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Sorry to hear about your unpleasant experience.

You're right, the density of the bone surrounding a tooth does dictate what type of injections can be expected to be effective. We have content that discusses this issue in regard to infiltration and block injections.

You also mention the presence of infection around your tooth. The acid nature of infected tissue typically hinders an anesthetic's effectiveness.

Unfortunately based strictly on percentages, it's not all that common that the first round of a patient's injections aren't 100% effective (especially with "hot" teeth) but with the use of supplemental techniques the effectiveness level can be raised substantially. But even then failures do occur.

There's no simple solution. The use of general anesthetic would be unacceptable for all extractions from the standpoint of patient safety. Sedating patients could be considered but with it conventional tooth numbing is still required.

Probably the best rule of thumb is to select a practitioner (dentist, oral surgeon) who has as much experience as possible, so both performing the procedure and anticipation of real and potential problems are handled as expertly as possible.

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