### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Hello, I have a crumbled jaw tooth and I have noticed it swelling recently @ the outer gum line. It has had a puss pocket that I have extabated excretions out of up to 3 times a day. My dentist will not touch me because my mouth will not deaden with novacaine. I have to have them pulled by an oral surgeon. But my medicare does not pay for the gen. Anthesia any more. Please help

### output:

HI your crumbled tooth seems to have Chat Doctor.  Broken down (Crumbled teeth), often leads to pulp exposure and subsequent pupal and periapical inflammation (i.e., inflammation in the socket of the teeth around the tips/ spices of teeth). During such inflammation, Abscess formation takes place. AND IT IS THE FACT THAT LOCAL ANESTHETICS LIKE NOVOCAINE OR ANY OTHER DOESNt WORK SOMETIMES IN PUS LADEN AREA. "B" You haven't mentioned which teeth and in which jaws, as it is related to area/ technique of anesthetic injection. If you don't wish for a General Anesthesia, you can try the following, for Local Anesthesia only to become effective 1) take antibiotics like AUGMENTING 625 for two times a day for three days to ward off the infection, so they LA can be effective2) Ask for around two shots of Local anesthesia and wait for half an hour 3) ask the dentist to use other alternative techniques of anesthesia like, local infiltration/ pulpla and Periodontal blocks, Nerve Blocks etc4) Lastly if nothing works out, see a second opinion from another dentist