Fear Of Needles
If you have anxiety about receiving dental injections, know that you are not alone. This is a legitimate fear that many patients have. The level of anxiety patients have about dental injections varies from person to person. Some patients only have the fear of needles in a dental office, while other patients try to avoid injections at all cost.
Most people who suffer from needle phobia have had a negative experience associated with dentistry, injections or pain during a medical procedure in general. We would like to help patients understand the reasons why dental injections can be painful and ways that we try to minimize discomfort as much as possible.
Location of Injection:
If the injection has to be administered in an area where the tissues are dense or tight, it is more likely to sting more than areas with looser tissues. For example, dental injections administered around upper molars are typically painless because the tissues in this area are soft and loose, allowing the anesthetic solution to slowly disperse throughout without stretching and causing pain.
In our office, clinicians use a technique which allows us to start administering the solution to areas with loose tissue, allowing the anesthetic to disperse and numb adjacent areas before continuing to numb other areas. This helps patients ease the fear of needles by only experience a minimal amount of discomfort even if the patient requires several areas to be numbed for a procedure.
Administering the anesthetic too quickly:
Some clinicians make the mistake of administering local anesthetics too rapidly. This causes too much pressure from the solution against the tissues. Stretching and micro-tears occur, which causes pain and fear of needles for the patients and prolongs postoperative discomfort. It is best to administer injections slowly to allow the solution to disperse into the tissues without increasing pressure. Depending on the injection site, more time may be necessary to reduce discomfort.
In our office, providers ensure that they have set adequate time aside to spend with each patient to avoid rushing through this process. It is important to us that our patients have a positive experience, especially during the administration of a local anesthetic to avoid the fear of needles in patients. Our clinicians will slowly deliver your anesthetic over the course of several minutes depending on what areas need to be anesthetized.
Not making the tissue taut and injecting gently:
In some areas, it is more comfortable for the patient if the tissue being injected is stretched taut during the injection to allow the anesthetic to move through the tissue more smoothly. Some clinicians apply pressure, vibration or use a q-tip to help block out pain transmission in different areas of the mouth during the injection. Applying pressure during injections on tighter, denser tissue like the palate during the injection helps to block nerve signals and reduces pain, decreasing patient’s fear of needles.
Causes of Burning Sensation During Injections:
Sometimes a burning sensation can be felt during a dental injection. There a few reasons for this. One reason is that the anesthetic may be delivered too rapidly. Another reason can be that the level of acidity in the tissue is much lower than the anesthetic solution. This can be a result of infection or inflammation. This sensation does not last more than a few seconds and is not acutely painful, but some patients may be more sensitive to it. As the tissue starts to become numb, this feeling dissipates.
Our providers inject slowly to ensure patients are as comfortable as possible. Topical anesthetic only works on the surface of the tissues. By delivering a slow injection, this allows the solution to diffuse throughout the tissues, creating a more comfortable injection and reducing postoperative soreness. Typically, providers will spend about one minute or longer delivering a single carpule of anesthetic.
Lack of Empathy:
Over the course of a dentist’s career, they see patients with painful teeth, abscesses and dental injuries. They may have pressure to work within stressful time constraints. This may create a level of desensitization toward empathy for their patients. It is ideal to find a dental provider who has not lost their compassion and empathy for patients and will spend the time required to utilize these techniques to create a more comfortable injection experience for patients diminishing the fear of needles. If you are feeling anxious about dental treatment, let us know. We know that many patients have anxiety about treatment and legitimate fears based on negative experiences they have had in the past. We will do our best to help you feel calm and comfortable before and during the administration of local anesthetic.
Not Using a Topical Anesthetic (Numbing Gel):
It is not impossible to administer a dental injection painlessly without using topical anesthetic in certain areas, but it should always be used for injections that could cause more discomfort. If it is left in place long enough, it is very effective for numbing the soft tissue and preventing patients from feeling the initial needle stick.
In our practice, we thoroughly dry the area where topical is applied to help the topical get direct contact with the area. Excess saliva will prevent the topical from contacting the tissue and make it less effective. Leaving the topical in place for at least 1-2 minutes is ideal.
Using a Dull Needle:
Disposable needles have eradicated this issue for the most part, but it was once a common reason for painful dental injections and fear of needles. If a needle is used for several consecutive injections it can become slightly dulled and make the injections more uncomfortable. Ideally, a needle should be changed after 3-4 injections to prevent this issue. For a patient with memories of painful injections in the past, this may have been the reason for fear of needles.
Our providers typically utilize more than one syringe to avoid this problem but will change the needle during anesthetic administration after 3-4 injections.
Allergy to Local Anesthetic?
Allergies to local anesthetics used today are quite rare, and only a few cases have been reported worldwide. Typical reasons for reactions to local anesthetics are more related to preservatives that are contained in the solution. Usually, when patients describe their reactions to anesthetics, they describe heart palpitations, shaking, sweating and feeling faint. These are not allergic reactions. These symptoms are related to the epinephrine found in anesthetic which is present in the solution to allow it to last long enough to complete the treatment in the area. This feeling typically lasts only 5-10 minutes immediately after local anesthetic is administered. We always let our patients know this is a very common part of receiving this medication so that they know it is not an allergy, nor is it an anxiety episode. Knowing this feeling is normal is very reassuring to patients, and will make the process easier for you.
Using Cold Anesthetic
Making sure that anesthetic is delivered at room temperature ensures that patients will experience less discomfort during the injection.
Mandibular Anesthesia: The High Approach
Over the years, many patients have expressed concern about receiving adequate anesthesia during treatment due to negative experiences in the past. Some areas of the mouth are notoriously difficult to numb using traditional techniques. One of these areas is the lower jaw. Traditional techniques are not always reliable due to the variation in normal anatomy between individuals. Our providers use a proven alternative technique to numb the lower jaw, ensuring complete anesthesia for patients. Our technique is a hybrid of a few traditional techniques and allows us to target the exact location of the nerve branch. This technique is called the high approach to the mandibular block. The insertion point and angulation of the needle for this injection ensures that the anesthetic can target the nerve branch, ensuring effective and fast anesthesia.
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