Redhead Dread Part II

A couple of months ago, I wrote an extensive blog post about my experiences as a general dentist treating redheads.  I called it Redhead Dread to suggest that redheads dread going to the dentist.  The post was based upon research which found that individuals with red hair required more local anesthesia than non-redheads.  A natural conclusion from that research was that redheads would avoid dental care and/or be fearful of the dentist because of a greater likelihood of a past, painful experience in the dental chair.

Joan on Mad Men is a Redhead - does she dread the dentist

Joan (Christina Hendricks) plays a sassy character on Mad Men. But would she secretly dread a trip to the dentist? (image from fanpop.com)

A research paper released just last month by the Journal of Endodontics detailed the findings of a well designed study which looked at the effects of dental local anesthesia on women with red hair.  This study had a control group of women with dark hair in order to observe the differences. Some of the findings were surprising. Key conclusions were:

  1. In standard injections for the lower teeth using lidocaine (not novocaine), there was no difference in the success of the local anesthesia between redheads and dark haired females.
  2. Redheads felt more pain on needle insertion than dark haired females.
  3. Redheads experienced “significantly higher levels of dental anxiety” when compared to dark haired females.

Considerations for Dental Patients

The first conclusion stunned me, as it contradicted both previous research as well as my own experiences treating dozens of redheads over the past several years.  This was a well designed study but there was a relatively small number of study subjects.  Could the small number of participants explain the unexpected response? Possibly.  But I am not going to doubt or second guess the authors.  Nevertheless, a follow-up study with more participants would be beneficial.

In my own observations as a general dentist, conclusions 2 and 3 are closely linked and were expected. The anticipation of pain can make anyone, regardless of hair color, either amplify a minor pain stimulus into a very painful one, or create a perception of pain when no pain should have occurred.  Stated another way, an expectation of pain can create pain out of nowhere!

Because the first conclusion was a surprise, I do expect there will be additional research on this topic, which I will write about. Until then, we can conclude:

Redheads will have greater anxiety when it comes to receiving dental care. If you are a redhead, don’t be afraid to tell your dentist about any fears you may have!

Comments

  1. myles ross says:

    I’m a male redhead and can understand why redheads are predisposed to having such fears. I have them myself and always had anxiety every time I went and still do. But I do know that redheads are hot as hell! [Inappropriate comment of a sexual nature deleted]. Good luck and thanks for the input. Hopefully some will get more out of this fact. Happy hunting…..

  2. Janet Otto says:

    I tried to have a root canal today but couldn’t go through with it. The endodontist said usually #12 and other molars/premolar’s usually only take 1 shot but I had 5 and still felt everything. She used lidocaine initially but when I told her it helped for a very short period, she used marcaine. She asked me if I was a natural red head and this isn’t the first time I’ve been asked. I’m not a ginger but I’m fair skinned and lighter hair when I was younger. Basically, she said the only thing we could do next time is gas or premeds for sedation. I think total, when all was said and done, I received 7 or 8 injections today.

    Is there anything else I can do in the future?

    • Janet,

      I wrote a two part series on this phenomenon: http://directionsindentistry.net/5-reasons-cant-get-numb-dentist-2/

      I would see if another attempt could be made with perhaps a little medication to relax you. Sometimes, a different day can make all the difference. The human body – yours and the endodontists – are variable – and don’t always do what we want them to.

      • Alley Davis BSW says:

        As a red head I would like to thank you. I had a horrible experience as a child that instilled great fear in me. I avoided the dentist at all cost, so much so that I recently had 20 teeth pulled. 5 were left on the bottom to allow for a partial denture there. I still need extensive work on the lower 5 teeth and they are in a great amount of pain. My procedure was performed under IV sedation but I awoke at some point during and was very uncomfortable, at one point I was told that I could not be given any more local for another 20 minutes, that it had recently been given again. My question would be, is there a cap on the amount of local anesthetic you can give. And also, why do so many providers laugh off my telling them that I require more local to get and stay numb. I can’t imagine that there is any reason for such a claim other than having a knowledge of your own body. Again, thank you for acknowledging that at the very least, our population may have different needs in the chair.

        • Alley,
          It is unfortunate you had bad experiences in the past. To answer your question, there is a maximum amount of local anesthetic that can/should be administered to an individual. It is a formula based primarily on weight, but other factors can come into play.

  3. Donna Wallace says:

    I wanted to give you guys a little extra here as I have been looking for research as to why I do not respond to the “caine” family. First, yes, I am a red head with hazel eyes (not the normal blue.) I have kept the same PCP and plastic surgeon for 17 years now because they understand and have walked this with me. I hate going to a new physician or dentist and get the same responses: they didn’t give you enough, they missed where it should be given, or it’s all in my head. I have total failure of the “caine” family. Not just in dental, but the entire body. I have melanoma and my plastic surgeon will no longer even do the removals under cons sedation because I have a tendency to remember things and that scares them. I have had the discussion of amides vs esters and none of them work. You can sit there and give me enough that it is seeping out of my gums and will never numb that area (or any other area.) To take this a step further, pain medications do not work well on me either. I never had a pain medication until I was 29 years old and I had enough to put down three very large men for a week in a three hour time period and got up and left the hospital. I don’t really care what this article that was done about redheads say, because I am here to tell you that many “old timers” physicians have told me that redheads are different and that is very true for me. I have been given the “caines” so much that I have now developed an allergy to them. I appreciate the articles in addressing this issue, but until the medical and dental community actually believe this is real, those of us that have this problem will go on hurting and feeling less of a person every time a physician or dentist tells us it’s in our heads. I am currently fighting this battle as I have a couple abscessed teeth and I can’t anyone to take them out. If I won’t let them use the “caines” then they don’t want to help me because it’s all in my head. I hope this helps anyone who feels like they are wrong. I will continue my research but so far, I have found only one study done by Brits that even discuss “caines” not working and it was done on one family. The study did say that the medical/dental community generally don’t believe those of us who actually have this problem. Thanks for the insight.

    • Donna,

      You bring up a lot of points. First, for patients who are truly allergic to local anesthetics – which is extraordinarily rare – those patients can typically only be treated with general anesthesia. You should go see an allergist to have that confirmed. Once the allergy is confirmed, it would be easier for you to interact with new providers – just bring documentation from the allergist. Many practitioners are a bit jaded/skeptical when they hear from a patient who claims to have a rare allergy because most of the time it is a misuse of the term “allergy” or “allergic.”

      My own experience is that redheads show extreme variability in how well they respond to local anesthesia. Some respond well, others not so much.

      Again, your best bet is to get the -caine allergy confirmed because that will help on many levels.

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