Do you dread making an appointment for dental treatment because you have difficulty getting numb? Do you also dread telling a dentist or oral surgeon that you’re “hard to numb” because you’re afraid that he or she won’t believe you, or think you’re just being overly dramatic? First, let us assure you that some people are more resistant to the effect of local dental anesthesia than others. And second, let us assure you that conscientious dentists recognize this fact, and work with their hard-to-numb patients to find a solution that will keep them pain-free throughout the procedure.
You may also wonder why you seem to be the exception, when everyone else you know can’t feel a thing after only one injection. While it might not exactly be a comfort, there are eight common reasons that prevent dental anesthesia from fully numbing your mouth the first time it’s administered.
1. Genetic factors
Genetic factors can make numbing difficult. Natural redheads, for example, often need more anesthetic due to a lower pain threshold linked to the MC1R gene. The MC1R mutation in this gene produces red hair due to the production of pheomelanin, which can increase the body’s sensitivity to pain. One study found that redheads need an average of 20 percent more anesthesia than non-redheads. Moreover, some people who have epilepsy may be more resistant to numbing.
2. Nerve location
Nerves in the mouth can vary slightly in their location and path from person to person, and X-rays don’t always give a clear picture of them. The size and shape of your jaw and the amount of fat and muscle impact where nerves are located. Another factor is that some people have multiple nerve branches supplying a tooth, making it harder to block all pain signals with a single injection. If the dentist’s injection doesn’t perfectly hit the target nerve, the anesthetic may not be effective.
3. Anxiety level
Feeling anxious or stressed can cause your body to release adrenaline, which can counteract the numbing effects of the anesthetic. Those who experience dental anxiety have an emotional reaction of fear, which triggers other negative physical symptoms, such as an upset stomach, racing heartbeat and sweating — among others. Our blog post — “How to Cope with Dental Anxiety” — covers these symptoms in detail.
4. “Hot tooth” phenomena
Yes, this is a real thing! As Golden State Dentistry explains it, “A hot tooth is a painful tooth that resists numbing due to hyperactive nerves. These overactive nerves generate additional pain receptors, necessitating a higher dose of anesthetic to achieve numbness.” However, the cause of a hot tooth is usually irreversible pulpitis — inflammation of the tooth’s pulp — which can occur due to periodontal (gum) disease, severe tooth decay, a leaking old filling, tooth grinding (bruxism) or trauma. Irreversible pulpitis is the reason people seek treatment; difficulty in getting numb is a consequence. Taking responsibility for your oral health by getting twice-yearly dental examinations can prevent irreversible pulpitis through early detection and treatment.
5. Individual metabolism
Your body’s metabolism can affect how quickly the anesthetic is broken down and removed from your system. Some people might metabolize anesthetic faster, leading to shorter periods of numbness or even preventing it from taking full effect. Intense exercise and caffeine can further speed up metabolism, reducing anesthetic effectiveness. To prolong numbness, consider moderating your workout routine and/or caffeine consumption before your dental appointment.
6. Medical conditions and medications
Certain medical conditions can hinder achieving adequate numbness during dental procedures. For example, Ehlers-Danlos syndrome is a rare connective tissue disorder that affects how the body responds to anesthetics. Bruxism causes lactic acid buildup, increasing sensitivity and inflammation, which can interfere with anesthetic effectiveness.
Moreover, prescription medications to manage hypertension (high blood pressure) can reduce the effectiveness of dental anesthetics. It’s essential to be transparent with your dentist about any prescription medications you are using for not only this reason, but to prevent adverse reactions. Update your dentist when you’re prescribed a new medication, or are taken off of a medication you’ve been using.
7. Vitamin C consumption
Consuming vitamin C — such as drinking a glass of orange juice before your dental visit or taking vitamin C supplements — can change the pH balance in your mouth and counteract dental anesthetics. Medical conditions such as asthma, emphysema, untreated diabetes and cancer can also impact pH levels. Avoid drinking orange juice or taking vitamin C supplements a few days before your appointment.
8. Patient movement during the injection
Even for patients who don’t experience dental anxiety, anticipating the injection of anesthesia can make you a bit jumpy. Most dentists apply a topical numbing gel to the injection site, but human nature being what it is, it’s still common to flinch. Even a small movement at the time of injection can cause the dentist to miss the nerve, thus making the anesthesia ineffective, or not as effective at blocking pain as it should be. Hold your breath just before the injection to prevent inadvertent movement at this critical time.
The Take-Home Message
If you’ve been difficult to numb for dental procedures in the past, talk to your dentist. As we noted earlier, dentists know and accept that some patients have this issue, and can discuss with you different techniques, medications, or sedation options to ensure that your procedure is pain-free. Don’t avoid the dentist or suffer in silence! You have the right to comfortable dental treatment.
At NK Family Dental, it is our mission to provide the highest quality and most compassionate oral care to our Chicago patients, including dental, orthodontic and periodontal services. Our practice is trusted for advanced oral surgery procedures and comfortable root canal treatment.
Our team of experienced, dedicated dental professionals will help address your oral health concerns, and determine the best solution for you based on your individual situation. We strive to identify treatment options that fit your needs. Our dental specialists include our general dentist, Dr. Nilofer Khan, our endodontist, Dr. Sabek, and our periodontist, Dr. Amir Danesh. Dr. Danesh is a board-certified periodontist and Diplomat of the American Board of Periodontology. He has contributed to the publication of two books, as well as published over 20 papers in prestigious dental research journals.
We serve the neighborhoods of Logan Square, Bucktown, Humboldt Park, and Wicker Park with the dedication that’s earned us the reputation as the Best Dentist in Chicago!
We understand that the main concern you may have is cost, which is why we accept all major PPO plans for dental insurance and also offer our in-house dental plan. Please see our financing page for more information.
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