Right canine painful root canal attempt

daverich

Hello,

I am not sure what I went through is normal as I am not sure what to do and need your advice.

Short story: I have been having persistent tooth ache for a week or two before I could get the appointment for the root canal treatment last Thursday. The tooth was very sensitive to the cold and hot and sweetness. But before the appointment the pain almost disappeared. I have been taking 3 ibuprofens in the evening to help ease the pain and it helped – apparently reduced the inflammation. I need to point out at night the pain started from somewhere near my upper check bone and then spread all over the upper part of my right jaw. It was rather horrible at times so I took diclofenac a few times to calm it down.

They took the xray which showed no inflammation on tooth top. They gave me a hefty altracaine doze which numbed my upper lips and upper cheeks and somewhat numbed the tooth. They started opening the tooth and it was a little bit painful at that time. But then when she approached the nerve cavity the pai just went through the roof!!! I have not been treated like this in all of my life (42). I asked to maybe kill the nerve with some medicine or put the painkiller directly into the canal – which she tried and which hurt strongly as well. Sending waves of pain through the right of my head. Then they waited ad tried to open the canal and when she opened it up it started bleeding – she tried to stop the bleeding and then managed to put some medicine and close the tooth with the temporary filling. Now I need to visit them the coming Thursday. I hate to even think of this. I have high blood pressure and do not want to go through this excruciating procedure ,let alone wait till they drill through the canal, which is very long and huge with a thick nerve inside!!

She said the tooth was not responding to altracaine because there was the inflammation inside the tooth itself. Can this be? Have I run into a wall of the medical dental science here which cannot make it painless???? Can you now just kill the nerve before drilling it out???

Please help!

Dav010

Irreversible pulpitis (inflammation in nerve) with associated hyperaemia can make a tooth extremely painful, and very difficult to achieve complete anaesthesia, no matter how much local anaesthetic is pumped into/around the tooth. That is not a failing in medical science, it is an anatomical and physiological response to pathology which makes LA less effective. To “kill the nerve” it needs to be numb, therein lies the challenge when the nerve does not respond to local anaesthesia. Typically the tooth is dressed with an anti inflammatory/steroid dressing, antibiotics prescribed and the process attempted again a few days later when hopefully the inflammation/infection has reduced.

daverich

https://www.boards.ie/discussion/comment/121070531#Comment_121070531

Thank you very much for your kind reply. I must tell you the tooth has been calm for the last few days after the last Thursday treatment - I mean it is still very sensitive to the cold - I did a test today and it responded with strong pain after being exposed to moderately cold water. gave some pain for some time and then calmed down. Overall it feels healthy now - maybe I had a facial nerve inflammation which irradiated into the tooth and exacerbated the pain - while in fact this tooth is just moderately healthy tooth which can just be closed with the permanent filling with no treatment ? btw they did not give any antibiotics just put into some medicine. How to avoid this excruciating procedure again?

Also when nerve does not respond to anesthesia can they not used blockade?

Thank you for your kindness!

dental_care

In cases where there is inflammation or infection within the tooth, it can be challenging to achieve complete numbness with local anesthetics like altracaine. This is because the inflammation can affect the efficacy of the anesthetic, making some parts of the procedure painful or uncomfortable. Dentists may use other medications to help calm the nerve inside the tooth before proceeding with the full root canal treatment. This can help reduce pain and inflammation over time.