Before painkillers appeared, tooth extraction was painful. Even at the beginning of the 20th century, such operations were performed without anesthesia. Now in dentistry, a lot of methods and a variety of drugs are used that allow you to remove your teeth absolutely painlessly. This helps to avoid discomfort and complications. After all, doctors choose drugs individually, depending on the patient’s state of health and the characteristics of the surgical intervention. Anesthetic is used for tooth extraction, treatment of pulpitis, periodontitis, implantation and other dental procedures.
Why is anesthesia performed in dentistry?
Before tooth extraction, anesthesia is necessary, as this operation is very painful. These sensations can provoke a heart attack or lead the patient into a shock state. Therefore, now such manipulations are performed with anesthesia. Most often, local anesthesia is used. The injected drug blocks the transmission of nerve impulses from a diseased tooth to the brain. The sensitivity of the gums and surrounding tissues is greatly reduced. Therefore, the tooth is removed painlessly.
Many patients do not visit the dentist on time precisely because of fear of pain. They drown out the discomfort with pills, which often leads to serious complications. But, the use of painkillers when removing a tooth allows treatment without discomfort for the patient.
Types of anesthesia before tooth extraction
In most cases, local anesthesia is sufficient for any manipulations in dentists. Usually, this is one or more injections into the gums. Some clinics conduct three-stage anesthesia, which completely eliminates the appearance of pain. In this case, anesthetic gel is first applied, then a short injection is made, and after a while a sufficient dose of anesthetic is administered. Sometimes it also becomes necessary to carry out a similar operation under general anesthesia. What kind of anesthesia for tooth extraction is required in each case, the doctor determines in accordance with individual characteristics.
Most often, local anesthesia is sufficient. Such anesthesia 100% relieves the patient from pain. Only tactile sensitivity is preserved , which can also cause discomfort, but not strong. There are several varieties of local anesthesia.
- Application anesthesia relieves pain only with superficial intervention. Usually it is used before the injection to make the insertion of the needle painless. Sometimes it is indicated when removing milk teeth in children. Such anesthesia is carried out using a gel or spray based on lidocaine or benzocaine. They are applied to the gums.
- Infiltration analgesia is the most common way. In this case, anesthetic when removing teeth is injected. Usually you need 2-3 injections from one and the other side of a diseased tooth.
- Conduction anesthesia is the introduction of anesthetic into the nerve region. After that, the entire area innervated by him loses sensitivity. It is usually used only on the lower jaw.
- Stem anesthesia is used in severe cases or with increased sensitivity of the patient. In this case, the medicine is introduced into the base of the skull.
In addition, sometimes a method such as sedation is also used. This is the introduction of intramuscular or intravenous sedatives. They soothe the patient, increase the pain threshold, and relax.
Preparations for infiltration anesthesia
Anesthesia in dentistry is most often performed using injectable solutions. The most common for this is "Lidocaine" or "Novocaine" in ampoules. It is with these drugs that anesthesia is performed in all budget clinics. For this, special syringes with a thin needle are used. But, recently, new technologies are increasingly being used. For example, private medical centers switched to carpul anesthesia. Its feature is the use of disposable cartridges with medicine. In addition, the needle for such injections is taken very hot, which ensures the absence of pain during the injection.
In addition to Novocain and Lidocaine, articain and mepivacaine have recently been used in dentistry. Based on these substances, there are several drugs:
- Ultracain
- "Scandonest";
- "Ubistezin";
- "Septanest".
The drug "Novocaine" in dentistry
This anesthetic was synthesized as early as the beginning of the 20th century. And for many years, Novocain in ampoules has become the most common means of pain relief during any surgical procedures. It is inexpensive, therefore, affordable for everyone, the package costs 30-40 rubles. But, in recent years, it has begun to be used less and less due to the high risk of side effects.
The instruction for Novocain warns that after its administration a drop in blood pressure, dizziness, weakness or allergic reactions are possible. In addition, sometimes it is not very effective, so it is administered together with other drugs. Most often, Novocaine is combined with adrenaline, but such a mixture is contraindicated in high blood pressure. The low effectiveness of this drug, as well as the loss of its functions in the presence of purulent inflammation, has led to the fact that it is now used very rarely in dentistry.
The use of the drug "Lidocaine"
This is the most common anesthetic, widely used not only in budget dental clinics, but also in private ones. It is quite effective, completely removes sensitivity for about 1-2 hours. In this case, it rarely causes side effects. But, sometimes there is still intolerance to Lidocaine. In this case, allergic reactions, a drop in blood pressure, dizziness, weakness, heart rhythm disturbance occur. Numbness of the lips and tongue often occurs, which can lead to their accidental injury.
In order for this drug to work well and not cause negative reactions, it is necessary to introduce it in the correct dosage. Sometimes it is sold not in ampoules, but in powder, so you need to know how to dilute Lidocaine for injection in dentistry. Most often, a 0.5% solution is used, but for conduction anesthesia in difficult cases, 1-2% can be used. Dosage is determined individually in accordance with the severity of the patient's condition.
The drug "Ultracain"
This is a strong anesthetic based on articaine. Additionally, the composition of the drug includes epinephrine. This is an analog of adrenaline with a vasoconstrictor effect. It is needed to lengthen the duration of the drug. "Ultracain" is considered a safer and more effective drug than previously distributed "Lidocaine" or "Novocaine."
The instruction notes that it has almost no contraindications. It is used even for children and elderly patients. The advantage of the drug is also that it begins to act after 10 minutes, and its analgesic effect lasts up to 3.5 hours. The drug is sold in pharmacies at a price of 500 rubles per pack of 10 ampoules.
Among the side effects after Ultracaine, headaches, nausea and muscle twitching are most often observed, but this is rare. Even less common is a drop in blood pressure or arrhythmia after administration of the drug. "Ultracain" is available in several forms, differing in the dosage of the active substance and epinephrine. The most popular "Ultracain D", which does not contain additional components, therefore, less likely to cause side effects.
The drug "Ubistezin"
The price of this pain medication is slightly higher than that of other similar drugs. But, it is common in dentistry due to its high efficiency. In addition to articaine, the composition of the drug "Ubistesin" includes adrenaline. It provides vasoconstriction at the injection site. Due to this, the drug is slowly absorbed and causes fewer side effects. Because of this, its action lasts a longer time. Moreover, the effect occurs within 3-5 minutes after the injection, which in some cases is very important. In addition to the common side effects caused by articaine, after an injection with a violation of the rules, tissue ischemia or neurological problems can develop.
The price of "Ubistezin" is quite high, since it is mainly sold in large packaging. 50 cartridges cost from 1,500 to 2,000 rubles, so they are purchased at the onsite dental clinics. This drug is allowed to be used even in pediatric dentistry. Its advantage is the rapid onset of analgesic effect and good tolerance. But, it is contraindicated to use the drug for arrhythmias, tachycardia, the presence of allergic reactions.
Septanest Anesthesia
The drug is produced by a well-known French pharmaceutical company. It has been used in dentistry for a long time, and has already proven its effectiveness. Therefore, in difficult cases or in the absence of contraindications, dentists often choose Septanest. Instructions for use of the drug notes that quite often there are allergic reactions to this drug. This can be explained by the presence of a large number of artificial additives. In addition, side effects such as respiratory failure and heart function often develop.
However, the drug is quite popular. Instructions for use with "Septanest" allows the use of the drug for children from 4 years old and pregnant women. Contraindications include only glaucoma, bronchial asthma and heart rhythm disturbance. If necessary, you can use similar anesthetics, also containing articaine: "Alfacain", "Brilocain", "Cytocartin", "Primacain".
The drug "Scandonest"
It is an anesthetic based on mepivacaine. It does not contain adrenaline, preservatives or other harmful components. It is used for intolerance to articaine or adrenaline. This drug can be used in the elderly, patients with diabetes mellitus, hypertension, bronchial asthma, and even in pregnant women. In addition to the analgesic effect, mepivacaine has the ability to constrict blood vessels, so adrenaline is not required. The analogue of the drug “Scandonest” is the anesthetic “Mepivastesin”.
Contraindications to the use of painkillers
Usually, all anesthetics have the same contraindications. They can not be used by patients with such pathologies:
- polio;
- meningitis;
- malignant tumors;
- heart failure;
- diabetes;
- serious problems with blood pressure;
In addition, drugs based on articaine are not used for joint diseases, osteochondrosis or spondylitis, pathologies of the nervous system.
The need for general anesthesia
Sometimes it becomes necessary to treat a patient under general anesthesia. This is necessary if the usual pain medication during tooth extraction does not help, for example, with a lowered pain threshold or fear of dentists. General anesthesia is also used in patients with various psychological or neurological disorders, as well as with increased vomiting reflex. When removing a tooth, this is rarely required, since this procedure is short, but during prolonged treatment, complex surgery or complete implantation, general anesthesia is necessary. For it, trichlorethylene is used, injected through a breathing mask or injectable drugs: “Ketamine”, “Propanidide”, “Hexenal”.
Dental Anesthesia Reviews
Now, dental treatment has become much more comfortable than before. Pain is usually not felt even when removed. However, many patients note that they received effective analgesia using the usual "Lidocaine". But there are those who can not tolerate this drug. And those who were given modern anesthetics note that they have a better analgesic effect. There are many positive reviews about the drug "Ultracain", patients note that nothing is felt even with complex surgery.