Novocain not enough


I have problems with the numbing medications commonly used by most dentists. It’s not a physical allergy, but, for some reason, the drugs do not work for me the way they do for most people. I have, after several horrible experiences, come to the conclusion that the only way I can tolerate dental procedures is if I am completely unconscious. Have you ever heard of a case like mine? I have to add that this is not a case of simple discomfort or inability to handle pain. I have had several surgical procedures and other medical interventions over the years, but nothing affects my like when I need to undergo a dental procedure. Please let me know what you suggest.


Jeremy in Boston

Dear Jeremy,

Many patients, particularly those with a history of painful or traumatic dental experiences, have trouble getting numb from the normal administration of Novocain. It’s a real biochemical phenomenon, in which the patient’s anxiety affects their body chemistry to the extent that the nervous system does not respond to the effects of the numbing medication and they are unable to become numb.

For many of these patients, administration of nitrous oxide prior to administration of the numbing medications is enough to alleviate the extreme anxiety that is interfering with their physical response to the Novocain. However, some patients need stronger sedation.

Rather than undergoing general anesthesia, however, I recommend seeking out a qualified sedation dentist. These dentists practice a technique known as conscious sedation, also known as “sleep dentistry,” which is a procedure that is less expensive, safer, and more convenient than general anesthesia. Most patients who undergo conscious sedation have no memory of their dental visit. I would investigate this route, first, before pursuing general anesthesia.

You can learn more about conscious sedation on our main website here.

Pain while bleaching teeth at home


I have been using an take-home tooth bleaching system purchased from a local drugstore for about two weeks with no problems. But yesterday, I used the strips and felt a sharp pain for about 30 seconds. The pain was in a front tooth on which I have had dental bonding done. The bonding was done about 10 years ago to repair that tooth after it was damaged and chipped. Could the dental bond be nearing the end of its life cycle or is the whitening product weakening the bond? I think it may be both.



Dear Kim,

It’s unlikely that the bleaching system is harming the dental bond. Also, if the dental bond were weak, the repair to the chipped portion of the tooth would fall off. You would not just feel pain.

The kind of pain you describe sounds like it could be caused by the bleaching gel reaching a sensitive part of that tooth. There could be a small space of tooth that used to be covered by the bonding agent that is now exposed. Unfortunately, your case is a good example of why it’s a good idea to only undergo teeth bleaching (whitening) under the supervision of a qualified dentist. If you have a dentist that you see regularly, make an appointment so that he or she can examine the tooth and determine the source of the pain. The tooth may be able to be coated with something that will allow you to continue the bleaching program pain free.

Categories : Teeth whitening