James Frey, Root Canals, and Novocaine.

Books, Oral Medicine January 27th, 2006

Lots of people are understandably feeling betrayed after having put the time and emotional energy into reading Frey’s memoirs only to find out that he lied. Oprah is no exception.

There’s a part in his book describing his experience of having multiple root canals without anesthetic. This is unrealistic to most people and also probably untrue in his case. Novocaine hasn’t been used in Dentistry for decades (we use other types of local anesthetics such as lidocaine) and most root canal procedures would be excruciating without anesthetic because we’re fiddling directly with nerve tissue. There’s also the issue of the local anesthetic potentiating his drug addiction. That’s untrue because local has no addictive properties. Local anesthetic interrupts nerve conduction rather than binding to receptors in the brain like general anesthetics or narcotics which make you feel stoned enough to not care about pain.

That being said, most endodontists have done some number of cases without anesthetic. For some patients, the fear of the needle outweighs the actual procedure. If you combine this fear with a tooth that is asymptomatic and already dead (no live nerve in it), it is possible to do a root canal without anesthetic. In fact, there are some cases where the tooth is so heavily infected that anesthetic wouldn’t work anyway because of the amount of pus that has gone into the gums. When these teeth are opened up and pus spews out, the patient usually feels substantial immediate relief.


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  • Princess Lennox

    Pus spewing out! Oh yeah! I had a lot of that going on in my infected tooth. :)

  • Patti

    Thanks for your comment on this topic on my blog. I had to run over here and get more cool background info on this!

  • WICatholic

    Am a RDH with added Local Anesthetic licensure and Certification in Community Dental Health who never gets a chance to use it. (Also an LPN).

    I saw a comment you had made on a couple of other blogs (not sure which ones I was at anymore), and had to come see yours. The word Ameloblast was eye-catching.

    Tell your Girl that I enjoyed reading about her work and seeing the Xrays, and that I wonder how long it took for her to teach you about them? lol

    Also had a cardiologist in our area tell his patients that Oral Infection (Perio) has absolutely nothing to do, ever, with any types of heart problems. He also refused to have his own prophy more than once every two years or so because it is all just a ‘scam’. (Yes, he told his patients this!!) Wonder if the ER doc and he will ever need an Endodontist or a Periodontist…. interesting to speculate …

    God bless!

  • denise louise

    at the following site

    http://www.newmediamusings.com.....s_fab.html

    i found this comment:

    “yes the dental scene is true, when a recovering addict comes into the dental office they cannot receive any sort of anesthesia. i am in my last year of dental school and come from a long line of dentists. i have experience in treating recovering addicts. the anesthesia causes similiar chemical reactions in the brain and can easily throw a patient off course…” by crystal.

    i would appreciate an opinion.

  • http://www.endodontics.ca Periapex

    My opinion is given in my post. Local anesthetic is not the same as general anesthesia. Local anesthetic can in no way reproduce the central nervous system effects of recreational drugs. General anesthetic can.

    A dental student would know that and would also know that local anesthetic is the primary type of anesthetic used in dentistry.

  • denise louise

    thank you, but i meant your opinion of crystal’s post.

    she claims, as you read, no anesthesia of “any sort” is given to recovering addicts in the office she worked at, which i read as neither local nor general. i am trying to determine if she, too, is either lying or misinformed.

    i have been unable to locate reliable information on the dentist who allegedly performed the procedures except a comment by frey that “he is dead” which seems remarkably convenient.

  • http://www.endodontics.ca Periapex

    I can’t say if that individual is lying or misinformed. I will say that they are misinforming. They are implying that either local or general anesthesia will potentiate addiction and as I’ve said in both my post and in my previous comment to you, this is incorrect.

    This is so incorrect, in fact, that it leaves that individual’s claimed credentials suspect.

    Why are you looking for Frey’s dentist?

  • denise louise

    i have only recently happened upon frey’s book and with it the controversy. if frey was lying, i would imagine the dental office in question would be quick to issue a firm statement denying his allegations, perhaps with proof we could all read for ourselves. so far i am unable to locate such a thing.

    an extract of frey’s note to readers, in the reprint of his book, regarding the dental incident is interesting:

    “There has been much discussion, and dispute,
    about a scene in the book involving a root-canal procedure that takes
    place without anesthesia. I wrote that passage from memory, and have
    medical records that seem to support it. My account has been questioned
    by the treatment facility, and they believe my memory may be flawed.”

    there has been so much investigation about this case, and i know i am late to it, but i would like to find a site, or record, or something somewhere that says for sure he was lying or not – not allegations – proof. the dentist seems the one to ask.

  • http://www.endodontics.ca Periapex

    The problem that you’re going to have is that his chain of truth is so questionable that it puts anything he claims in question. This includes the entire dental incident. There is no way to know whether the incident even happened. You are looking for facts that you are assuming have arisen from truthful beginnings.

    I am a practising dentist (not a supposed dental student, nor someone with a vast dental lineage) who has, many times in the past, used local anesthetic on recovering addicts without re-addicting them. My last such patient was a previous addict who is now an addiction counselor. They, of anyone, should best know what would re-addict them.

  • denise louise

    thank you for all your input.

  • http://www.endodontics.ca Periapex

    No problem…

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