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Dental Anesthesia

5 anesthesia injections for a filling

04/10/2009

Question:

Last week (Friday, today is Wednesday after 10:00pm) I had a filling removed and redone. The cause of the problem was that during my last cleaning, my dentist did not recall that I had had a filling in between two upper molars. He instead thought I had some kind of tartar buildup and started digging and brutally scraping the specific molar where my filling was. Immediately after the cleaning I experienced pain and sensitivity on my two molars, with more intense feeling on one of them. I went back and he made nothing of it, prescribing only a mouthwash. The two cleanings I`ve had with him have been very aggressive, so I thought he just hurt me more than usual (I actually had a piece of my gums hanging from the scraping he made me undergo). His response, both times I have complained that his cleanings are much more aggressive than any others I`ve had, is that I need to floss. I may not floss religiously, but my teeth are considerably clean as I have been told by all other dentists I have ever seen.

So the pain on that molar went away and would come back. Last week it came back more persistently and I requested an appointment to have the issue examined again. After reminding him that I had a filling in between the affected molars, he consented the he had scraped at the tooth thinking it was buildup, and that perhaps the process had damaged my filling. He flossed me and said nothing was visibly wrong with it -- that is, until I made him go back to the tooth and examine it once again because there was obviously something that had come off and was stuck in between the molars. It turned out it was my filling. He removed it and redid it. However, not before making me go through at least four, if not five, anesthesia injections. He began with one, given to the outside of my upper gums. After about 20 minutes, he went in to drill. It felt as if he was drilling on my bare tooth. I told him I could feel everything. He gave me another injection on the inside of my gums and waited about 3 minutes before proceeding. When I insisted that I could still feel the pain quite significantly, he gave me at least two more injections. It could have been three more, because by this time I was terrified. Needless to say, once the filling was over, I could not feel the entire half side of my face. My eye was numb and it was hard for me to focus, to the point where I had to rest before working up the courage to head back to my office (I also cried from how upset and unsettled I felt to have no feeling whatsoever on half of my face). I went about the rest of the day (Friday) without being able to show any expression on half of my face. If I smiled, my left side was frozen dead. The weekend went by and my face remained significantly and visibly swollen, not to mention the exact pain that had brought me to his office remained despite his having fixed the problem. Monday came and I had to miss work because my face was still swollen (I also missed a class on Saturday because of the swelling and pain). It is Wednesday, almost midnight (Thursday), and I still show some swelling on the affected half of my face. When I look in the mirror, the affected side looks ver different from my normal side. People notice this if they stare at me for a couple of extra seconds. I am concerned that this will remain. I am trying cold compressions, but am not seeing the swelling disappear. Also still have pain and sensitivity and can barely eat with the affected molars. Help, please.

Answer:

Injections for the upper back teeth can cause swelling in the deeper tissues that become visible on the surface. This happens to every dentist from time to time. It may take as long as two weeks or longer for the swelling to completely resolve. This can also be associated with some pain on chewing and mouth opening. Generally this will resolve. The facial muscle weakness usually clears up several hours after the injections.

From what you have told me, this may take a little more time to completely clear up. If you are concerned, however, you most definitely should be examined to ensure this is the proper diagnosis and a needle tract infection or other very rare event has not occurred.

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Response by:

Steven I Ganzberg, SB, DMD, MS Steven I Ganzberg, SB, DMD, MS
Formerly, Clinical Professor of Dentistry
College of Dentistry
The Ohio State University