Going to the dentist is a responsible matter requiring strong nerves. Whether it is a bad tooth, an inflamed jaw nerve or gum, all this is accompanied by severe pain, the inability to lead a normal lifestyle. Fear of intervention and fear of pain often leads to the fact that the patient postpones his visit to the doctor until the last.
Good painkillers used in dentistry help to solve this problem. One of them is Ultracain D. It negates all the fears of patients, completely blocking the sensitivity at the site of manipulation.
Why is this drug preferred by most dentists?
Features
There are many different painkillers used in dentistry. The most famous of them are Novocain and Lidocaine.
Dentists, knowing that the fear of their patients sometimes does not allow for timely and proper medical care, prefer to use the most powerful painkillers in their practice. This is due to the fact that a large number of nerve fibers are located in the jaw area.
By the strength of anesthesia, Ultracain D is 5 times more effective than Novocaine and 2 times more effective than Lidocaine.
Moreover, this type of "Ultracain" does not contain epinephrine, which is present in two other forms of the drug. Epinephrine has a number of contraindications and is not allowed for use in patients with intolerance to this component.
The content of epinephrine in the anesthetic also includes the presence of appropriate preservatives in it to preserve it, which may be allergenic to patients.
Thus, this form of the drug is optimal for use in individuals with a high probability of an allergic reaction, including those with a diagnosis of bronchial asthma.
Description
Ultracain D is available as a colorless, clear solution for injection.
1 ml of it contains: the active component is articaine hydrochloride (40 mg), additional components are water for injection and sodium chloride.
The drug is referred to as local anesthetics of the articaine series.
It is used as an injection in dental practice for conduction and infiltration anesthesia.
The freezing effect with loss of sensitivity of the site in which the injection was made occurs within 1-3 minutes. This effect lasts about 20 minutes.
Since articaine is rapidly destroyed in the body to a non-toxic acid, re-administration of the drug is allowed if necessary.
This anesthetic accumulates in the liver, is not excreted in breast milk, crosses the placenta, and is excreted by the kidneys.
Indications
"Ultracain D" (the composition excludes the presence of epinephrine) can be applied to groups of patients with intolerance to sulfites.
Also, this anesthetic is permitted in conditions that are contraindications to other forms of "Ultracain" containing epinephrine. These are heart and vascular diseases, tachyarrhythmia, tachycardia (paroxysmal), the use of non-cardioselective beta-blockers, pheochromocytoma, angle-closure glaucoma, hyperthyroidism, severe arterial hypertension.
Anesthetic Ultracain D recommends use in dentistry for the following purposes:
- conduction and infiltration anesthesia of the departments of the oral cavity in patients with epinephrine intolerance;
- short-term dental operations (for example, in the area of canines, incisors);
- cleaning carious areas of the tooth;
- grinding teeth for prosthetics;
- manipulations requiring a small amount of anesthetic volumes.
Contraindications
Contraindications for the use of Ultracain D include conditions such as:
- individual intolerance to articaine and other amide type anesthetics;
- serious cardiac conduction disturbances;
- acute heart failure;
- severe hypotension;
- vitamin B12 deficiency anemia;
- hypoxia;
- cholinesterase deficiency;
- central nervous system diseases;
- long-term or volume dental operations;
- patient age up to 4 years.
Use with caution
We remind you that Ultracain D contains articain that crosses the placenta. In this regard, the decision on the use of this anesthetic in pregnant patients should be made by a doctor.
Artikain, unlike other local painkillers, passes through the placenta in very small quantities, but permission to use it can be justified only if the potential benefit from it is higher than the risk to the fetus and mother.
The drug is not contraindicated for lactating women, since articaine is rapidly excreted from the body and does not pass into breast milk.
Mode of application
"Ultracain D", the instruction warns, it is not recommended to enter into the inflamed tissue.
Before administering the drug, it is necessary to conduct an aspiration test in order to avoid getting the solution into the blood vessel. For this, after introducing the syringe needle into the area of the planned injection, it is necessary to slightly pull the syringe plunger in the opposite direction and make sure that no blood appears in the drug solution. The presence of blood in the syringe indicates that the needle pierced the blood vessel, then the injection site or depth should be changed.
If the test is negative, the drug can be administered in the selected area to anesthetize it.
Dosage
For infiltration anesthesia, 1.7 ml of the drug is required for one or two adjacent teeth.
For conduction anesthesia performed below the alveolar nerve, 1-1.7 ml of solution will be needed.
The maximum permitted dose for adult patients is 4 mg per 1 kg of weight.
Side effects
What undesirable consequences can Ultracain D cause? Instructions for use in dentistry warns that after the administration of an anesthetic such side effects as dizziness, weakness, hearing loss, headache, drowsiness can occur.
If the dosage of the drug is exceeded, the patient may experience impaired consciousness or breathing, as well as convulsions.
Dyspeptic disorders - vomiting, nausea - can also be caused by the introduction of the drug.
Disturbances in the system of the heart and blood vessels after the injection of Ultracain D can be as follows: decreased blood pressure, heart rhythm disturbance, heart failure, collapse, bradycardia, chest pain.
Before using the drug "Ultracain D", the instructions should be well studied. An anesthetic may be allergenic for patients, therefore it is recommended to conduct a preliminary test for sensitivity to this anesthetic.
The following symptoms indicate an allergy to the drug: redness of the skin, swelling at the injection site, urticaria, itching, rash, rhinitis, conjunctivitis, swelling of the face (swollen lips), swelling of the larynx, shortness of breath, anaphylactic shock.
With damage to the tissue of nerve fibers , paresis of the facial nerve, paresthesia of the tongue and lips, loss of sensitivity and taste perception can occur.
Overdose Support
Ultracain D is well tolerated by most patients. However, precautions should not be neglected when using it.
Symptoms of an overdose of the drug are: loss of consciousness, dizziness, bradycardia, excessive motor activity, decreased blood pressure.
Help: give the patient’s body a horizontal position with legs up. Provide fresh air and ensure that the airways are clear.
When using the “Ultracain D” anesthetic, the instructions for use recommend monitoring blood pressure and heart rate.
If breathing is difficult, give the patient oxygen. When breathing stops, mechanical ventilation is indicated. With laryngeal edema, endotracheal intubation and mechanical ventilation.
In case of seizures - inject intravenous barbiturates, give the patient oxygen, control hemodynamics.
In case of shock and serious circulatory disturbance, administer albumin, plasma substitutes, glucocorticoids, electrolytes intravenously.
Interaction
Since the anesthetic in question does not contain epinephrine (an adrenaline analog), which is a vasoconstrictor, it is obvious that Ultracain D without adrenaline, when used with anticoagulants, increases the risk of bleeding.
Like any local anesthetic, the drug enhances the action of drugs that depress the central nervous system.
10 days before the use of anesthetic, it is necessary to cancel the use of MAO inhibitors. This will reduce the risk of hypotension.
Vasoconstrictors and narcotic analgesics enhance and prolong the effect of the drug. The latter, in this case, can cause depression or respiratory arrest.
Reviews
About the drug "Ultracain D" reviews come down to the fact that it has a good, but short-term analgesic effect.
Patients to whom this anesthetic was used during dental procedures note the following:
- the drug is sold in almost all pharmacies at an affordable price;
- This anesthetic anesthetizes well, completely relieving sensitivity and pain;
- the effect of the drug is short-term, which allows you to quickly get rid of numbness, talk freely and eat;
- optimal anesthetic for those who do not like the long-term freezing effect of such drugs;
- a good anesthetic for people with bronchial asthma or with thyroid disease;
- unlike "Ultracain" containing epinephrine, this drug does not cause cardiac abnormalities, such as heart palpitations, bradycardia, etc.
"Ultracain D", patient reviews confirm this, is very popular. The minuses, as well as the pluses, can be attributed only to its short-term effect as an anesthetic.
Despite the fact that the drug can be independently purchased at the pharmacy and taken with you to the dentist’s office, you should consult your doctor before buying. Only a specialist can determine how long the procedure will take, and may suggest using a longer-acting drug.
Ultracain D Forte
Trade name of the preparation: "Ultracain DS Forte". It is used in dental practice as a local anesthetic.
Available as a clear, colorless injection.
1 ml of anesthetic contains: articaine hydrochloride (40 mg) - the active substance, epinephrine hydrochloride (0.012 mg) - the active substance; sodium disulfite, water for injection, sodium chloride - excipients.
The ratio of epinephrine to articaine in this form of the drug is 1: 100000, which is indicated on the packaging of the anesthetic.
Features
Epinephrine (an analog of adrenaline) in the composition of the anesthetic is a vasoconstrictor and allows to prolong the analgesic effect of articaine.
The low toxicity of the drug allows its re-introduction if necessary.
This anesthetic temporarily eliminates the sensitivity of nerve fibers in the injection area.
The effect of “freezing” tissues occurs within 3 minutes after injection and lasts at least 75 minutes.
Indications
The drug is used in dental practice for infiltration and conduction anesthesia, which is required for operations on the oral mucosa or on the pulp of the tooth, to remove a broken tooth, during long-term surgical interventions.
Contraindications
This anesthetic is contraindicated in almost the same cases as Ultracain D described above. This is due to the common active ingredient in both drugs - articaine. Only long-term operations in the oral cavity are not a contraindication for this anesthetic, since epinephrine prolongs its effect.
However, epinephrine itself has a number of contraindications that apply to this form of release of Ultracaine.
These include:
- intolerance to sulfites and other substances in the composition of the anesthetic;
- bronchial asthma;
- tachyarrhythmia;
- paroxysmal tachycardia;
- thyroid disease;
- severe hypertension;
- the use of non-cardiac selective beta-blockers;
- glaucoma (closed angle).
Use with caution in the presence of angina pectoris, cardiosclerosis, cerebrovascular accident, atherosclerosis, stroke, pulmonary emphysema, diabetes mellitus, chronic bronchitis, severe renal or hepatic impairment, lack of cholinesterase, blood coagulation disorder, if overly excited.
Pregnancy
It is undesirable to prescribe Ultracain D during pregnancy, because articain penetrates the placenta. But if there is a great need for the use of an anesthetic, it is better to choose a form of "Ultracain" that does not contain epinephrine or contains it in a lower dosage than "Ultracain DC Fort
The drug is not contraindicated for lactating women, since its amount in breast milk is very small.
Dosage and route of administration
It is recommended to administer the drug only in those areas where there is no inflammation.
This anesthetic must not be allowed to enter the bloodstream!
To perform one treatment procedure, an adult patient needs a dose of anesthetic based on: 1 kg of weight - not more than 7 mg of the drug.
For children from 4 years, the maximum dose of painkiller should not be more than 5 mg of solution per 1 kg of weight.
Elderly patients and those suffering from severe liver or kidney failure are not recommended to administer the amount of the drug in excess of the minimum dose necessary to achieve the effect of pain relief.
Adverse reactions to the drug
Side effects of this form of release of "Ultracain" are the same as that of "Ultracain D". However, the presence of epinephrine in solution can cause additional negative reactions from the body. True, such complications occur extremely rarely, they include tachycardia, cardiac arrhythmias, and increased blood pressure.
If the drug enters the blood vessel, areas of necrosis may occur at the injection site.
"Ultracain DS"
The only form of release of Ultracaine that does not contain epinephrine is Ultracain D. Ultracain D-S, in turn, includes epinephrine, but at a lower dosage than Ultracain D-S forte.
Structure
1 ml of anesthetic contains 40 mg of articaine and 0.006 mg of epinephrine. The ratio of epinephrine to articaine in this form of the drug is 1: 200 000. Also, additional substances are included in the solution: water for injection, sodium disulfite, sodium chloride.
Features
When this anesthetic is injected, its effect occurs after 3 minutes and lasts at least 45 minutes.
Due to the small dose of epinephrine, the drug does not have a significant effect on the heart, which allows it to be used safely for longer-term medical procedures.
Indications
Conduction and infiltration anesthesia during dental operations, such as:
- tooth extraction;
- grinding teeth for prosthetics;
- processing of carious teeth.
Contraindications
Since the ratio of epinephrine to articain in the composition of the drug Ultracain D-C is 1: 200 000, contraindications to the use of this anesthetic are mainly associated with sensitivity in patients to articain.
The drug is contraindicated in bronchial asthma and hyperthyroidism due to epinephrine, which, although in a small dose, is present in the composition of the anesthetic.
Nevertheless, this form of Ultracaine is relatively safe for use in pregnant and lactating patients, people with compensated heart and vascular diseases.
Attention! The drug must not enter the blood vessels and inflamed tissues!
All other recommendations for the use of this anesthetic: interaction with other drugs, side effects, contraindications, indications, overdose consequences, coincide with the instructions prescribed for Ultracain DS Forte.
Release form
All 3 types of Ultracain D are produced as a solution in 2 ml ampoules (in a package - 10 pcs) or in cartridges with a capacity of (Ultracain D) 1.7; 100 pieces in a box.
Before using the anesthetic, it is necessary to carefully read the instructions, check the shelf life of the solution, verify the sterility of the upcoming procedure, conduct a test for sensitivity to the drug and an aspiration test.
After the injection, it is recommended to carefully monitor the patient's condition and, if necessary, take the necessary measures to provide him with first aid.