Hot Novocaine?

zoobyshoe

This morning I went to the dentist and when she shot me up I was startled to feel that the metal body of the hypodermic was hot when rested it against my lip. I stopped her and asked if she had heated up the novocaine. She said it wasn't hot, merely warm, and proceeded with the shot without offering any explanation.

I have two separate ideas about why she might have done this. I'm about 100% certain that the tooth in question was infected and the usual approach is to treat the infection before proceeding with work because lidocaine doesn't work on infected teeth. Heating the lidocaine might somehow get around this problem. This "hot shot" was actually the second she gave me. The first, cool, one numbed my lip well but didn't touch the tooth pain. In fact, the pressure of the injected lidocaine made the pain worse.

The second guess is that she hadn't actually heated the lidocaine, or intended to, but had merely just taken the hypodermic body out of an autoclave. The second shot was farther back on the jaw and vastly more painful, indicating she'd targeted a more basic nerve and used a lot more lidocaine.

Anyone certain why the "hot shot"?

Evo

You might be correct that the syringe and needle were hot.

zoobyshoe

I returned today for Root Canal II: Digging Deeper and got a chance, when the suction tube was out of my mouth, to ask her what the hot lidocaine was about. She said she did it because she believed the shots were more painful whenever the lidocaine was at a temperature lower than body temperature. Personally I think they're more painful when they shove it in faster than it can anesthetize the tissue ahead of the needle.

Evo

Go to a doctor that does laser root canals, painless, takes one visit. No drilling the root canals, I want another root canal, it was that good.

zoobyshoe

I didn't know there was such a thing.

DaveC426913

Have you accounted for the possibility that your senses were fooled into thinking it was hot?

When I got my wisdom teeth pulled, I got a needle in the arm that knocked me out. As the anesthetic was fed in, I remember the feeling of sharp heat coursing up my arm.

bobze

Her response was correct. The "deeper" shot she gave you was to block the maxillary nerve (or one of its branches depending on the tooth). The lidocain (and probably epinephrine) numbs everything distal to the block. The problem is that is cramped anatomy and highly innervated (can be especially sensitive to thermal changes) so people (both dentists and docs) will warm the local when they pull it from the fridge for the patients comfort.

To be honest though, as someone who's both given locals and received them (far to many) I am of the opinion it hurts no matter the temperature and would rather just get it in there and done!

zoobyshoe

Well, she confirmed she had "warmed it up" on both visits. We were in disagreement about what constitutes "hot" as opposed to "warm". Dentists are like that. They'll tell you you only experienced "discomfort" when you know you felt pain. The body of the hypodermic, only, felt hot, as she rested it against my lip. The body is a reusable metal device into which a separate, one-time-only cartridge is inserted, on the same principle as a caulking gun. The liquid she injected had no perceivable temperature. I don't know what temperature value to give to indicate how hot the syringe felt, but it was startling, without being hot enough to burn or blister anything. I've never had this experience with any other dentist, and my experience as a dental patient is extensive, and spread over many parts of the country.


Thanks! It makes so much more sense to find out it has just been pulled from the fridge and might seem obviously cold if it weren't heated.

I find that when the shot is delivered in increments with a delay between pushes the whole experience is very much less painful.

DaveC426913

I did not realize you were able to clearly tell that it was the body of the hypo, not the needle, that was hot to the touch. Conceded.

Evo

Well, this guy is from Minnesota, so he performs rut canals, but I think it's the same as root canals.

I've had two laser root canals, completely painless, took about 30 minutes to complete the entire tooth (all 4 canals). Unbelievable.

http://www.dailymotion.com/video/xbt...therapy_people

zoobyshoe

Very cool.

'spensive?

Evo

Same price as a regular root canal.

marcus

I was curious to know more so I googled around some and found that if I googled these three words "waterlase root canal" I got information about a cleaning method that was claimed to be FDA approved.

I'm wondering if that was the technology your dentist was using. There is a tiny laser-tipped probe that can go down into the very narrow "tubules" and deliver both heat and a high-pressure spray of water. The laser+water combination is not doing any drilling, it is washing debris out the tiny tubular pores. It sounds like an elegant method that takes substantially less time spent in the dentist-chair, compared with the older method using a tiny probe with a file at the tip.

I asked my dentist about this and he did not know of it. His assistant immediately called their root canal specialist's office that they always refer people to, and they claimed not to know of any laser root canal technology. My dentist is a bit of a techie, he likes to be informed about stuff, so he asked me to write back to you and find out more.

It seems as if this is fairly new, perhaps even controversial, and only a few offices have it.
I hope it is not tactless of me to ask.

Evo

Odd, it's been around awhile. The waterlase might have been it, in my original post the day I had it done, I did talk about what seemed to be warm water going in and out without needing additional suction or rinsing and spitting. I really don't know anything about the technique.

http://articles.cnn.com/2001-08-13/t...ser?_s=PM:TECH

This sounds different from the waterlase though.

phinds

I was first introduced to laser dentistry about 20 years ago, but it wasn't a root canal it was gum-line scaling. They put a red dye on the gum/teeth line and the plaque absorbs it and then the laser only zaps the plaque. VERY cool way to get your teeth cleaned. Also, my daughter had a nasty fever blister inside her lip and he cleaned/cauterized it in about a 10 second pass of the laser and it never bothered her after that and was totally painless while he did it.

zoobyshoe

Any "discomfort"?