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Local anaesthesia and fear of dentist needles- what can be done to help?

fear of dentist needles

According to research conducted by K B Hill et al. in 2009, approximately 36% of the population have some form of dental anxiety or fear with an additional 12% experiencing extreme dental fear. This dental fear happens for a variety of reasons, according to research conducted in 2014:

Exogenous factors (Factors present and active in an individual but that originated outside of the individual), including but not limited to:

  • direct learning from traumatic experiences
  • vicarious learning through significant others
  • vicarious learning through the media

Endogenous factors (factors present and active in an individual that originated from within the individual), including but not limited to:

  • genetic inheritance inheritance
  • personality traits

This is all very interesting but doesn’t help anyone that struggles with a fear of the dentist, local anaesthesia and particularly dentist needles. So, what can we do to help? This blog post will answer this and other questions about dental injections and tooth numbing.

What type of anaesthesia is used for dental work?

This is a ubiquitous question but often has a double meaning, it could either mean ‘what type of drug does a dentist use for anaesthesia in dental work’, or it could be ‘how is that drug administered?’ – let’s look at both.

What drug does a dentist use for anaesthesia?

Typically Lidocaine is used for dental injections, and it works by temporarily blocking the pathway of pain signals along the nerves. It also has the added benefit of decreasing bleeding in the operative site. Lidocaine typically works within around 4 min and last for approximately half an hour to 3 hours.

How are dental injections administered?

Typically a dental injection is administered using a very fine needle, modern needles are tiny and therefore cause very little pain or discomfort. The real key to making this type of dental injection comfortable is in the injection technique used by the dentist.

However, there are new and modern ways to administer a dental injection.

The Wand helps nervous patients by using a computer-controlled delivery mechanism that prevents the classic bee sting type pain associated with traditional injections. It uses a small handpiece which looks very much like a pen, it then gives a controlled supply of the anaesthetic drug in a very slow comfortable manner below your pain threshold, preventing pressure building up which often is the cause of pain and discomfort.

The low pressure and slow rate of delivery provide improved anaesthesia,  and also ensures that a small drop of the anaesthetic drug is always in front of the needle offering pain relief before the needle goes in further.

How long does local anaesthetic last

You will typically find that the tooth that is being treated will be numb for approximately 1-2 hours, if your lips or tongue have gone numb also this may last for up to 5 hours. Individual people are affected slightly differently by the anaesthetic given depending upon their heart rate and metabolic rate.

Dental anaesthesia side-effects

Modern dental local anaesthesia is extremely safe; however there are certain times when you may experience one or more of the following side effects:

  • muscles twitching
  • a tingling sensation in or around the injection site, particularly as sensation returns
  • dizziness
  • headaches
  • drooping of the mouth
  • dribbling
  • allergic reaction, although this is incredibly rare

Very occasionally the injection needle could damage and nerve, this can lead to an extended period of numbing, possibly for several weeks or months. However, the good news is that this it usually repairs over time and does not persist in the long-term.

Image credit: www.atandme.com

Do you operate a ‘sip and puff’ wheelchair?

Because a dental anaesthetic is likely to affect your lips as well as your teeth this can make wheelchairs operated by a mouthpiece challenging to control, this is due to the inability to create a proper seal around the mouthpiece. If you are likely to be affected by this, please ensure you have alternate wheelchair operating methods or someone with you to be of assistance.

I am terrified of the dentist, what can I do?

It is not unusual to have some anxiety about visiting the dentist or to have a fear of dentist needles; however it is more uncommon for dental patients to have extreme anxiety or even dental phobia.

Here is our advice:

  • Talk openly to us. We will NOT judge you or tell you off for not coming to see us… honestly
  • Ask if you can have an appointment to go to the dental practice without going into the surgery or sitting in the chair, this is a great way to build your confidence slowly.
  • Book an appointment in the morning; this will ensure you can relax for the rest of the day as your appointment will be over.
  • For regular appointments, make sure you have a good breakfast. This will set you up for the day and ensure your energy levels remain high.
  • Lay off the alcohol! Not only does it dehydrate you, but it can also make you worry.
  • Bring a friend. Decide beforehand on what you are going to talk about, make it subjects that relax you and keep you calm. Perhaps discuss a recent holiday, or where you are going next time.
  • Agree a stop signal with us; this will ensure that YOU are in control
  • Ask for a topical anaesthetic gel which can be applied before any dental injection is given; this makes the whole process far more comfortable

Why are we scared of dentists?

What is important to know is that being scared of the dentist is a learned behaviour. We aren’t born being afraid of the dentist. This can be very empowering. If it is a learned behaviour, then another behaviour can also be learned.

People tell us the reason they are scared of the dentist is:

  • Feeling out of being out of control – this is why it’s important to tell your dentist of your concerns, they can then ensure that you remain in control, giving you stop signals so that you can halt treatment at any time.
  • Fear of needles – modern injections can be incredibly comfortable, and this is particularly so when using the Wand as well as with topical anaesthetic gels which is applied to the gum area to numb it before giving the injection.
  • worrying about swallowing blood, saliva or choking – the dentist will always use gentle suction in your mouth to ensure that blood and saliva doesn’t build up, this is moved around by the dental nurse/assistant to ensure you stay safe

Because being scared of the dentist is learnt, if one has a series of positive experiences, taking small steps at a time, it is possible to learn a new behaviour without the anxiety, fear or being scared.

Shrik Kotecha
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