Better than a punch in the arm
I saw a 15 year old patient yesterday. He's going to be getting braces and he had a groove cavity that I was concerned about. I recommended that we restore the groove before he gets his braces on. I explained the pros and cons to Mom and he listened intently. When I was done with my explanation, I asked him if he had any questions.
"Is it going to hurt?"
Are there any other questions more important than that?
I replied, "No. But I am going to give you anesthesia."
Then I remembered I was talking to a 15 year old patient and and not a dental colleague.
"Which means I'm going to give you a shot that will numb the area. But I promise that you won't feel the shot. If you feel the shot, you can punch me in the arm as hard as you want to."
His face brightened. He and mom were both satisfied, I think.
So, how can I be so sure he's not going to punch me in the arm?
I have to admit that there are some areas of the mouth that are more difficult to give a painless shot. The upper front teeth are especially challenging to do without discomfort. But over the years I've refined my technique enough that I'm pretty sure I'm safe.
Here are my secrets…
- really tiny needle: whenever possible I use a 30 guage needle. This makes it so the patient doesn't feel the poke part of the shot. Very occasionally I need to use one that's a bit bigger. When I do, I actually use the small needle first to numb the area where the larger needle will have to go.
- really slow injection: injection pain comes from delivering the anesthetic solution too quickly. I often take a minute or more when I'm giving anesthetic. Some patients think I'm dawdling…and I am, kind of. But I've had really good luck giving comfortable shots this way.
- the wiggle: sometimes I will wiggle the patient's lip as a distraction from the shot. This works surprisingly well. I learned this trick from my dad, who is a dentist in Midland and still uses it to this day.
- topical numbing gel: we have several kinds of topical anesthetic gels that we will place in the area that we're going to give a shot. I dry the tissue really well before placing the anesthetic and let it sit for a little while.
- STA: I sometimes use the STA unit. This high tech tool uses a computer to deliver anesthetic in a slow and controlled way.
Do you have questions or comments about this blog entry? Would you like to become a patient in my Saginaw dental practice? We'd love to have you! You can email me at firstname.lastname@example.org or call the office at (989) 799-9133.
***Edited on 6/8/2011***
I saw him yesterday afternoon. He didn't punch me.