The Challenge of Anesthesia Resistance

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The BBC recently highlighted an unusual but challenging condition some patients deal with: resistance to local anesthesia.

Local anesthesia has revolutionized the practice and image of dentistry. Where past dentists performed their bloody work on screaming and struggling patients, modern dentistry has the power to be performed cleanly and without causing significant discomfort to most patients. Even a procedure like the placement of dental implants can be performed with little immediate discomfort. But when patients can’t take advantage of this benefit, what can be done?


Why People Are Immune to Anesthesia

Actually, we don’t know why some people can’t be numbed by local anesthesia. There are many theories, though. It may be that people just have their nerves in slightly different places. This would prevent them from getting the benefit from the locally injected anesthetic because the nerve just isn’t there to be numbed.

Another possibility is that the chemistry of their cells, especially, the cell membrane, may be different, making it harder for the anesthesia to penetrate the nerve cells. This means that some types of local anesthesia may be more effective than others because they have different qualities.

More recently, it has been suggested that a mutation in the genetic structure related to sodium channels (which help transmit pain and other signals between nerves) could make people resistant to local anesthesia.

Learning to Cope with Pain

It’s important to remember that there are people (although not many) who voluntarily get dental treatment without anesthesia. Usually, this is because people have found other ways to control pain. Visualization techniques, for example, allow some people to simply imagine themselves away from pain. They just think of something else and they can get dental care without local anesthesia, including traditionally uncomfortable procedures like root canal therapy.

While we can’t expect everyone to learn to have root canal therapy without anesthesia, it’s certainly worth exploring this as a possible approach for people who can’t benefit from local anesthesia.

Sedation Dentistry to the Rescue

Another potential approach is to utilize other avenues of pain relief. For example, sedation dentistry can significantly reduce a person’s experience of pain. In fact, nitrous oxide was the dental anesthesia of choice for many years. For most people, it doesn’t work as well as local anesthesia, but the improvement is still significant when compared with the possibility of having no pain relief.

General anesthesia is also considered an option. The risks associated with general anesthesia are higher, so it might not be recommended for routine dental care. But it can certainly benefit people undergoing more invasive dental procedures.

Some may also benefit from NuCalm, a drug-free approach to relaxation dentistry.

If you are a person with dental anxiety, including difficulty getting numb, sedation dentistry can help. To learn whether sedation dentistry can help you, please contact us today for an appointment with a Westchester County sedation dentist at Advanced Dentistry of Mohegan Lake.

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