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Dental Anesthesia

Can someone be immune to anesthesia?

07/01/2008

Question:

My girlfriend is 17 years old. She said that the last time she went to the dentist, they gave her seven shots of anesthesia, and she still felt horrible pain when they did the procedure. She says that this has happened all her life, like Tylenol and Advil do nothing, as though she`s immune to painkillers. She`s in the dentist again now and having panic attacks, and has an upcoming appointment for wisdom teeth removal.

Answer:

Thank you for your question. It is unlikely that your girlfriend is "immune" to anesthesia and analgesics. The drugs you mentioned all have different mechanisms of action, and it would be very rare indeed to not have any type of pain medication work. As to local anesthetic, especially in the lower jaw, the anatomy of the nerve supply can make anesthesia more difficult. This is generally not a problem in the upper jaw. Some options that may improve local anesthesia would include the use of 4% articaine with 1:100,000 epinephrine or the use of intraosseus anesthesia which is a technique where the anesthetic is injected into the bone next to the tooth. It may be that your girlfriend may need general anesthesia for dental work. If the lack of local anesthetic effectiveness is documented, this may be covered by medical insurance. General anesthesia for wisdom tooth extraction is usually covered anyway but make sure you are getting "general anesthesia". Most oral surgeons only provide IV sedation. The other thing to consider is the anxiety level that might be present. With high anxiety over dental procedures, which is understandable in this case, even slight painful sensations may be misinterpreted as greater than they are. This is not to say that the perception is not real, just that its interpretation may be exaggerated. Discuss this with your dentist to ensure the best outcome for your girlfriend.

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Response by:

Steven I Ganzberg, SB, DMD, MS Steven I Ganzberg, SB, DMD, MS
Formerly, Clinical Professor of Dentistry
College of Dentistry
The Ohio State University