Well that is interesting to know, I've had more than 1 person be like oh they make you do weeks of antibiotics before they do anything, they won't just drain it because blood and infection yadda yadda. I always thought that was bullshit cause well abscesses need to be drained.
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It’s harder to get full anesthesia sometimes when there is a presence of infection due to the acidity or something (I don’t remember the exact science behind it) so you have to do some antibiotics first.

I try to limit use of abx as much as possible due to the issues with resistance that are rising, so I usually take the tooth out or drain it.

I have had patients with hot teeth or what we call irreversible pulpitis where it hasn’t abscessed yet but it is intense pain. Only way to fix it is extraction or root canal. Sometimes doing the root canal you can’t get the tooth all the numb so you have to do what’s called an interpulpal injection. Basically you tell the pt “this is going to be uncomfortable for a few seconds” and you drill a hole into the pulp or nerve of the tooth and shove a needle down into the root as far as you can and force anesthetic down it.

It’s not the most comfortable thing but it gives immediate relief and lets us work with a comfortable patient
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I once knew someone who had watermelon seed teeth, good thing he fixed them.
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Here is a question for you o.city: Have you ever been extra rough with a patient who was a pain in the ass or a jailed convict you treated that you found out did something real bad?
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Nah, I don’t usually ever even know what they did anyway. Don’t really care, not my job to judge them. I’m there to help with their tooth ache. Nothing more.

I do have a few PIA patients (I’ll let you figure that one out) that when I see their name on the schedule I kinda cringe but that’s pretty normal.

I get people had bad experiences and the dentist isn’t the funnest place to be. But it’s hard as shit to hit a moving target with a spinning drill so try to sit still
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sorry:-)
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I hear the sweet young ladies who clean my teeth, when they see my name on the list, put their sexy undies on and wear their plunging neckline shirts.
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I’m skeptical on that but you never know :-)
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Well they are nice, and pretty. So I have no complaints..
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Another thing

It’s just water and your own spit. It’s ok to swallow it, it won’t kill you.

I had to stitch a guys tongue up the other day because as I was prepping a lower molar for a crown he thought it would be interesting to lick the drill that’s spinning at 40k rpm. “Is that blood I taste doc”?

“Yeah, good thing half your tongue is numb, or you’d be upset right now.” Then I scolded my assistant a bit for now retracting the tongue (it wasn’t her fault I was just half heartedly giving her shit).

A few silk sutures later he was ready to go
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I have some fun dental experiences too.

I've always had this thing where I don't get numb. Since I was a kid I'd tell a dentist it still hurt, and they'd assure me I'd had enough and continue. Sometimes it's fine, sometimes I can feel every single thing you're doing and every single nerve twinge while you're drilling.

2-3 years ago, I had a molar crack down into the gum along the root. If I touched my teeth it was a thumping ache like I'd never felt. I was sent to an oral surgeon to pull it. Local shots, and I could feel everything. More shots and I can still feel it. More shots and they start the extraction. It's rough. I'm sweating, It hurts like a sonnabitch and after a few minutes of wrenching on top of me the dentist stands down. I think he's don and tell him "wow, that was way worse than the other times I've had this done"....I'd had 3 wisdom teeth done with local only, and it was fine. He looks mortified and says...we're just getting started. You've got a "hot tooth" and it's not going to go numb....we're far enough along, this has to come out.....Normally I'd knock you out but I can't because...reasons....this isn't going to be fun. He spends 10 minutes wrenching an not only can i feel it, but I get this really intense nerve pain...he finally asks I if I want some gas. I've never had that, but yes I want the F'ing gas.....and they put on the mask....It's good stuff, I'd like to have some for home.......it helps but man. Eventually it comes out.....It was the dental experience everyone is afraid of....fun times.

I had another time a lady dentist cut me with the drill. I didn't move, she slipped...and then she bitched at me for bleeding too much after she cut me.

Last year I went in to a new dentist for 2 fillings. I was in the chair 20 minutes total, it was like a nascar pit stop in my mouth. When they were done, the fillings were rough......and I got charged $1,300.....for 2 fillings that took 20 minutes total.

It's not always bad experiences, but you should know that even reasonable, otherwise tough people aren't enjoying that visit either.
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Yeah, that’s rough. Sometimes shit happens. They call it practicing dentistry for a reason!

That sucks man, I’ve been there. I had a guy with a bad tooth once and i could not get that dude numb. I tried and tried and to top it off he had some cardio problems so I had to limit my epinephrine and use some local without it. That makes it burn thru it a lot faster so I had to work quick.

When you’re working on the mandible aka lower teeth, you have to do a block on the inferior alveolar nerve because it runs in bone to supple those teeth. You have to get it way back near the tmj and block the whole right or left side. Everyone’s anatomy is different so it can happen where you miss or shoot too low and don’t get anesthesia. I had a really good oral surgeon that taught me in school how to do those so I haven’t missed one in years it seems

Of course I’ll miss 2 Monday now saying that lol.

Some guys run their offices at optimal speed. I am a little more slow paced as I like to spend time talking to each patient as I feel it helps them get more comfortable with me. Corporate dentistry is a big thing and it’s a fucking drain on dentistry

It sucks that patients get screwed at those offices and don’t know their getting screwed.
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Light complexion people with red hair always have trouble with anesthesia. It’s kinda folk lore and I’m not sure there’s actual literature there but they always have it in my office

Of course my father in law (who posts here hope he doesn’t read this lol) is that way and I have to work on him. He always bitches at me he needs more anesthetic. I’m pretty sure he’s just a baby

And yeah the gas helps. It’s more just turns your give a damn down it doesn’t do anything for anesthesia
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I kind of fit that description. I don't usually have trouble with anesthetics, but the last time I got a filling I had a new dentist, and she had to give me something like five shots. After the fourth one, I was thinking, "Are you trying to save money on anesthesia or something?" The first three shots had zero impact at all on me. It was odd.
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Injections are the thing that most people hate understandably

Funny story on how we actually learned how to do those. We had the class of course did actually taught by a retired oral surgeon. Really great surgeon and teacher. Anesthesiology 1 or whatever

Then towards the end of the semester we have a Saturday booked up in the oral surgery clinic upstairs at the dental school where all the oral surgery residents are there and we dental students have to partner up. You give your partner the 10 main injections under supervision then switch places and get it done on you.

Stick and squirt is what they called it. I’d had a lot of dental work done as a kid so it did t bother me. A lot of people were kids of dentists or whatever so they’d always had perfect teeth and never a cavity or any issue so they freaked out.

One guy was doing a block on this chick and he went to lateral and the needle comes out the side of her cheek and we can see anesthetic squirting out. Two people pass out.

So we give each other two carps of lidocaine to do the injections. Everyone is numb everywhere

Then we head to the bar up the street for drink and drool
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