Numbing not working at the dentist? Learn why local anesthetic can fail and how sedation may help. Consider contacting us today to learn more.
Local anesthetic does not work the same way for everyone, and there are well-studied reasons why. There are also real options when numbing alone is not enough. If this sounds familiar, call The Dental Anesthesia Center at (314) 862-7844 or request a consultation. Our practice offers sedation and general anesthesia for patients who have had trouble getting numb.
I had a dental problem that needed attention quickly. They got me in the next day and we identified the problem and came up with a great solution. I have been going there for over 10 years and they always come through.
Response from the owner:Thank you for your continued trust in our team over the years! We’re always happy to help and truly appreciate your kind words and recommendation!
Always a great experience. Carrie does a wonderful job keeping my smile healthy and bright. Dr. Thoms is always very nice and professional. They make going to the dentist much less stressful!
Response from the owner:Thank you for the great feedback! We're so glad Carrie and Dr. Thoms have made your visits comfortable and enjoyable.
I’ve had wonderful experiences at this dental office. The team is professional, the care is top-notch, and appointments run smoothly. I’ve never had to wait long in the waiting room. I highly recommend them!
Response from the owner:Thank you for your kind words and recommendation! We’re so glad to hear you’ve had such positive experiences with our team. We truly appreciate your support!
I love coming to the Dental CENTER , all the ladies are so nice and they keep you up to date. Dr. Belah is great and Carrie are so good. They do a great job.
Response from the owner:Thank you so much for your kind words! We’re thrilled to hear you’ve had such a positive experience with our team. We’ll be sure to share your appreciation with Dr. Behl, Carrie, and the rest of the team!
Dr. Hoffman is a friendly individual and readily answers can't questions you may have. His office staff are all friendly. One in particular,Meaghan, has learned to put up with the grumpy old guy from Illinois. I would recommend you give these people a try for your special needs relative.
Response from the owner:Thank you for the kind words and recommendation! We’re so glad to hear you’ve felt welcomed and well cared for by Dr. Hoffman and our team. And we’ll be sure to let Meaghan know she’s doing a great job putting up with our “grumpy old guy from Illinois!”
The Best Dental Office In St Louis! Thanks for keeping my pearly whites shining! … back again and they always do a great job and make me feel comfortable! They have an exceptional staff who are friendly and also very good at their jobs!!
Response from the owner:Thank you so much for the wonderful review! We’re thrilled to hear that you always feel comfortable and well cared for. Our team truly appreciates your kind words!
The practice is top notch. Could not ask for better care. Wish dental care was more affordable.
Response from the owner:Thank you for your kind words! We’re grateful for your feedback and are proud to provide high-quality care in a supportive environment.
The best staff for dealing with my level 3 non verbal autistic son. Very understanding and supportive.
Response from the owner:Thank you for your kind words! We’re so glad our team could provide a supportive and understanding experience. Your feedback means so much to us!
Dr Thoms is the best. He and his team are very attentive and extremely dedicated to the dental care for our special needs son
Response from the owner:Thank you so much for your kind words! We truly appreciate your recognition of Dr. Thoms and our team. Providing compassionate, attentive care is at the heart of what we do!
We brought our 1.5 and 3.5 year old daughters here for cleaning / check ups. Our dental hygienist Laina was amazing...made them feel so comfortable. They had a great time and keep asking when they can go to the dentist again. Dr. Hoffman was great too and made everything super quick and not stressful. Great place for kids in addition to adults!
Response from the owner:Thank you for your kind words! We’re so glad to hear your little ones had such a positive experience. We’ll be sure to share your compliments with Laina and Dr. Hoffman! 💙
Every person in the office is so personable. That first off makes you comfortable. But then the methods used to clean my teeth, particularly. I don't feel a thing, and it's the first time in my life that I haven't. And I have a lot of anxiety about dental work, and I really do not feel a thing when my teeth are being cleaned
Response from the owner:Thank you for your kind words! We’re so glad our team could help make your experience comfortable and relaxing. It means so much to know you felt at ease with your care!
I came here with my 18 year old daughter who has an immense fear of Doctors and Dentist , The kindness and understanding without any judgement we received from Dr.Thom was just unbelievable. The work he did on my daughter was life changing for her . I would recommend him to anyone . Just amazing, kind talented Doctor.
Response from the owner:Thank you so much for your heartfelt words! It means a great deal to our team to know that you felt welcomed, understood, and cared for. We’re especially grateful you shared how meaningful your experience was.
We met Dr. Shawn in Sept 2023 and in December, he removed our adult nonverbal son's wisdom teeth. Not gonna hold you, general anesthesia is billed incrementally (by the minute/quarter-hour) and is a heavy financial investment. I love this clinic because it really is a safe space for special needs families. There's a huge calm that accompanies knowing your dependent person is getting healthy. Dr. Shawn is exceptional. We drove 6 hours to get here so we'll choose a local practice for routine sedation cleanings down the road. I hope to see more neurodivergent acceptance built locally in our state's dentistry like this team has here. Meanwhile we are so grateful for this practice and grateful our son was in Dr. Shawn's care.
Response from the owner:Thank you so much for sharing your heartfelt words. We’re honored to be a place where families feel safe, supported, and understood. Your trust in Dr. Thoms and our team truly means so much to us.
Dr. Thoms and Robin are excellent in their care, concern, and support. Dr. Thoms explains everything and takes his time. If I have questions or concerns, he is easy to talk to and listens well.Robin is right there by my side throughout procedures. Her technical skills and professionalism are impressive. She is terrific!
Response from the owner:Thank you for your kind words! We’re so glad Dr. Thoms and Robin made you feel heard, supported, and cared for. We’ll be sure to share your wonderful compliments with them—they’ll mean so much!
Individualized care, expertise in general anesthesia, and attention to detail are why we keep returning for our son.
Response from the owner:Thank you for your kind words and continued trust in our team! We’re grateful to be part of your family’s care and truly appreciate your confidence in us.
The dental anesthesia center is hands down the best dental office I have ever been to. I neglected my teeth for years due to severe dental anxiety. I had work done under anesthesia with doctor hoffman who did an amazing job. Doctor Behl is not only a fantastic dentist but one of the nicest people I have ever met. The dental hygienists are both thorough and gentle. Stop your search and just go here
Response from the owner:Thank you for your incredibly kind words! We’re so glad our team could help make your experience comfortable and positive. We truly appreciate your trust and recommendation!
I had a great experience at the Dental Anesthesia Center. The reception area Personnel the Doctor-Dentist and one of his assistants all helped to make sure I was comfortable, informed and ready to get it done! Thank you Dental Anesthesia Center team!! CB
Response from the owner:Thank you for your kind words! We’re so glad our team could help make your experience comfortable and reassuring. We truly appreciate your 5-star review!
Their staff was truly caring and respectful in everything they did. The dentist explained what they found in the initial tests, asked us questions about our 82 year old sister, then explained the options that would give the best results.
Response from the owner:Thank you for your thoughtful feedback. We’re grateful for the opportunity to provide compassionate care and appreciate you taking the time to share your experience.
My hygienist, DeLaina Joost, takes excellent care of my teeth with her advanced skills, gentle touch and great “chair side” manner. She is a consummate professional, and such a compassionate person. I look forward to my visits at DAC!
Response from the owner:Thank you for your kind words! We’re so glad to hear you had a positive experience with our team and appreciate you taking the time to share your feedback.
Why Local Anesthetic Sometimes Fails
Infection and Inflammation
A severely inflamed or infected tooth is one of the most common reasons numbing fails. Inflamed tissue is more acidic, which makes it harder for the anesthetic to reach the nerve, and the inflamed nerve itself is more sensitive than usual. In studies of lower molars with severe inflammation, the standard lower-jaw injection failed for a large share of patients; in some studies, more than half.
The Lower Jaw
Upper teeth usually numb well with an injection near the tooth. Lower back teeth sit in thicker, denser bone, so the dentist numbs a larger nerve that runs through the jaw instead. That injection depends on reaching the nerve in the right spot, and anatomy varies from person to person. Some people also have extra nerve branches that one injection does not reach.
Anxiety and Past Experiences
Fear changes how the body handles pain. When you are anxious, your nervous system is on high alert, and pressure or vibration can register as pain even when the tooth is numb. One hard visit can make the next one harder, creating a cycle.
Genetics and Certain Health Conditions
Some people respond differently to local anesthetics because of how they are built. Research has linked variants of the MC1R gene, the gene behind natural red hair, to a weaker response to local anesthesia and greater dental anxiety. People with Ehlers-Danlos syndromes (a group of connective tissue disorders) also report the problem far more often. In one large survey, they reported nearly three times the rate of numbing not working among people with the condition compared with people without it.
Could It Be An Allergy?
Many people who had a bad reaction to numbing are told, or assume, that they are allergic. A true allergy to the local anesthetics used in dentistry today is very rare. More often, the reaction has another cause:
Epinephrine. Most dental anesthetics contain a small amount of epinephrine (adrenaline) to make numbing last longer. It can cause a racing heart or shakiness for a few minutes. That is a side effect, not an allergy.
The preservative. Anesthetics with epinephrine also contain a sulfite preservative, and some people react to sulfites. Anesthetics without epinephrine do not contain it.
Anxiety or fainting. Fear can bring on a fast heartbeat, sweating, lightheadedness, or fainting, which can feel a lot like an allergic reaction.
If you suspect an allergy, an allergist can test you for specific anesthetics and ingredients. Bring the results to your next dental visit. You can also read how we care for patients with local anesthetic allergies.
What Can Help When Numbing Does Not Work
Start by telling your dental team everything: which visits went badly, which teeth were involved, and how you reacted. That history shapes the plan. Depending on your situation, options may include:
A different approach to the injection. More time, a different anesthetic, or supplemental injections near the tooth can help when a standard injection is not enough.
Calming the inflammation first. When a tooth is severely inflamed, your dentist may address the inflammation before treatment so numbing has a better chance of working.
Sedation.Oral or IV sedation helps you relax deeply, which may make the visit much easier to get through. Learn more about IV sedation.
General anesthesia. For some patients, sleeping through treatment is the most comfortable path. Under general anesthesia, you are fully asleep and monitored throughout.
At The Dental Anesthesia Center, our dentist anesthesiologists and sedation dentists provide every level of sedation in our Clayton office, from oral sedation through general anesthesia. If local anesthetic has let you down before, we can plan around it instead of hoping it works this time.
Contact The Dental Anesthesia Center
If numbing has not worked for you in the past, you do not have to keep bracing for it. Our doctor-owned practice cares for patients with dental anxiety, special needs, and complex dental histories from across the St. Louis area.
