooth wouldn't numb

JamieW24

Seen a few posts with similar experiences where their tooth wouldn't numb with local anesthetic. I had 3 cartridges and everything but the tooth that needed to be numb was numb (painful when I pressed the top and not just pressure).

Plan was to extract the tooth, but in the end I gave up. After what must have been 15 different injection sites and pain (I felt him hit bone, a nerve and injected into the abcess which felt like it then blew up like a balloon). He then wanted to instead drill down into the tooth to drain the fluid which I don't know about anyone else, I wasn't a huge fan as the tooth wasn't numb. This wasn't my usual dentist mind and he was really trying hard to numb the area. He gave me more antibiotics (had a 5 day course already) in the hope it reduces enough for the LA to work more effectively next time. 3 questions, 1 slightly unrelated.

1 - why with an abcess do they not Lance the gum? I've read this is common practice. Surely it would have made the area much better to then extract the tooth on another appointment?

2 - what are the chances it will work a second time? I'm now quite nervous about it.

3 - if it doesn't work next time, has anyone tried Sedation as one way or another this needs sorting and I'd rather not have a tooth pulled with no LA.

Cheers
Jamie

Robin9

Had an abscess this week - dentist released a bit of puss, took photo's and a course of antibiotics (not allowed to drink for a week !) and everything is fine.

gettingtheresometime

I once had an injection prior to a filling but when the dentist started I screamed so much she decided to give me another injection.

Once again it had no effect so she followed the course of action your dentist followed ie prescribing antibiotics & when I returned the treatment was successful

Toothsmith

This is a very common problem. Teeth that come to us in a really painful state can be a pig to get to go numb sometimes.

It's always worth trying, as it's not all the time, and if you can get into the tooth, or get it out, then that really is the quickest way you can get the patient out of pain.

As you've seen from previous replies Jamie, there is a very high chance that once you've been on antibiotics for a while, there will be no problem the next time you go - so don't worry too much about that.

Draining an infection via lancing the gum is not possible in most cases. If the infection has tracked through the gum to form a well defined swelling that has begun to 'point' - then a well placed scalpel cut can provide almost miraculous relief! From an operator point of view too, it is a really satisfying thing to do when you lance a big swelling and get a load of pus flowing out!!

But - this sort of toothache is relatively rare. Usually the pain is from an infection within the tooth, and the pressure effect of that in the bone. The area might have caused a 'swelling' around it, but that swelling is just a reaction in the surrounding tissue and not the 'infection' itself. This is where you need to get inside the tooth to relive the pressure there. If the tooth has been dead for a while, then that's never really a problem. It could probably even be done with no anaesthetic, and the patient feel no pain. (But one should still be given!). The problems come with teeth that are dying, and still have vestiges of live nerve within them. They can be the ones that are hard to numb.

Just to add though - from a dentist point of view, the real problem patients are those that come in with pain, you can't get the tooth numb, so you give antibiotics and reappoint, then they either cancel or miss that appointment because it's 'got better' - then the next time you see them, they're back in pain again!!!

You still need to get it fixed, even if it's stopped hurting!!