Why is there severe pain even after anesthesia during tooth extraction?

Question

Hello doctor,

I went to the dentist this morning for an extraction on a bottom molar on my left side. After being completely numbed he started the extraction and I had excruciating pain. He numbed me more but no matter how much he numbed, it hurt so bad. He eventually said he would refer me to a dental surgeon so I could be sedated. He was extremely nice about it the entire time but I could tell he just thought I was anxious and misinterpreting the pressure as pain. I was extremely nervous and anxious so I understand but I have had a tooth pulled before and I know the pressure, but this was an intense pain even though I was numbed. He said the dental surgeon would give me an IV that would relax me and make the procedure easier for me. I am worried that being sedated will not stop the pain. He said because I had a bad infection in the tooth that it could be causing the pain so he prescribed me some antibiotics to get rid of the infection. My questions are is this normal to have such terrible pain even while completely numb and will being sedated even help with this pain?

Answer 1

Hi,

Welcome to icliniq.com.

It is the best question I have got in my practice and the most frequent query is how and why.

This is due to two reasons. Infected tooth with much inflammation or patient's anxious nature. So to tackle such cases it is better to prescribe antibiotics for five days then extract even if patient complaints, again it is better to give him or her tablet of Alprazolam before extraction one or two days to relieve anxiety. Moreover, before blocking the nerve, we can also give an injection of Dexamethasone which reduces inflammation.