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Types of local anesthesia for dental work

There are a number of different techniques that are used to provide anesthesia by dentists. Without going into too much technical detail, the two main methods involve something called as local infiltration or a nerve block.

Local infiltration is provided by numbing the nerves immediately around the tooth. In the upper jaw, this kind of anesthesia is enough to provide adequate anesthesia for most purposes. In the lower jaw, though, the bone is denser and does not always allow the anesthetic agent to reach the tooth in adequate quantities.  

Here a nerve block is given, the most common kind of nerve block given in the lower jaw is the inferior alveolar nerve block which is given near the back tooth but numbs the entire half of the jaw on the side where it is administered.

Within these two basic types, there are many different techniques used to tackle different situations that the dentists may encounter.

What to do if local anesthesia does not work on you?

If you are someone who feels that local anesthesia is unable to numb their pain before a dental procedure adequately then here are the possible reasons why it could be happening.

Poor technique from the dentist

Even the best dentist can sometimes have a little trouble anesthetizing teeth because of normal variation but if it occurs every single time for every single procedure with you then you may need to look for a new dentist. Administering local anesthesia requires adequate training and is pretty basic.

Anatomical variation

In a small number of people, the placement of their nerve is not where you would normally expect it to be. If that is the case then the patient will not respond to a correctly administered local anesthetic injection.

The dentist should be able to work around this situation pretty easily by changing the position where the injection is administered, Augmenting the block with local infiltration, or utilizing advanced techniques of local anesthesia administration that unfortunately, not all dentists are familiar with.


The presence of an acute infection around the tooth where the anesthesia is supposed to act can throw a spanner into the works. Local anesthesia functions within a certain pH level of the tissues. An acute infection can decrease the pH so much that the local anesthesia is unable to penetrate the tissues and take effect.

The situation here can be managed by using antibiotics to reduce the infection before the procedure is carried out.


Patients that are very anxious may find that local anesthesia takes a long time to start acting on them or wears away very quickly. It is recommended that the use of anti-anxiety medication or gas be used to put the patient to ease.

The effectiveness of local anesthesia increases greatly after the patient has been put on anti-anxiety medication.

Rare conditions

Certain patients who are suffering from inherited disorders like Ehler-Danlos syndrome or have a mutation of the gene MC1R (seen in red-haired people) may be less affected by local anesthetic agent than other people.

A lot more local anesthesia may need to be administered for the effect to take place and in extremely rare conditions, dental procedures may need to be performed under general anesthesia.   

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