Dr. Naveen Thomas
Dentistry
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
I started to have pain in the left top part of the jaw for two days. I took Azithromycin for it and the pain went away. After that, I started to have pain on the right top part with swelling. The doctor worked on the right upper part with topical Articaine and I do not had pain. He worked on the lower premolar on the right side and I do not had pain. He tried to remove the lower second molar on the right side and it was very painful. Six Articaine shots were given and it failed to produce a painless procedure.
During the third time, the doctor worked on the front tooth on the top to clean the roots in the root canal. He used Ultracaine with Epinephrine. It resulted in weak anesthesia. I had a painful tooth cleaning. After having a visit with the dentist every time, the anesthesia worked less than before and it was very painful. Please advise about the ways of insertion to have better anesthesia.
Hi,
Welcome to icliniq.com.
In the lower molar extraction, inferior alveolar nerve block has to be given properly and it has to be given very close to the bone at the correct point. For root stumps, an infiltration of Lidocaine can be given directly to the roots after inserting the needle along the sides of the roots. This will help to achieve excellent anesthesia. Front teeth at the top get anesthetized easily and it seems that the dentist is not injecting at the correct point of the nerve opening. Sometimes, some patients have little pain tolerance, causing pain during pulling pressure. If possible, try to do further treatment with an experienced dentist.
Patient's Query
Thank you doctor,
I wish to find an experienced dentist. I always get an expensive service and it is not painless. I watched a video in that the doctor numbs the molar with a substance called Sitnusplaine followed by Lidocaine. I have not found any anesthetic substance by that name. After that, he says about the other substance called lijet and he says it as pressure anesthetics. Would these two methods be more effective? Can I develop resistance to Articaine or LA?
Hi,
Welcome back to icliniq.com.
Proper nerve block given with Lidocaine and Articaine infiltration is more effective in the side of the molar and it usually never fails. I have not heard about Sitnusplaine. Lijet method is unreliable. The inferior alveolar block has to be administered correctly along with Articaine and Lidocaine infiltration to the side of the concerned tooth and it is the best way to anesthesia lower molar teeth. I have not heard about LA (local anesthesia) resistance. But sometimes, patients need two to three syringes according to their body weight.
Patient's Query
Thank you doctor,
On molars, he gave me six shots. He blocked the nerve and I lost the feeling for half of the jaw. But when he started to dig the roots, it became very painful.
Hi,
Welcome back to icliniq.com.
Sitnusplaine can be a different anesthetic substance like Lidocaine and Articaine.
Patient's Query
Thank you doctor,
I saw another video. In that, there is a big sack of pus under the teeth, and the doctor drills through the teeth. The pus squeezes out through the teeth when pressed on the sides of the tooth. My doctor did not agree with it and he told me that it is done only when the pus is inside the gums. Nobody can dig inside the tooth to extract pus and it is useless. But I think when I apply pressure on the sac of pus causes discomfort. Cleaning one of the roots results in extracting pus and it can reduce the swelling and allows for the painless extraction of these roots. What do you think?
Hi,
Welcome back to icliniq.com.
In your case, there are only root stumps on the lower molars (left side). So drilling will not help you and ask your dentist to infiltrate it by giving periodontal infiltration near the root stumps. If there are swelling and pus, some local anesthetic agent can be injected into it.
Patient's Query
Thank you doctor,
I also read in the oxford handbook of clinical dentistry that there are many more ways for anesthetizing molars, apart from Inferior Alveolar Block. They are gow-gates technique and akinosi technique. Do these techniques provide better comfort?
Hi,
Welcome back to icliniq.com.
Gow gates method is a sure shot method to have complete anesthesia. It has to be given by a well experienced oral and maxillofacial surgeon as it is dangerous and can result in hematoma if not given correctly.
Patient's Query
Thank you doctor,
I thank you for giving me a detailed answers.
Hi,
Welcome back to icliniq.com.
You are welcome.
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