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Many, many patients complain about "the shot".  It can be painful and for some it either doesn't completely work or it takes a very long time to work.  Dreadful.  It is true, that there are anatomic reasons  such as extra nerves or nerves that are placed differently.  Infected areas don't numb easily either.  If the doctor is very expert, takes time, and uses topical anesthetic, that helps.  Still, it may be painful and not work.  Why?  The pH.  Local anesthetic is very acidic.  It must be or it quickly breaks down.  But..for it to work it must be alkaline.  The anesthetic must be made more alkaline either by the body or some other means.  I have known this for years and experimented with indirectly increasing buffering.  I had some success.  When in my anesthesia residency, I saw some of the anesthesiologists mixing local anesthetic with sodium bicarbonate. Of course!  They were directly buffering it, making it painless or much less painful, much quicker acting, and much more effective.  People that wouldn't otherwise get numb, got numb.  Quickly too.  So simple.  So what is the barrier?  Dentists are so accustomed to premixed carpules that the idea of mixing your own anesthetic is very foreign.  But it can be done.  If compassion, the wish to relieve suffering of others, is important, than we must consider a simple, proven solution that solves a very real problem for patients. 

I am one of those patients that doesn't numb well.

--Dave


 



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