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Comment by tomcam | Hacker News Reader

I will ask you anything then! Please tell me why I have to be sedated for everything. No amount of anesthetic ever works on me. Drilling always feels like a horrifying electric shock. And every time they touch my fillings with a metal probe, I get shocked too.

I’m not afraid of needles. I’ve had plenty of uncomfortable medical procedures. I can tolerate all other kinds of pain. But why doesn’t local anesthetic work on me for dentistry?

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You could have a sodium channel mutation (such as SCN9A) that makes you highly pain tolerant, but lidocaine-resistant[0].

It's a known syndrome, and may be associated with ADHD symptoms, episodes of intense skin flushing or redness (erythromelalgia) and epilepsy.

0. https://www.healthbusinessgroup.com/2008/01/11/what-causes-a...

Other medical sources:

  https://www.ncbi.nlm.nih.gov/books/NBK1163/
  https://www.ncbi.nlm.nih.gov/books/NBK481553/

Thank you so much. yes on the ADAH, no the skin flushing. Really appreciate your help.

TBH I have never had a patient on which anesthesia didn't work...the only case that's fairly common is if you have an acute infection on that tooth, in which case the effectiveness of anesthesia is greatly reduced

Lower molars receive 2-3 different innervations and it is sometimes hard for a dentist to get all of them numb

I'll say that some dentists are good at nerve blocks and others are not. Bupivacaine takes time to work and some dentists don't allow it to take its proper time. But if you have a local anesthetic properly infiltrating the nerve, and given the time to work, you will have no sensation.

Do you have red hair?

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1362956/

That article is about a different process, inhalation anesthetic, rather than local (nerve-blocking,depolarizing) anesthetic.

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