decayDental Work without Local Anesthetic


I saw a patient recently, a male over 75, who has some decay around large fillings that will require crowns. He has been a patient for only a year and I have never provided any service at my office other than dental cleanings. He was fine with proposed treatment, but he wanted me to know that he never took any dental anesthetic for his dental work. WOW!


During many years of practice, there are a few people who have asked to have fillings or crowns done without any anesthetic. They know who they are as a rule. They seem to perceive pain differently than most patients (including me) and do just fine through the drilling. If a patient tries drilling without anesthetic and he starts to feel it, it’s easy to stop and administer a local anesthesia at that point.


As a practicing dentist for over 35 years, I don’t recommend having work done without being numb. Dental pain on drilling can be very intense and very few people would even think about attempting it. If I have a patient with an extremely small filling who is a little older (it seems that teeth get less sensitive as patients age), then I’ll recommend trying it. This call is one of the times that experience and good judgment are invaluable. If someone has had root canal treatment on their tooth, where the nerve has been removed, they will usually do fine for drilling as long as the procedure is small. Most teeth that have root canals need a crown rather than a filling. In this case there is too much vibration for the patient to be comfortable during the procedure, so I recommend numbing almost all of the time.


I am glad we have anesthetics for our patients’ comfort.