5 Reasons You Can’t Get Numb at the Dentist

As a dentist in private practice, I hear stories ALL the time about patients who “couldn’t get numb at the dentist.” Not surprisingly, many of the comments that readers post here on this site also deal with this very issue.

In response to this, I decided to compile a Top 5 list of reasons for why this happens. So here goes:

1. You have an infection
dental abscess on gums showing infection with pus

This tooth was difficult to get numb because of the infection in the gums above the tooth!

Sometimes, a patient comes in with an active infection and it can be difficult to get them completely numb. This is obviously very frustrating for both the dentist and the patient. Why does this happen?

An active dental infection will usually result in the presence of pus. In most cases, the pus is acidic. Conversely, dental anesthetics (lidocaine, novcaine, etc.) function best in slightly basic environments. The end result is that the unique chemistry of the infection “deactivates” the local anesthetic, making it so that more anesthetic is needed. And in cases of severe infections, sometimes you simply cannot get the patient 100% numb.

2. You moved during the injection

Let’s face it – some injections – but not all – hurt! And it just so happens that the one that hurts the most is the one that requires the most patient cooperation. I speak from experience having done this well over ten thousand times.

large dental needle for nerve blocks to get numb

We have to sink this needle deep into the tissue. If you move, it is easy to miss the target. Paper clip is for scale.

For lower back teeth, we nearly always need to do a nerve block.  This is where we have to go deep through muscle and other tissue and deposit the local anesthesia near the nerve. We can’t actually see the nerve – we have to use various anatomical landmarks to guide us to the area.

If you move suddenly, the needle will also move.  Most often, it will have moved away from the nerve! So we then end up depositing the anesthetic farther away from the nerve than we would like. What happens next? You don’t get numb. Fortunately, if we have to administer a second injection, it will rarely hurt, and then we can place it spot on.

On rare occasions – and this has never happened to me nor most dentists – you can move so much that the needle can actually break!

3. I am not using epinephrine

I’ve blogged about this before. Epinephrine is added to dental local anesthetics because it enhances the numbness. How does it do this? Epinephrine acts as a vasoconstrictor and reduces blood flow in the area of the injection. The end result is that the local anesthetic stays around much longer and gives a more profound feeling of numbness.

marcaine dental anesthetic with epinephrine

Marcaine with epinephrine. The epinephrine will allow for a more profound level of local anesthesia

In certain circumstances, we use a local anesthetic that does not contain epinephrine. Why? Patients with certain cardiac conditions or who take certain medications are best served with one that does not contain it. Others have experienced a mild adverse reaction (some mistakenly think they are allergic to epinephrine) and prefer we don’t use it. A small fraction of patients are allergic to the sulfite preservative so we can’t use it in those cases either.

If we can’t use epinephrine, there is a chance you won’t feel numb enough. Or we’ll have to re-inject multiple times.

4. You’re wired differently

The human body is incredibly variable. People are double jointed. Remember the kid in grade school who could move his ears? Why is Usain Bolt faster then any other human? You get the picture.

Do you think your nerves look like the drawing below?

trigeminal nerve anatomy variation can make dental numbing challenging

Nerves going to lower teeth. Each person is different! Image courtesy wikipedia commons.

If you answered yes, then you’re probably wrong!

Most people have what I might call “standard anatomy.” This means that the nerves going to your teeth are where you might expect them to be located. But just like Usain Bolt and the kid from fifth grade who could move his ears, some patients have extreme variability with the nerves going to their teeth. We see this most frequently with lower molars.

Some people may have up to 4 nerves going to their lower molar teeth. This can mean 4 different injections to get them numb! This doesn’t mean your dentist is incompetent – it means you’re wired differently. So if that happens to you, just think about Usain Bolt and the kid from fifth grade who could move his ears.

5. You have red hair

Joan from Mad Men has red hair and can't get numb at the dentist

Joan from Mad Men would have difficulty getting numb!

I’ve blogged about this on two separate occasions – here and here.

But to summarize, people with red hair have a built in resistance to local anesthetics. This means that more local anesthetic is required to achieve profound numbness in those people with red hair. The reason behind this is complex, but the genetics for red hair also confers resistance to local anesthetic.

I can say definitively that from personal experience, redheads nearly always require more local anesthetic. All of my red haired patients are aware of this – and we joke about it each and every visit!

Want to see reasons 6 through 10? Here they are!


  1. It’s hard for me to get numb and oddly enough, I was born with red hair, but it turned blonde by the time I was a year old.

  2. This just happened to me today – 3 novocain shots, the entire side of my face was numb but I felt everything the poor dentist tried to do on my lower molar. Rescheduled for another time. Hopefully, he can get that novocain to the right spot next time. 🙁

    • Jill: As an aside, it’s not likely to have actually been Novocain. Novocain has not been used for a long, long time. More likely you were injected with Lidocaine. Novocain has not been used routinely by dentists for ~30-40 years.

      More here:

    • Same here. I went back and it didn’t work the second time either. So, now I have to get an IV sedation.

    • Nikesh Kathayat says

      hey what happened in your next schedule could please share an experience with me… i am having similar problem

      • Nicole Skinner says

        Problems w getting numb? Ask Nicole….I have had repeated problem w getting numb. Once w epidural they asked if I still had pain,I said yes…they gave more…finally I was told they could not give any more!. Again w upper endoscopy proceedure, doc said I was waking up during the procedure. Repeadly w DENTAL procedures extream difficulty getting numb.sent away even! Today, I don’t know how many shots,I heard the assistant tell the endodontist she gave me enough meds to last a life time. It’s very sad fearful & frustrating. Im female and have heard it said hormones may play a role in this..i have had dental extractions and have had issues w extream pain afterward and dry sockets also. The maxillofacial surgeon said that there could be a correlation between time of menstrual cycle and dry socket issues. It’s something that I have come to accept,though at times being one who deals w pain it can put you at your wits point when needing pain management. Regardless if its teeth or not I think the resistance can be a whole body issue affecting all types of procedures beside teeth. To those who have this problem it can be traumatizing. Memories of being sent away in pain,tears. Wondering if this shot will work. Unfortunate as it is my daughter has same problem. My son’s do not. I think if you work w your dentist you can build more effective. ” cocktails”mixing shots.. even ibuprofen immediately after a procedure. Next time I will come in 30 min earlier to get shots and they will try harder to help me before it’s even time for my appointment. You dont realize how patient as being a patient you actually have become!. People who go through this have to stay longer,endure longer ect. And learn to tolerate so much more. For us…remember it’s frustrating for those who are giving the meds, they want it to work too. Tell them thank you even for trying… because it’s a puzzle that’s not always so easily solved.Continue to be patient and communicate let them know truly where exactly you feel pain. To the providers I say it may seem conjured up when after 9 shots the patient claims pain …but believe me it’s real! So be cautious with them.. creative w the injections( try some other areas),and have compassion.. consider how they must feel!
        I think I’ve been so many years at the endodontist he’s seen me age! Try to cheer yourself up because you made it through today…!

        • Tracy Molyneux says

          I just had a tooth pulled, and once again the lidocaine didn’t take. It’s been 7 days I’m in extreme pain from the repeated novicain injections, & the dentist jabed me so deep with the pick because she didn’t believe that I wasn’t numb. I also had an epidural that never took, but a spinal that did. I have every symptom of EDS, but not diagnosed. I have Lupus, connective tissue disease, fibromyalgia, RA., Sjogrgens syndrome etc… The struggle is real!!!

          • I also have MCTD and had over 15 shots yesterday just to remove temporary crowns and put permanent on. I never did get numb but had maxed out on the meds. Trying again in 30 days

    • I had 4 today and you had to use epinephrine andvit was the lower back right color. I have strawberry blonde hair. Makes sense everything he stated

  3. Bill payne says

    Ehlers danlos=resistance to local anesthetic!!

    • Bill,
      You are correct about Ehler Danlos. But remember, there are MANY variations of Ehler Danlos, and NOT ALL will result in a resistance to local anesthetic. I will be publishing another post about this.

      • I had an unsavable 1st bicuspid extracted, no infection but a big cavity, it took the doctor about an hour and 6 shots. Need less to say each shot after the first was because of nerve pain. She never gave up. I’ve had a few others pulled over the years and always had trouble getting numb. Years ago I had another DDS give up and referred me to a surgeon. I don’t have red hair but grandma did and we’re Swiss/German.
        Is there a test to detect this resistance ?
        Thanks for your time…..

        • There are a ton of other variables to consider before thinking you are resistant. I outlined 10 in the 2 blog posts and there are other factors not even listed.

        • Menotnumb says

          I do not have red hair but my mother, sister, and daughter do. My grandparents on my father’s side were both Swiss. No one in my husband’s family have has red hair. I recently had a tooth removed because I cracked it. I told the doc that people have trouble getting me numb. And he kind of shrugged it off. That was until he started. An hour and a half in I was still talking normal, but my noise was numb. He was completely beside himself. I also have woken up during surgery. I thought it was interesting the correlation between the red and Swiss.

  4. I am a redhead… I went to the dentist for extreme pain on a tooth on the top right side tooth (3rd tooth from the front right tooth), the dentist started a root canal – he removed 2 nerves with no problems – went back 5 days later to have the root canal completed – 4 shots later, I could still feel him trying to clean the tooth out. He put me on penicillin for 7 days as he thinks I now have an infection – I am into day 4 of the anti, and I’m still experiencing pain – what are the odds that the dentist will be able to get me numb enough to complete the root canal 4 days from now? Should I be going to an endodentist vs. a local dentist?

    • Tina,
      This will occasionally happen. The fact that you got numb the first time suggests it has less to do with you being a redhead and more to do with a possible infection. There many general dentists who are just as skilled at performing root canals as endodontists, so I can’t really answer that question.

  5. I went in today to have a filling redone and a crown on a tooth that has been cold sensitive for some time. It is a molar on the lower left side. I was given 3 injections which resulted in my left side of my face being numb but could still feel cold on the tooth. So she told me it was due to having caffeine this morning so we reschedule the procedure.I have never had this problem before or have I ever heard of caffeine causing this. I’m not sure what to do next. Any suggestions?
    PS not a red head

    • I’ve done a fair amount of research on this subject and my conclusion, and this is mine alone, is that there’s no real evidence to suggest that caffeine alone can significantly affect your ability to get numb. The “bible” of all textbooks on local anesthesia in dentistry (Handbook of Local Anesthesia by Malamed) has no mention of this phenomenon.

      Caffeine can affect the vascular system which, in some cases, could theoretically cause the local anesthetic to travel away from the site of action. But that can likely be overcome by using a local anesthetic with a vasoconstrictor.

      In your case, you have a lower molar, which can be notoriously difficult to numb due to variable and complicated anatomy. As I’ve posted before, there can be sometimes 5 different nerve branches that can affect a lower molar. I suspect your dentist simply did not get local anesthetic around one of those nerves.

      That doesn’t mean your dentist is incompetent; it happens to everyone. I treat many “hard to get numb patients” and for lower molars, we sometimes have to spend 30 minutes with 5 different injections just to get them numb. Patience and a methodical approach to anesthetizing all the nerves is what it takes in nearly all the cases I see.

  6. Shannon Kreis says

    Can you give advice to people who are resistant to locals? I’m a redhead as well and I just had yet another painful experience. I told the dentist I have had trouble getting numb and not just at the dentist. My dermatologist doesn’t like having to give me locals, either. I think he took my concerns into account and was very thorough in the initial injections. During my two fillings, I didn’t feel like the dentist believed that I could still feel pain. I even felt the subsequent injections he did when we were halfway done (I’m pretty sure he hit bone but not sure if it was intended or not) I couldn’t sit still for him to drill. He was trying to rush through and just get it over with and it hurt badly. I felt embarrassed and guilty, like it was my fault I wasn’t numb. I was in tears when it was over and I have a fairly high pain tolerance. How can I communicate to the doctor in a way that he or she will understand? My words don’t seem to be sufficient.

    • Shannon,

      Sorry about your negative experiences. If you were to poll 100 dentists about redheads, I would suspect that less than 20% are aware of this phenomenon, and likely much fewer.

      The key, in my opinion, is open communication. It is possible your dentist does not know about the redhead phenomenon. I talk to all my redhead patients about this.

      You should go ahead and communicate your concerns in advance of any appt that would involve local anesthesia. I have many patients – not just redheads – who are difficult to numb (I attract lots of “tough to numb” patients because of this blog”). In those cases, we have them come in a half hour early, I administer special type(s) of local anesthetic, we have them relax, and usually we can get things done after waiting enough time. It all comes down to open communication.

      I doubt your dentist was enjoying himself. He was probably just as frustrated as you. If the two of you can come up with a plan, then it should hopefully work out.

      • Dr Calcaterra,
        You mentioned that you administer “special type of local anesthetic”. What do you use? So that next time I could let my dentist know what to use. My dentist is very understanding, but I have the same problem with resistance to local anesthetic. I have heard of the articaine instead of lidocaine?

        • Most dentists agree that articaine can give a more profound sensation of numbness than lidocaine. And if the dentist buffers the local anesthetic, that can help is well.

          For “tough to get numb patients”, I will frequently use large quantities of articaine that is buffered. That, along with a very methodical approach and patience, can usually do the trick most of the time.

  7. Tabitha Brown says

    I went to the dentist about 2 months ago for a filling. She numbed me without any problems. However, after the procedure about 3 weeks later I still felt sensitivity so I went back so she could adjust the filling and she tried 5 different shots and I couldn’t get numb. My face was numb but each time she blow air or water I felt it. So I left feeling discouraged and was planning to leave her, but another dentist told me that sometimes that just happens so to give her another try and I did on last week and I got numb with no problem at all. This was my first time ever experiencing anything like that. Hope it never happens again.

    • Tabitha – let me guess – was this a lower back tooth?

      • Does smoking for many years have a negative effect in getting nerve numb?

        • Smoking tobacco for many years has many negative effects. But I am not aware of any research – or even anecdotal knowledge – that suggests that long term smoking can alter the effectiveness of local anesthetics.

          • went to the dentist today for a partial crown on tooth #30 she was able to get most of the decay out to open up the nerve and get some pressure out and get the tooth treated with medicine but when she hit the nerve i jumped out of the chair i had been stuck like 6 times and my face and lips were so numb and fat. she went ahead and sealed me up with antibiotic and a temp crown and prescribed me some methylprednisolone. she says that my root canal wont be painful as it was today and i really hope this is the case! i’ve never felt a pain like that before not fun at all.

      • Mine was today. I have had several root canals crown fillers and fillings. Doctor today was the first time I had to do several shots and with epinephrine with the last. No infection I am strawberry blonde but It was the lower back tooth

  8. Chelcea Farrar says

    I’m red headed. And I have to get three shots (well every visit of mine I’ve gotten 3) and I can still feel it but it’s not really pain. It is true here

  9. How would I go about finding a dentist that would be able numb my tooth before drilling. My present dentist has filled several small filling and 2 crowns which all hurt some more than others. I think the routine has been to give me 3 shots waiting sometime in between each one to see if it works then saying I have to tough it out. And I end up crying and making him stop several times. I just can’t do this any more. I never had any issue until about 14 years ago when I had a tooth pulled and they couldn’t numb it and had to give me gas to get it out. Still hurt but I honestly did not care cause of the gas. My face gets numb like a pervious poster but not the tooth. Thank goodness I am not at the dentist as much as my husband. But I am having an issue with a tooth right now and have an apt in a couple days. I told them when I called that I just don’t think if he needs to fill any thing that he’ll be able to touch this one without numbing it. She said I needed to talk to him which I have everytime but hes told me sometimes people that have high blood pressure have issues which I don’t usually although now going through all those times not being numbed I can’t imagine it doesn’t spike now. Anyway he also gave some other reasons which none applied to me except maybe having a square jaw and my nerves being a little different than normal. But I take issue with that unless nerves can shift and move cause as a child I had a lot of major fillings done ( chewed a lot of that big fat sugar filled bubble gum ) and like I said up until I got that tooth pulled never had any problems. Anyway the person I talked to said they couldn’t do anything else for me short of knocking me out. So I thought maybe it’s time to start looking for another dentist but I would like to find one that know how to deal with this type of thing and one that excepts my insurane . So any suggestions, ideas or advise on how to go about this would be Super Appreciated. Thank you .

    • You sound like you have a low pain tolerance. It is common especially with past bad experiences and anxiety. I have had 12 fillings. 4 root canals. My wisdom teeth pulled. Two other teeth pulled. Bondings,three crowns that kept breaking and an implant. I have had issues with numbing only bottom back teeth it’s normal. I have never had gas and only was knocked out with wisdom teeth. Even my old dentist said tooth pain was the worse pain he felt. I rather go into labor again than have another root canal with an abcess. With that said. Sounds like the only way your not going to feel pain is being knocked out. Very few dentists give gas for just a filking so knocking you out pribanly wont be an option. And fillings do not really hurt especially the ceramite. I will have 8 fillings at once with no gas soon It sucks . Just gone done with a crown and a filling. Yeah I have the worst teeth in the world!!! I think it hurts waaay worse after the numbing is completely gone. It throbs big time! Good luck and remember the dentist doesn’t enjoy it neither. Do your best to stay string and a little pain is unfortunately part of life

  10. I just left my dentist office. I have a cracked uper left molar that needs to come out. I told him I’ve had several traumatic experiences with dentists drilling without my tooth being numb. Years ago I found a great dentist who told me my nerves are “wired differently”. He was able, after several atempts to numb the correct tooth. Today I tried to explain this to my current dentiat but he wasn’t hearing me. He had given me 3 shots of a local anesthetic. My left ear, cheek & eye socket were numb but every time he touched that tooth I could feel it. He insists it must be an infection. I’ll take the antibiotics as prescribed to rule that out. But despite 3 shots I could still feel my entire upper left lip and each of those teeth in the upper left of my mouth. I have another appointment for the extraction after I finish the antibiotics. Is there something I can say to get him to pay better attention to the “wired differently” issue? It is so frightening and frustrating to have to use a specific dentist for insurance purposes but not have him listen.

    • Faith,
      I understand your frustration. It could be a lot of factors – infection, your nerves, poor technique.
      When I have a patient who I know is tough to get numb, we have him/her come a half hour early. I administer extra local and then let them sit and relax while we give it plenty of time to work.
      You could also inquire about a relaxing pill to take beforehand and/or nitrous.

      • My dentist does that for me. He is very calm and kind. He knows how hard I am to numb, and always schedules extra time so I am not anxious and can give the extra shots time to work. You sound like a lovely dr. 🙂 Thats why I have been with the same dr for 11 years!

  11. Ever since I was 10 and saw my first dentist I’ve had trouble getting numb. I unfortunately have bad genetics for my teeth and although I brush and floss daily I’m 22 and currently had around 10 crows, most of my teeth filled and one route canal in an infected front tooth when I was 14 which did deteriorate some of the bone. (I saw a dentist every sixth months, my dentist somehow just didn’t catch it even after I complained 5 years before.) Anyway from what I know my grandpa has the same problem of not getting numb and was told it was just his nerve structuring. Red hair does run in my family (my hair is brown though) and so does lack of teeth enamel. A couple of ears ago I got into a car accident and was pumped with morphine and anesthetic so that they could put a tube through my chest and to the doctor’s disbelief I felt all of it. Anyway, with my last dentist he gave me the anesthetic with adrenaline after I jumped in the chair and after about 15 shots in total I still had pain. I get completely numb but it seems that when they get closer to the nerve I get a sudden unexpected jolt of pain which literally causes me to jump. Their reasoning was to prescribe me an anti anxiety medication, but it doesn’t work on me and nor noes morphine or laughing gas in normal amounts. I’ve had them from injections in the er about 3 times and they just don’t work. Anyway, I’m about to go to the dentist again soon after about a year. I just recently switched to a better dentist but unfortunately she takes HOURS, but my mom’s insurance just isn’t that great so we can’t be choosy. I just don’t know what to do. I have 6 cavities and 5 crowns to get done. when they told me that I literally almost passed out, I went extremely shaky and pale and started crying in a full blown anxiety attack. My problem isn’t the pain, it’s that I don’t know when it will come so as a reflex it causes me to jump hard in the chair, and I been yelled at multiple times for it and dentists saying they almost cut my tongue off. So I’m just afraid what will happen when I jump from the sudden random pain and will get a serious injury. I can’t afford to be put out because my insurance won’t cover it so I’m just looking for a solution. If I ask her to give me like 25 shots and numb every single area possible will that prevent it? I’m desperate because I fear that they next time I jump it’ll be my face or tongue cut off.

    • Sam, did you find out more about your situation. I have been the same way my whole life. I remember as a kid going to the dentist and believing that the shot was just part of the “necessary” pain inflicted on me, because the injection hurt and then I felt the entire drilling process. It wasn’t until later that I realized I could ask for more it it hurt and I still often need 5-7 to make it tolerable (and that is front teeth as well). Surgeries as well. I wake up in severe pain – local did not help a bit. Along with that, almost any pain reliever does nothing for me. Ibuprofen, naproxen, acetaminophen – all worthless. Opiates, such as Norco and Percocet, help a bit, but I need about 3-4 times the normal dosage for that, and doctors look at me like I am a druggie. Would love to hear if you have found out anything more. And no, I am not a redhead.

  12. Victor Stephens says

    I had a right back molar extracted yesterday. It was the most horrific and agonizing dental experience of my lifetime. Things began well as I was very relaxed from the “laughing gas” and the right side of my face was numb. However, after the dentist began extracting the tooth, it was like the cloud I was relaxing on, ran into a brick wall. The pain was excruciating as the extraction procedure lasted for about 10 to 15 minutes. Additional injections of Lidocaine failed to reduce the intense pain.

    This was the second time I had a tooth extracted while awake. The first extraction was a breeze … feeling only slight pressure and no pain. So, I was caught off guard when the second extraction was not pain free as the first extraction. If I ever have another tooth extracted, I will option to be put to sleep.

  13. I went to get a molar removed a few days ago, the dentist had to inject me atleast 20 times and i still felt extreme pain as she started and jumped out of my seat, we couldnt get me numb and she referred me to an oral surgeon.. my appt is monday and im scared to death ill have to go thru that pain again….how do i get this tooth out. Help! Ty shannon

  14. Elaina Scott Knaus says

    I had 2 lower molars filled and one upper at the same time. It usually takes 3 rounds to numb me. After I left my jaw was very sensitive. I have had root canals and orthodontic work on my teeth before so the time my mouth was open for procedure was no biggie for me. Now 2 weeks after my jaw is still compromised, I cannot bite into food, I am not able to open very wide, and my neck is stiff opposite from the side that had work done. I went back and had them adjust my bite once which was difficult since I can’t open wide. I can’t pull my lower jaw teeth in front of my upper teeth, and when I try my ears feel weird. I went to Walmart and got a bite guard to help with my urge to clinch at night, but am having to wear it all day now to help ease my jaw.

  15. Hi Dr. Calcaterra,

    I came in contact with your blog and it is wonderful. I have a had a chronic dental pain problem that has stumped dentists and specialists over the last 9 years. I wont go into the details, but I have a had many, many injections for evaluations and dental work. I went to an alternative health web site that was making proclamations that dental anesthetics are possibly dangerous long term since they contain coal tar type substances(that may be carcinogenic) that are not broken down in the body very well. Certain anesthetics such as Lidocaine and Carbocaine. Others like Septocaine are less dangerous. It has me a bit worried, but not being a scientist or dentist as well as reading and interpreting data I probably have no clue on what I read. I certainly have more dental evals and work ahead of me. Thank you for your time and this wonderful blog you provide.


  16. I don’t know if you have come across this in your practice, but I have a condition called Ehlers-Danlos Syndrome. Long story short, its a connective tissue disorder that makes it EXTREMELY difficult for us to get numb. Case in point, I needed a root canal on a lower molar last night. My dentist and I have a long relationship, and he understands my condition and what it takes to get me numb. SIX shots of novacane and a nerve block later, I STILL wasn’t numb. AT ALL. It was a night mare. He couldn’t do anything. Part of the reasoning behind it is that with EDS we have what are called “flares” which makes all of our joints, tendons, connective structures inflamed. And it sucks lol. Also “double jointed” people are people with a type of EDS. Its the one I have 🙂

    • EDS patients are difficult but not impossible to treat. Here is an article I wrote:


    • I too have Ehlers Danlos type III and I’ve had so many issues with local anesthesia. It take years to be diagnosed to begin with and in the meantime I’ve had many injections and procedures done that required the administration of local anesthetic and it has very little effect even in large doses. I had prolotherapy (multiple injections at trigger points) on my knees and the Dr. administers one shot of local and one shot of whatever it is they use…in several dozen places at a sitting, I just started skipping the local, ouch!

  17. Anita Parfitt says

    Dear Nicholas, I got an infection in my bottom left hand molar back in August while on holiday. Early September when I returned I went to see my dentist, he agreed it was an infection so antibiotics was prescribed with a follow up appt for a root canal. At this next visit 6 injections and I was only partially numb, he was able to open the tooth & start the root canal but couldn’t finish it. One more visit 6 more injections and still could not numb or finish the job, temporary filling back in but this time the next day the tooth cracked in half!! He was able to glue it together twice more The next visit he injected my mouth another 4 times & then called another dentist in to do a block right in the back of my jaw. Everywhere was numb except the same corner of my tooth!! He did an imprint for a crown & filled it temporarily again which fell out that night. I went back and a lady dentist did another temporary filling which stayed until my next visit. On Thursday he used a wand to inject straight into the canals (painful) the one canal as usual did not numb so couldn’t be done. He fitted the crown temporarily, since then I have been in pain. The crown feels high & im taking painkillers again, it feels like there is another infection.
    Although I have dyed blonde hair I am naturally an auburn Irish woman. I am now taking blood pressure tablets since December. So I’d like to ask if you have any suggestions please. Thank you

    • Anita,

      What you’re describing happens occasionally. It is really a perfect storm: a lower molar with a history of infection who may be a redhead.

      It sounds like most techniques have been tried and exhausted on you.

      There are some techniques where a very small hole can be drilled into the jawbone allowing local anesthetic to be deposited next to the tooth. I don’t know if that is available in the U.K. Other techniques involve sedation. Between the two, the procedure can likely be accomplished. Hope this helps.

  18. Michael Nielsen says

    Any recommendations, since I was a child, I have suffered through ineffective local anesthetics, followed by a couple of rubber blocks jammed down my jaw, to prevent me from closing my mouth, then held down, while the dentist just drilled, completely ignoring my pain, claiming that i was just me being hysterical, as the local has taken all pain.

    As an adult, I now have a really significant anxiety towards dentists (and doctors, they are the only two thing, that I’m afraid of – almost literally). I have been searching for dentists (or even research), that accepts that there may be issues with the local, and perhaps are open, or aware of other means of performing the local, those dentists are, however, extremely rare here.

    Once while I was a child, I got the injection AND NO (Laughing gas), and the tooth extraction was almost painless, and another dentists has successfully, used a strange device, that “clicked”, hitting nerve points in the mouth (10-15 times), however in about 41 years, these two are the only pain-free procedures that I have tried. (I haven’t got a clue what that clicking device was, but it worked, but no other dentists uses it, and the one that did, has gone on pension).

    Sometimes dentists have tried up to 6 x the normal dose of local, however, I still feel the pain acutely, and two days ago I was made aware that people that have red hair, or tendencies that way, have a heighten resistance to the locals, and combining this with anxiety, I’m near impossible to numb..

    Are there any alternatives to the usual needle, or do you have an idea of what the name of that click device that the other dentist used was ?

    • Michael,

      You are 100% correct about redheads having a resistance to local anesthesia. I’ve blogged about that here: https://directionsindentistry.net/redheads-feel-more-dental-pain/

      The research clearly suggests that anxiety decreases the pain threshold and makes you more likely to feel pain.

      The “click” device to which you refer – there are different ones out there. Nearly all purport to penetrate bone and allow the local anesthetic to literally surround the tooth. The devices are effective, but they can be expensive, difficult to use, and sometimes the healing afterwards can be lengthy.

  19. The only way injections ever work on me is if I get fully knocked out. I got 8 teeth pulled and at least half were seriously painful because I wasn’t numbed. So now, every time I go to the dentist, (today I’m getting cavaties filled) I have to get fully put to sleep. It’s much more effective than numbing shots.

  20. Jackie D says

    Never experienced anything like this. Still puzzled-have gotten many novocane injections in the past.

    I Returned to my dentist because my crown was too high and the gum around the tooth was inflamed and painful. I was not able to eat comfortsbly. My dentist gave me about 5 injections and I was still not numbed and in a lot of pain

  21. Thank you for this information. I was really angry because they were unable to numb me…. Hopefully after the infection clears they can for my next visit!

  22. I see that there are things which might make a local less numbing. Is there anything I can ingest or apply to enhance the numbing? I have two root canals one one day coming up in a week and in the past have felt everything they did. Beyond traumatic. I might go ask my doc for a vicodin to at least make me calmer.

    • If you are anxious or stressed, the local anesthesia is less effective. So a relaxing medication such as Valium/Ativan/Halcion/Xanax (generics are diazepam/lorazepam/triazolam/alprazolam) can help. In my experience, vicodin beforehand is not quite as effective as one of the meds listed above. If you call your dentist, he/she should be able to prescribe one for you.

  23. Lorie Nettles says

    Went to the dentist today she gave me as many shots as she was allowed give me patient she was trying to pull two teeth by molar bottom right teeth and the one beside it .
    Back and forth didn’t hurt so bad but when she pulled up on it it was really bad ended up having to wait to go back next Monday she did give me antibiotic

  24. Kathryn A Dettenrieder says

    Some people care “lidocaine-resistant”. All my life dental work has been a living hell for me. None of my dentists believed me. They told my mother that I was being a baby. Seven years ago I had to do through a mammography biopsy. The doctor put as much lidocaine as possible and it didn’t numb me at all. I suffered through his removing tissue from my breasts. I refused the next time a biopsy looked necessary. I did state that if I had to go through the biopsy with lidocaine, the doctor was to be worked on right next to me with no anesthesia.

  25. Mark Bryant says

    I had problems with getting my tooth numb rosary for a extraction of the upper jaw near the back. I had three shots to start with then after 5 mins he checked the numbness which I could feel pain when he push a probe about. I then had another two lots of 3 shots and still I could feel a sharp pain. I felt the dentist was starting to get frustrated and wound up by this, which made me feel uncomfortable, so I asked him to stop and said maybe it would be better if we done this another day, which I am booked in 5 days time and dreading it, I have slight redhead maybe I should mention this do you think.

  26. I had a lower left moler taken out today the dentist ended up giving me 12 full sets of injections it numbed my cheek my gum and my tongue but I could still feel everything the pain was horrible I was told it was because I had got an infection in the root of the tooth is this actually true as why I could feel the server pain of having it out

  27. my dentist applied something bitter using cotton buds near gums before injecting which numbed(i guess) the area. so the injection itself painless.

  28. Ann D (not the same Ann who posted already) says

    Something weird is going on with me when it comes to getting numb. All my life dentists have been able to numb me, effortlessly. I’m 50yrs old now and the last 2 times I’ve been to the dentist for fillings, which was one filling a month ago, and then this morning another filling, both times I wasn’t fully numbed. I felt numb initially, but after about 10 minutes of drilling I started to feel it. It hurt! I’ve been going to the same dentist for years, and I adore her so I’m not inclined to blame her. I don’t meet any of the above criteria for why I can’t be numbed. It’s now spooked me about having any further fillings. Have you ever seen a person like me suddenly not be able to be numbed after a lifetime of being able to? I mean I get a little numbed, but not fully numbed, maybe like 50% numbed. If you have any tips or suggestions, sir, I would be thankful, sir. P.S Both times when I told her it hurt she said she was almost done. She didn’t give me any more Lidocaine.

  29. I have to be knocked out simple numbing does not work I have been givin in one sitting 5 shots with no luck I did not move.oddly when they took my wisdom teeth took just one shot for each tooth? When my teeth are pulled does not hurt very long afterwards.

  30. I’m not a redhead – I’m wired differently. This posting has helped me make sense of an experience I am going through now and it has also strengthened my faith in my new dentist because it would appear he knows this does happen and that is why he is willing to keep trying when I am not properly numb. Tomorrow, I go in for attempt #2 at a root canal on a crown he replaced 18 months ago which never completely settled down and has been painful off and on for all that time. Last month he could see the inflammation on the x-ray and he probably knew it was going to be a challenge. He was able to get the upper molars right above it completely numb to put on permanent crowns but couldn’t get the lower molar quite numb enough to finish the root canal. He put a medicated filling in and we talked about what next steps would be. It sounds like he is already planning to go for different lidocaine injection spots this time. The strategy worked 18 months ago with the crown so I’m pretty confident he’ll have success this time. The fact that he believed me every single time I confirmed I could still feel it and just kept giving me more and waiting for it to take effect was huge. It helped make up for decades of dentists who didn’t do that and seemed frustrated with me. I remember going to a female dentist, figuring she’d be more compassionate and she just laughed in a puzzled manner when I told her she had just numbed my earlobe but not my tooth. I cannot tell you how emotionally scarring a lifetime of dealing with this challenge has been. But so far, the new dentist has been successful with 4 new crowns and even the medicated filling after the root canal attempt has taken the pain away. Wish me luck tomorrow.

  31. I metabolize ALL anesthesias quickly. From local dental( it takes four visits to do a cleaning), and I have had every “caine” under the sun for dental work. They loved me at the local dental school as well because I was a great learning patient for the students. Oral surgery, general anesthesia( felt pain and was aware enough to recite facts and conversations to surgeon after.They were 1/2 hour behind when they started on me, but made up the time. Broke a tooth upon extraction and the nurse picked out a piece from my hair, I opened my eyes and looked at her. She patted me on the arm), and the topper? I had to have lidocaine poured into my c-section incision due to feeling it burning as they were stitching and stapling me up. Should have seen the looks in the OR that day as they tried to figure out what to do asap. I also felt pain of delivery with my other kids as well, after receiving epidurals. So, there are individuals who, despite medical professionals best attempts, metabolize quickly

  32. I had impacted wisdom teeth drilled out/removed under local anesthesia when I was 17 and had a terrible experience at the end because most of it had worn off. I couldn’t get the surgeon’s attention or he ignored me. I’m 41 now and I’ve been to the dentist only a handful of times since then. I particularly hate the sensation of the scraping, but I have no issue with the injections as long as I get numb. Luckily, I can keep my teeth in good shape (and I do to avoid the dentist), but I recently had to go in because a small piece of a lower back molar chipped near a filling.

    I went in Tuesday afternoon to have the tooth repaired and the filling replaced. It took nearly 90 minutes and most of that time was stopping to give me additional injections. I do have a suspected sulfa allergy so I assume after reading some articles that I did not get epi. I stopped counting after 15 injections/applications, some spread over the empty tooth area itself. In total, I wasn’t in a lot of pain, but every few minutes, he would hit another spot and we would have to stop. I still have a bitter taste in the back of my mouth and I can see areas where there is still some irritation on Friday morning. I’m glad this dentist took the time to make sure I was as numb as possible and this does explain my terrible earlier experience.

  33. Ryan ann says

    I have a few questions regarding infection and freezing. I went to a fairly new to me dentist(whom I may add I am NOT happy with, but he is less expensive than most and Im on a tight budget). I should add I never took care of my teeth sadly and have had issues for 20+ years, I am 36 now. Upon exam, he explained all my top teeth needed to be extracted due to decay. I knew this was already a possibility. We went ahead and booked the extractions to have them done in his office. I am terrified of needles for one, take atenalol for my heart and valsartan for blood pressure. Any dentist Ive had in the past has checked my bp before doing ANYTHING, which is often high when at the dentist due to fear, and on occasion have given me the “gas” to calm me down and relax me a bit. My new dentist doesnt offer the gas. Anyway, this new dentist of mine didnt do any of that, sluffed off all my medications, didnt treat me for infection first with antibiotics for the infection(which had spread and was making me sick), tried to freeze me and pulled all the teeth in his office. My two top front teeth and one other tooth would NOT freeze. When he began trying to loosen them, I was not frozen, could feel everything, and was crying in pain. He told me there was nothing he could do and pulled them anyway. Yes, I sat thru it. Is this normal not to freeze when you have a bad infection in your mouth? And considering my health issues, was there something he should have done differently? Also wondering, I go back march 8th, that will be 2 weeks from the date of extraction, to have a mold done for dentures. Is this normal also to go back 2 weeks AFTER all the teeth are gone? Ill also add that 3 days after the extractions, I was in the emergency room in extreme pain. Turns out I had a pretty bad infection and dry socket. Can this be caused by the dentist? The dry socket? I didnt smoke and followed after care suggestions to a “T”. Needless to say, the emergency room dr gave me clyndamicin(not sure how to spell it(, and something for pain, and told me I should find a new dentist. Who, by the way, wasnt willing to write me a perscription for perscription strength advil or tylenol even after knowing I had dry socket. At the end of the day, my questions are…
    1. Will you freeze when you have a bad infection or was it something I did?
    2. Is it safe to go back to him just to do the mold for my dentures and how soon after the extractions should this happen?
    3. Theres a good possibility that I may have to have all my bottoms out(thats his opinion), should they be done in office or hospital? The emerg dr I saw said the extractions that he did should have been done in hospital while under anesthetic. She was happy to put a referral thru to the specialists that handle that(not sure how it works). I believe I have coverage for this type of surgery so I dont HAVE to go back to him.
    Thank you for reading. Hope to hear back.

    • Ryan Ann,

      Your description of what happened sounds complicated and I can only speculate from a distance.

      I do have to point out a couple of things. You openly admit going to a dentist that is cheaper, but then seem to believe this less expensive dentist is the source of many of the problems during and after the procedure. In addition, the less expensive dentist did not offer the amenities (nitrous oxide) that you were expecting.

      Not all dentists are created equal. They have different levels of training and interests. Some choose to further their training and learn new techniques and embrace new technologies. Some do not do that. Some are also restricted as to what they can use and how long they can spend with patients by the owner of the clinic/facility. Others are not.

      You may want to consider seeing the specialists that you mention and/or switching to another dentist. In many cases, you get what you pay for.

  34. I too had a horrific experience when I was 17. Dentist started a root canal and the tooth was not dead. I knocked him right off his chair. Since then( I am now 64) I am horrified to see a dentist and because of it, my teeth are bad. I recently started seeing a dentist that told me it is because my adrenaline spikes to ridicules heights. So my first shots do nothing but offset the spike in adrenaline. But for anything from a root canal up, I require to be put out. I just had three implants done and was out 2 1/2 hours and felt nothing. AWESOME!

  35. I had a root canal done on a molar all the way in the back on the right this morning and I can’t even count how many injections it took before I was completely numb. The endodontist was surprised at how much pain I was still in after several injections but she never gave up and I finally had relief (numbness) and it was easy-peasy from there. She and the technician were incredibly kind and understanding with me. If I ever need a root canal in the future, however, I probably will need to be put under. I’m not a redhead either. And the tooth was badly infected so I’m sure that didn’t help.

  36. My tooth next to the front tooth started hurting I got to dentist was prescribed amoxicillin on Monday the next day there was so much infection it was blackening my eye..I was told to go to ER I did was prescribed clindamycin but was scheduled for root canal on Thursday I went…wow she stuck needles in upper gum area where a huge pass like blister was I can’t tell you the pain I jumped raising my hands hit the dentist arm & was poked where I shouldn’t have been but I cried entire time and then my doctor said infection will not numb?? Is this true?

  37. I had a cracked bicuspid that had become infected extracted 3 days ago…It was a horrible experience! He started me on nitrous because I had asked for it but did not turn it up high enough so I barely felt it. Then he proceeded to numb me up using the gel stuff and several shots…I have never felt the shots before when having dental work and I think my old dentist was probably much more skilled than this one…One of the shots seemed to go into my jawbone and hurt so bad I could barely stay in the chair…He started working on the tooth and I could feel everything so he gave me more injections…7 in all! I was in so much pain I was crying and he just kept going…Finally he got it out and showed it to me…There was a cyst on one of the roots and the roots were very long. He said he was sorry it hurt so bad but when there is infection it is difficult to get the patient numb. He also said the good news was he got it all and I would have no more pain. My other teeth back teeth all have root canals, thank god because I don’t think I could go through this again. I am a natural honey blonde so maybe this is partially why but I will NEVER go back to that dentist! I was actually thinking of a suing him but since I have read the comments here realize he probably did the best he could…I do believe though that after seeing my x-rays he should have sent me to a specialist.

  38. My rear molars do not get completely numb. It’s the same routine at every new dentist.
    They give me a shot, then tap on the tooth and ask if I can feel it. I’ve almost jumped out of the chair a few times. Another injection, then they stab my gun with an explorer. Yes I can feel it. Then they give me two more shots. Then two more of a different kind of anesthetic. Finally 90% numb and can tolerate the pain. Crank up the nitrous. Can usually get through shorter procedures. Anything over an hour, or requiring drilling deep, more shots.