Eight Reasons Why You May Have Trouble Getting Numb for Dental Treatment

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.

Schedule your visit through ZocDoc, or contact us directly. We look forward to treating you soon!

What You Need to Know About Bleeding Gums

You’re brushing your teeth as usual and rinse out. But instead of just clear water and foamy toothpaste going down the drain, you see bright red blood. It’s an unnerving sight, but what does it mean? Can you do something to treat your bleeding gums yourself, or do you need to see your dentist as soon as possible?

First, give yourself points if you recognize bleeding gums as the first sign of early gum disease, known as gingivitis - which, if left untreated, can progress to advanced gum disease - known as periodontitis, which is one of the leading reasons for tooth loss in adults. We’ll cover this in detail, but there are other conditions that can cause your gums to bleed.

The Leading Causes of Bleeding Gums

The main cause of bleeding gums is the buildup of plaque at the gumline. As our blog post —“Types of Gum Disease” - covers, plaque is a sticky film composed mainly of bacteria. Plaque forms on your teeth when starches and sugars in food interact with bacteria normally found in your mouth. Brushing your teeth twice a day and flossing once a day removes plaque, but it very quickly forms again.

If left to establish itself, plaque can harden under your gumline into tartar (calculus). Filled with bacteria, tartar is harder to remove. The longer plaque and tartar remain on your teeth, the more damage they can do. You can’t get rid of tartar by brushing and flossing. Only a professional dental cleaning can remove it. If not removed, plaque sets up the conditions for gingivitis.

Other causes of bleeding gums include the following:

Diabetes — The link between diabetes and oral health problems is high blood sugar. As Cleveland Clinic explains, “If blood sugar is poorly controlled, oral health problems are more likely to develop. This is because uncontrolled diabetes weakens white blood cells, which are the body’s main defense against bacterial infections that can occur in the mouth.” Another complication of diabetes is that it causes blood vessels to thicken. This slows the flow of nutrients to and waste products from body tissues, including the mouth - which results in the body losing its ability to fight infections. Our blog post - “Diabetes and Oral Health” - covers this topic in greater detail.

Moreover, according to Golden State Dentistry, gum bleeding is more common in those with other health issues - such as liver disease, blood clotting disorders, anemia, leukemia and temporal arteritis.

Blood-thinning medications - Blood thinning medications reduce the ability of blood to clot, which can result in easier bleeding. This can be a concern for dental procedures that cause bleeding - such as a deep cleaning, extractions and dental implant placement. Therefore, you should always tell your dentist if you are taking blood thinning medications at every dental visit.

Pregnancy - Some women develop a condition known as “pregnancy gingivitis,” an inflammation of the gums that can cause swelling and tenderness. According to WebMD, 40 percent of women will develop gingivitis sometime during their pregnancy. Your gums also may bleed a little when you brush or floss. Your dentist may recommend more frequent cleanings to prevent gingivitis. And yes, it is safe to visit the dentist while pregnant! Our blog post - “What You Need to Know About Dental Care During Pregnancy” - covers this topic in detail. Also, hormone fluctuations that occur during puberty and menopause can cause gums to bleed.

Smoking — According to WebMD, it appears that smoking interferes with the normal function of gum tissue cells. This interference makes smokers more susceptible to infections, such as periodontal disease, and also seems to impair blood flow to the gums ― which may affect wound healing. Our blog post ― “How Smoking Affects Your Oral Health” ― covers this topic in detail.

Nutrient deficiencies — It is possible to eat three full meals a day and still be poorly nourished! Some ingredients in processed food can irritate the gums and cause them to bleed. Avoid processed and sugary food, and opt for a balanced diet full of fruits, vegetables, and food rich in calcium, vitamins A, K and C, and magnesium.

The deficiencies most commonly associated with bleeding gums are:

Vitamin K. This vitamin helps your blood to clot and also helps to moderate your immune system and fight inflammation. So not only does a lack of vitamin K make your gums more susceptible to bleeding, it also makes you more vulnerable to infection and inflammation from gum disease.
Vitamin C. This vitamin keeps teeth and gums strong and repairs damaged tissues. Deficiency is associated with swelling and poor wound healing, so gums might bleed easily and take longer to heal.
Vitamin D. The “sunshine vitamin” is essential for a healthy immune system. As with vitamin K, a lack of this vitamin can leave you vulnerable to gum disease and bleeding gums.

Brushing too hard — Contrary to popular belief, brushing your teeth vigorously doesn’t get them cleaner. In fact, it can cut and irritate gums, as well as erode enamel - which can’t be replaced. Dentists recommend a soft-bristled toothbrush, and flossing to thoroughly remove food from between teeth. Buy a new brush every three to four months.

Poorly fitting dentures — Dentures that do not fit properly can cause gum bleeding if they scratch your gums and cause sores. People who don’t remove their dentures at bedtime may be especially prone to bleeding gums. In addition, it is especially important to brush your remaining teeth and clean your dentures well to prevent plaque buildup and gum inflammation.

Treatment of Bleeding Gums

Even if you think the cause of your bleeding gums is mechanical - such as brushing too hard - don’t diagnose yourself! Scheduling an appointment with your dentist is the only way to receive an accurate diagnosis and timely, appropriate treatment.

By the way, you may have seen the toothpaste commercial that asks if bleeding gums should be a cause for concern. However, the commercial doesn’t communicate the urgency of seeing your dentist as soon as possible. Bleeding gums always indicate a condition that needs immediate attention. Brushing with one particular toothpaste brand won’t treat the cause. Your dentist may recommend a particular brand after an examination and diagnosis of gingivitis, but attempting to diagnose and treat yourself based on a TV commercial will put your oral health at serious risk.

If your dentist determines that something other than periodontal disease could be the cause, you may be referred to your primary healthcare provider. If so, follow up with your dentist afterward to let him/her know about your diagnosis and treatment - including medications you’ve been prescribed.

How to Prevent Bleeding Gums

As you’ve probably assumed by now, making good oral hygiene practices part of your lifestyle is essential to preventing bleeding gums. Colgate and Healthline recommend the following protocol:

Brush twice a day using a fluoride toothpaste and floss daily. If you’re not used to flossing every day, you might notice a little bleeding at first. This should go away after a couple of days of consistent flossing, so be sure to make it a non-negotiable part of your daily routine.
Your oral hygiene tools could be the cause of your bleeding gums. Although it might seem like a toothbrush with medium or firm bristles cleans your teeth better, harder bristles usually cause irritation - which as mentioned earlier can cause your gums to bleed. The American Dental Association (ADA) recommends using a toothbrush with soft bristles, which cleans your teeth and gums thoroughly without irritation. You might also consider using an electric toothbrush. The specially designed brush heads on these toothbrushes can help you to clean your gumline more easily than a manual toothbrush.
Be careful with dental floss. Snapping the floss or sawing away at your gumline can cause bleeding gums, so go gently. If you find that floss isn’t working for you, consider other interdental cleaning tools, like water flossers or picks.
Your dentist may recommend an antiseptic mouthwash to minimize plaque. If so, make it part of your routine. Rinsing your mouth with hydrogen peroxide can likewise be beneficial in preventing plaque build-up. Ask your dentist which is better for your particular oral care needs.
Of course, schedule a twice-yearly examination and cleaning with your dentist! This regular cleaning will remove plaque, as well as allow your dentist to monitor your teeth, gums, upper/lower palate and tongue for any changes that may require treatment.

The Take-Home Message

Although bleeding gums can have many causes, each cause necessitates scheduling an appointment with your dentist for diagnosis and treatment. Fortunately, there is much you can do to prevent your gums from bleeding. Practicing good oral hygiene, taking care of your overall well-being and visiting your dentist twice a year will go a long way in keeping your gums healthy!

At NK Family Dental, it is our mission to provide the highest quality and most compassionate oral care to our Chicago patients, including both dental and periodontal services. Our practice is trusted for advanced oral surgery procedures and comfortable root canal treatment.

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!

Schedule your visit through ZocDoc, or contact us directly. We look forward to treating you soon!

What Should Your Experience as a Dental Patient be Like?

Your dentist is an important member of your healthcare team. Because our team at NK Family Dental always emphasizes that dental health is part of overall health, we want you to know that your patient experience should meet certain standards to ensure the best possible treatment, care and outcome.

As our blog post - “How to Choose a Dentist” - covers, your dentist should be more than someone you see twice a year for a cleaning and oral exam, or visit when you have a toothache. A good dentist will be your partner in helping you achieve and maintain optimum oral health by recognizing and treating conditions - such as periodontal disease - in their early stages, as well as recommending a regular oral health routine for you to follow at home, based upon your individual situation.

With this in mind, you should expect the following experience as a dental patient.

Expect a Clean and Comfortable Dentist Office with Up-to-date Equipment

All conscientious dentists agree upon this fundamental necessity. As Twin Aspen Dental Center puts it, “First impressions make lasting relationships. If your dentist doesn’t take pride in the appearance of their office or the friendliness of their staff, then they probably won’t put in the effort when it comes to your oral care. A good dentist maintains a clean, orderly office and hires staff that is friendly and approachable when you have questions, ensuring you feel at ease during your visit.”

At the front desk, the office should be computerized, instead of using paper charts.

Moreover, take notice of the age and condition of equipment, such as imaging equipment (the X-ray machine) and the dental chair. The dental chair is part of the dental unit, which consists of specific parts that also include the dental chair, stool, lighting, hydric box, aspiration and other elements. All imaging equipment and the dental unit should be up-to-date and functioning efficiently. Imaging equipment should be digital, not film. Dental technology is continually improving, so a dentist using old equipment isn’t likely to provide the best possible treatment.

Expect Clear, Open Communication with Your Dentist

Your dentist should answer your questions to your satisfaction, in a manner that you understand. Good dentists know that patients may be unfamiliar with certain medical terminology pertaining to oral diseases, or need to have a complex condition broken down in easy-to-understand terms. In addition, your dentist should be clear and detailed about the recommended course of treatment, and disclose the cost. You may be referred to the front desk to discuss payment options or financing. Good dentists also know that a patient may be anxious, and will communicate in a way to alleviate fear and apprehension.

Your dentist should never try to upsell you on procedures or care that you don’t need. It is also very important for you to know that you should never feel that you are being pressured to consent to extensive, expensive treatment. This can be a situation in practices that heavily promote cosmetic dentistry. You need to take the time to consider the proposed treatment, your budget and your payment plan. Do not sign any form or document before you are comfortable with your decision. If you feel that you’re being coerced to do so, leave, and find another dentist. Don’t worry about what the dentist thinks - you need to look after your own best interests.

Expect Pain-free Dental Treatment

Depending upon your age or experience at the dentist’s office, you may have had dental treatments or procedures that caused pain. Unfortunately, in years past, this often was considered typical. However, today’s wide range of dental anesthetics help ensure that no one experiences pain during any type of procedure. Even the injection of local anesthesia can itself be pain-free by the application of a topical numbing gel to the gum. The gel may even have a pleasant flavor or scent!

Of course, it’s the responsibility of your dentist to provide you with a pain-free, comfortable experience. Going back to the importance of good communication, tell your dentist if you’ve been difficult to numb during previous procedures. Also, make sure that your dentist is experienced in the procedure he or she is recommending. A dentist who usually doesn’t perform root canals or dental implants may not have the experience and/or up-to-date instruments to do so without causing discomfort or pain - not to mention being able to achieve a successful result. A conscientious, ethical general dentist will refer you to a specialist or oral surgeon for treatment that is outside their qualifications or experience.

Your Responsibilities as a Dental Patient

As in any type of relationship - which should work both ways - the patient has important responsibilities, as well. The basics are as follows:

Be on-time for appointments, and give adequate notice if your appointment needs to be changed.
Provide, to the best of your ability, accurate, honest, and complete information about your medical history and current health status.
Understand that you have the responsibility for consequences resulting from declining treatment or from not following the agreed-upon treatment plan.
Understand that you have the responsibility for maintaining good oral health practices, and following your dentist’s instructions for any specific at-home oral care treatment that has been prescribed or recommended.

The Take-Home Message

Visiting your dentist should be a positive experience on every level. Even if you need treatment, it should be pain-free and result in a successful outcome that cures or corrects the cause of the condition. Your dentist should also be your partner in helping you achieve an effective oral care program to prevent tooth decay and periodontal (gum) disease. 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.

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!

Schedule your visit through ZocDoc, or contact us directly. We look forward to treating you soon!

Why IV Sedation May Be Right for You

There are many forms of sedation used in dental treatment, for a variety of reasons. You may be familiar with methods such as nitrous oxide, also called laughing gas, or oral sedatives. Today, however, we’re discussing the use of IV sedation in dentistry and why it might be the right option for you depending on factors such as the type of dental treatment you will receive or your anxiety level. When administered by a properly trained dentist or anesthesiologist, IV sedation is very safe and effective.

So, how does IV sedation work, what are the benefits and is it the right choice for you? Keep reading to find out!

How Does Intravenous Sedation Work?

IV sedation, short for intravenous sedation, provides a higher level of sedation compared to oral sedatives or nitrous oxide that provides a deep feeling of relaxation. As the name implies, IV sedation is administered intravenously, meaning through a vein. The anesthesiologist or dentist will insert a small needle either into the inside of an elbow or into the back of one of your hands. For those not fond of needles, even the tiniest ones, your dentist or anesthesiologist can apply a numbing agent on the skin before administering the IV.

The next big question you likely have is how will you feel under IV sedation during your dental treatment. Typically, IV sedation makes most dental patients feel very relaxed, almost to the point of fully falling asleep, although some patients may drift off into sleep if they are not required to be more conscious during treatment. Your dentist or anesthesiologist will choose the appropriate amount of sedation to provide depending on the needs of your dental procedure, as you may still need to perform basic commands and give simple responses to your dentist. Your dentist will also be able to monitor the level of sedation you are receiving throughout the procedure and make appropriate adjustments as needed.

After your treatment, you will still feel drowsy for some time while the sedation medication wears off. Because of this lingering drowsiness, an adult with a vehicle and a valid driver license will be required to accompany you during the entirety of your appointment and to drive you home afterward.

Benefits of IV Sedation for Dental Treatment

You now know there are different levels and methods of sedation in dentistry, but what does IV sedation offer that some others don’t?

Here are just some benefits of IV sedation for dental treatment:

For patients with dental anxiety, IV sedation gives a deep feeling of relaxation both physically and mentally during the procedure.
The medication used in the sedation allows for full or partial loss of memory during the procedure, similar to as if the dental patient were fully unconscious during the procedure.
Patients under IV sedation retain some control over their responses if they are under a lighter amount of sedation, and are able to breathe on their own
For patients with circulatory complications, IV sedation provides stabilization of their hemodynamic condition during the procedure.
Recovery time from IV sedation is relatively quick and safe after the treatment is finished.
After a procedure with intravenous sedation, patients have a significantly reduced risk of experiencing nausea, vomiting, urinary complications including urinary retention, and a rare but serious condition known as malicious hyperthermia.
Lighter levels of sedation allow patients the ability to speak, while higher levels can help patients enter a deep sleep.
Most dental patients qualify for receiving IV sedation if needed or desired, and it is especially safe for patients requiring minor oral surgery.

Is It the Right Choice for You?

Not every dental patient and not every dental treatment will require the use of IV sedation. So how do you know if IV sedation dentistry is the right choice for you? The two primary reasons your dentist might suggest IV sedation are for patients with dental anxiety or for longer and more in-depth dental procedures, including oral surgery, teeth extractions or root canal treatment.

Your dentist will discuss your sedation options with you prior to scheduling any dental treatments. Current health conditions or medications you may be taking can affect your eligibility for different types of sedation, including IV sedation, so be sure to inform your dentist.

To learn more about the different levels of IV sedation and how IV sedation is used in wisdom teeth removal, you can read our previous blog post, “What to Expect with IV Sedation.”

IV Sedation Dentistry for Bucktown and Logan Square Patients

NK Family Dental offers a variety of sedation options, including IV sedation, for dental patients in the Bucktown, Logan Square, Wicker Park and Humboldt Park areas of Chicago. Our highly educated and trained dentists on our staff are able to safely administer IV sedation for patients with dental anxiety or who receive one of our best-in-Chicago dental treatments such as root canal treatment or wisdom teeth removal.

Compassionate and high-quality care for our patients is our commitment. For your Bucktown or Logan Square dentist needs, we hope to see you soon at NK Family Dental.

Schedule your next appointment with us today!