Our results indicate that there is clinical meaningfulness for a variety of powerful psychosocial and cultural influences that come to bear on the perceived need for anesthetic in tooth drilling. Although gender and age affected Scandinavians to some degree, pain beliefs by ethnicity and differences in health-care systems were variables with predictable outcomes across ethnic [...]

Avoiding Disturbing Effects of Numbness.
Although nonuse of anesthetic among Anglo-Americans was rare, American dentists most frequently said that Anglo-American patients wanted to avoid the feeling of numbness after the appointment to have full control of their tongue, lips, and cheeks. These often have social implications such as embarrassment, as a 40-yr-old male Anglo-American dentist described:

Frequency Distributions for Nonuse of Local Anesthetic
American dentists (n = 51) reported a median of 1% of patients not using anesthetic compared with 90% among Chinese (n = 31) and 37.5% among Scandinavian dentists (n = 40). American patients (n = 112) reported 6% nonuse of anesthetic compared with 90% of 159 Chinese and 54% [...]

Subjects were 163 Anglo-Americans from Seattle, WA (n = 112) and Columbus, OH (n = 51), 195 Mandarin Chinese from Taipei, Taiwan (n = 140) and mainland China (n = 55) and 167 Scandinavians (n = 112 Danes from Arhus, Denmark and n = 55 Swedes from Go-teborg and Linkoping, Sweden); a total of 129 [...]

Even though pain has elements of both physiological response and psychosocial conditioning, only a few studies have tried to reveal how pain attains meaning or emotional significance from the nature of the social or cultural context from within which it is experienced. Even fewer studies have specifically investigated tooth-drilling pain and the use of local [...]