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Dental Anesthesia

Immunity to Local Anesthetics

11/11/2009

Question:

I am a 48 year old female, over the years I have had several teeth pulled by different dentist`s. I have also had a few lacerations that required stitches. With one exception I have never had local anesthetic work. That dentist used something besides novacaine and it was wonderful to be numb. Do you know what it might have been? I also have trouble with pain killers it seems anything codiene based or novacaine based has no effect. Is this problem rare? Most of the physicians don`t seem to believe me when I tell them I would rather they do what they have to do without the shots. They only irritate an already sore area and honestly hurt as much as the stitches anyway.

Answer:

It appears you have two questions. One is which local anesthetic was used, and you will have to contact your dentist. This will be listed on your medical record the dentist maintains. Local anesthetics are not universally effective, and dentist anesthesiologists (http://www.asdahq.org/) provide general anesthesia routinely for patients who find local anesthetic ineffective.

The second question is about oral analgesics. Some oral analgesics, like codeine, are not effective for some people as they lack a properly functioning enzyme that activates the drug. There are also some drugs, like fluoxetine (Prozac) and omeprazole (Prilosec) that affect this enzyme and may make codeine and other analgesics much less effective.

You should discuss this with your dentist. There are alternative medications that can be used. Good luck.

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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