Overcoming pain (and fear of pain) at the dentist
 

Hi all,

I went to the dentist yesterday and as usual I left him shocked and feeling bad about himself, simply because he was hurting me A LOT!

Not his fault, he is a great dentist, but my fault..

I cannot seem to control the pain when I am at the dentist. I have tried several things:

Breathing: doesn't work because the pain is so sudden always that I forget to breath normally. When I do remember again, it doesn't seem to help.

Meditation: going to my happy place doesn't work. I feel happy, I feel good, but it still hurts like hell!!

Medication: I swallowed some advil last time, just to already have a bit less pain, but it didn't work...

The process: I've tried the process before, during and after, but it doesn't stop the pain. I appreciate the pain and the power that it must have cost to make me believe it, but it still hurts!

The dentist always uses anesthetics but they don't work either.. my entire mouth (or that side at least) gets numb, but I still feel the pain, as sharp as before...

I am not really afraid of the dentist itself, I go there happily for checkups and stuff, but I am afraid of the pain.. which of course makes it worse again..

The only thing that remotely works is when I put my nails into my hands or arms. Feeling pain there somehow takes the focus away from the pain in my mouth and since I control the pain in my hands it hurts just as much, just differently.
But my husband doesn't like me coming home with marks all over my hands (I cannot blame him...).

So my question is:

Does anybody know something that might help? I have to go back next Tuesday, so it would be wonderful if I had some more tools before that time.

interesting that things like anesthetic don't work. has he tried various types, like it sounds like he used the shot of lidocaine stuff, has he used nitrous too?

honestly? it sounds like this is psychological. sounds like you had a past experience where it was way more painful than you expected, and now you expect that level every time. (interesting enough, i drove my mother to the dentist yesterday and ended up meeting a beautiful little girl.)

maybe considering it might be mostly psychological will give you some space to revise the experience?

or... you enjoy some less vanilla sexual experiences... maybe you could imagine he is playing the Dom and this is what you agreed to submit to, to see it as a sexual/erotic type of pain? weird idea i know, but it could work right?

I have no idea... it is all in Spanish :( But Tuesday my husband is coming with me, so I'll ask him to ask if there is anything else he can try...
I am considering this, and I do believe that it might be true... I've tried to be extremely objective about it, but still, it HURTS!!! If I am objective about pain, for example cramps or something like that, I can tell if it really really hurts or if it just feels bad.

I can make that distinction at the dentist as well. I know when it just doesn't feel nice, and when it actually hurts.
So, although it has something to do with me not being in control, not being able to decide how much it hurts, I can and have gotten over that part (and it helps, things that just feel bad, don't hurt anymore).

I wish it was that easy.. :)

But this is not-nice pain. Somethings are simply not nice, doesn't matter who does it...

well, i don't know if i have any perfect suggestions. if it is too much to bear, maybe you could see a doc or i think Mexico has pretty relaxed policies so you could go and get a prescription of some sort, to take before your appointment.

i don't think pills are always the answer and they are often not the best answer, but i also know something like Valium can work well in situations like that. it doesn't make the pain go away, it is there, but the medication affects you in a way so you just don't really care about it like you did.

i don't even feel too comfortable with this idea, but i guess it could be helpful.

You need some pain killers. You could call your dentist and explain that the local A. isn't working and you insist on proper care. See if he will write a script earlier in the day OR ask if he has any oxycodone (either by itself or in Percocet combined with tylenol) at his office. If he does, take at least 2 (10mg).

At 10mg you will still feel pain but you won't care as much. To really feel no pain I think around 15-20 mg is necessary. Having an empty stomach will increase the effects.

Rei's suggestion of valium isn't bad for relaxation and stopping anxiety beforehand but there is zero analygesia and pain is still really annoying on benzo's (valium, ativan, klonapin...).

Or the Doc may choose a weaker version like Vicodin (hydrocodone) or Tylenol with codine. Vicodin is ok but the Ty w/ codine is extremely weak.

It bugs me that MDs are withholding pain meds to ordinary people all over the world now because of lawsuits and things.

I am thinking to going to a doctor on Monday to explain my problem to see if he has some stronger pain meds.

The dentist here are not allowed to prescribe anything :(

But I wonder if it will work? I remember when I hurt my wrist, they gave me some pretty strong pain killers in the hospital (the ones you put under your tongue) and although it made me care less that it was hurting, it was still hurting the exact same amount...

Maybe it is a type of pain killer that doesn't work for me. Because advil (ibuprofen) normally works well for headaches or other pains...?

I am going to do some research, going to the doctor on Monday, and ask if the dentist has a different painkiller on Tuesday :)

Tnx all!

well, both types of medication are addictive and i don't recommend that anyone play with them. but docs will prescribe benzos like Valium to people with chronic back problems - they wouldn't do it if it didn't help with the psychological resistance to the painful stimulus. sure, technically the pain is still there, but it is far easier to deal with it.

yes, painkillers can work too, but she said she doesn't have a lot of success with that. opiates should work though? i have heard of people having funny reactions to opiates (nausea, rashes, hallucinations) but not sure i've heard of them just not working, though it could be they didn't help with the level of pain.

if all else fails, maybe the docs over there could put you on some Vercet - it's a combination of benzo medicine and opiate medicine, so you are both relaxed/care less about the pain and feeling less pain. docs used Vercet with me for a procedure before, that stuff does work...

Thnx. I'll write down all the names, get my husband to translate them and ask on Monday.

Right now I don't care about side effects. I could turn purple for 3 days and it would be ok with me if I didn't feel as much pain :)

It is not just for me... the poor dentist is freaking out as well :) He says he doesn't like hurting people (he's in the wrong profession!!) and feels very bad every time I am hurting:)

Doseage has a lot to do with it too. Docs are often too conservative.

The strongest oral prescription analygesic (pain relief)med is oxycodone.
Usually used in a combination tylenol-oxy drug called Percoset.

As long as it's not taken in an abusive way it's an excellent med for pain relief. It converts 100% to morphine.

Vicoden (hydromorphone) is effective too.

If he suggests codiene that's not a big help. It will depend on how you describe the pain levels you are feeling to him. Based on that he can choose the proper med.

morphine sulfate works too. oxycodone or oxycontin often doesn't have the same staying power.

p.s. Vercet is given through an IV, not taken like a pill. so i don't know if they would give it to you, it depends on a lot of different factors i guess. but since you're turning this into a bit of research i wanted to clear that up. at least in the states, they only give it in a sterile environment like a hospital or the surgical procedure area of a clinic.

Some types of back problems warrant a benzo because they relax the muscles similar to a muscle relaxant.
The psychological reaction to pain isn't changed with benzos, that's what opiates do. I've used benzos for a long time and they sure are a miracle for anxiety but when I was getting off oxycodone the benzos didn't change any pain experiences.
Or evenings I'd come home after grappling with an injury they just made me tired enough to sleep in pain.

I'm familiar with the psychological pain altering power of opiates. That includes all physical and emotional pain.

Yeah that op/benzo mix would work, when both meds get together they synergize each other. 90% of all opiate deaths are from mixing with benzos!

i have back issues, and once every couple of months i take valium for them. the experience of just not caring as much about the pain you're feeling is something i can draw on myself, which is why i mentioned it. your own experiences are obviously different, but of course i'd imagine almost nothing can soften your pain experience if you have tolerance from oxy. perhaps that is where your perspective is coming from here?

i will give you that, i'm sure if your chemical and psychological system is used to the experiences that are triggered with oxy, benzos will seem useless. luckily, as far as i can tell, Sandra is not on an oxy regimen, so that could be an option for her.

my understanding is that opiates flood your brain with signals, overloading your pain receptors to produce endorphins - i believe that's why they are called antagonists, because they 'antagonize' your brain into producing endorphins. it is a physical level way of dealing with pain, but i suppose if you have tolerance or use them in some habit-forming way it becomes psychological.

hmmm, well, problem with oral morphine (morphine sulfate)is the bioavailability - it's taken orally and only ~55% is absorbed that way. But docs don't give extra to compensate. It's the lamest thing? I had those once, and in order to ...

Oxycodone taken orally is like ~85% absorbed by stomach.


Oxycontin is a 12 hr time release pill so that doesn't seem like it has staying power problems.
"contin" means CONTinuous release of oxycodone.

Perhaps you could try accepting the pain, rather than trying to block it out. It won't make the pain go away to accept its presence, but you'll feel a distinct difference toward how you feel about it. I'd describe it as being able to simply see it for what it is and knowing that, you'll have no reason to resist its presence. At a basic level, pain is just a message to your consciousness, telling you to pay attention to something. Most people automatically react in the opposite way, trying to ignore the pain. Instead of doing what everyone seems to do on instinct these days, focus on that pain. Let it drown out all other thoughts and distractions. Be present with it entirely. Don't ignore it, embrace it and give it your full attention.

You may be surprised at the result of this. You're brave enough, I can tell :D

Edit: I want to elaborate on why our instinctual reaction is to ignore pain. Since it is a message to your consciousness that your body is being harmed in some way, your instinct is to stop the source of pain immediately. Example, you immediately pull your hand back from a hot surface when you touch it. The problem occurs when we are unable to quickly pull away from the antagonizing force, so instead of accepting it for its duration, we keep attempting to resist that pain.

Are you sure he's "needling you right"? I've had good dentists and bad, and one thing I can't do without is a dentist who knows how to aim the needle and put those nerves to sleep.

I've now ended up with a woman who is very adept at anesthesizing, and she's also pretty gentle (I've had others where I had the feeling they wanted to push down the drill into my jawbone by applied pressure alone....), and that hurts/vibrates a lot less than with any other dentists I've had before.

So make sure the dentist is a good fit, friendly, gentle, knows his stuff and "vibes with you". Trust really matters, so find a good one for you!

Oh well if they work on your back pain I guess they can help with pain.
I did have a high oxy tolerance for a while because I was an addict but what I meant was the benzos didn't seem to help my withdrawl pain when I occasionally faced that sitch.


OP's do almos pretty much what you said. They enter opiate receptors in your brain which causes a release of all our natural pain killers, happy drugs, all the dorphins and cause a big bliss.

But they're called "Agonists". Antagonists block the opiate receptors and do not allow the oxy, heroin (diacetyl morphine) or whatever opiate to bind to the receptors. Naltrexone is an antagonist and it actually rips out opiates off the receptors. Good for overdose patients. Ambulances carry it. My drawer carries it.

right, that makes sense... got the words mixed up. thanks for addressing that.

So true. I have been to a fair share of dentists and the best ones make you relax so you feel less pain. It's never a pleasant experience for me and there's usually some amount of pain involved (if nothing else, the needle hurts), but I find that a good, compassionate dentist goes a long way to alleviate the discomfort.

But if you have to go to this dentist, then my advice is to bring music (some dentists even have glasses you put on that you can view movies from!) to distract you from the process. It helps, plus you're not hearing all those annoying drilling noises.

Tnx. I agree with this point and if I wasn't sure about him, I wouldn't go back there again :)

But he is a very warm and friendly guy, and he does find the nerve to put the needle in. But is has never worked for me, but I have also never had carries that went that deep and close to the nerve before....

I can do this with continuous pain, and it does go away when I do this :D It is my preferred method of dealing with pain :D

But the problem is that the pain is always very sudden and very sharp. It doesn't give me any time to adjust to it. It is an instinct reaction that I cannot control. It is also a pain that goes from my teeth to my entire jaw, and makes it impossible to think :(

Of course, I could keep on trying, and maybe after 10 treatments I would manage do to that.. but I would prefer something faster :)

He already gives me the double of what he normally gives and adult man :) He already numbs my entire jaw on that side, instead of just part of it.. :)

But thanks for the descriptions of the pain meds. I'm going to take that to the doctor on Monday to see what happens.

Ah I see. Regular topical anesthetics not working is very interesting. The opioid resistance makes sense from your history though. Has your dentist tried a benzodiazepine?

I have friends who say cocaine does nothing for them, Ive never tried it. When i see the Dentist he gives me Novocain (cocaine derivatives) it dose nothing much at all... one time he gave 13 shots. i said try that new super stuff, he said that was the new stuff. i try to go to the happy place, next root canal I'll bring my acupuncturist I guess i will skip the cocaine use.

:cool:

I think hypnosis could work very well in this case. The power of the mind over the body is just amazing. But I don't know who could teach you or help you in this matter. I think he could, though :)
YouTube - Derren Brown - Anesthesia using Hypnosis NLP Body Piercing
This one is actually about giving someone a tooth acke though hypnosis and NLP.

Second looking into self-hypnosis. Did meet one practicioner who said she used it at the dentist to make her mouth go numb, didn't use pain meds, didn't experience pain. But I haven't done it.

Hope you will find something that works for you!