Before the advent of painkillers, tooth extractions were painful. Even at the beginning of the 20th century, such operations were performed without anesthesia. Now in dentistry, many methods and a variety of drugs are used that allow you to remove teeth absolutely painlessly. This helps to avoid discomfort and complications. After all, doctors choose drugs individually, depending on the patient's state of he alth and the characteristics of the surgical intervention. Painkillers are used during tooth extraction, treatment of pulpitis, periodontitis, implantation and other dental procedures.
Why is anesthesia used in dentistry
Before removing teeth, anesthesia is required, as this operation is very painful. These sensations can provoke a heart attack or enter the patient into a state of shock. Therefore, now such manipulations are carried out with anesthesia. Most often, local anesthesia is used. The injected drug blocks the transmission of nerve impulses from the 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 the fear of pain. They drown out discomfort with pills, which often leads to serious complications. But, the use of painkillers during tooth extraction allows treatment without discomfort for the patient.
Types of anesthesia before tooth extraction
In most cases, local anesthesia is enough to carry out any manipulations in dentists. Usually, this is one or more injections into the gum. Some clinics perform three-stage anesthesia, which completely eliminates the appearance of pain. In this case, an anesthetic gel is first applied, then a short injection is made, and after a while a sufficient dose of anesthetic is injected. Sometimes it is also necessary to perform such an 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 relieves the patient of pain by 100%. Only tactile sensitivity is preserved, which can also cause discomfort, but not strong. There are several types of local anesthesia.
- Application anesthesia relieves pain only with superficial intervention. It is usually used before an injection tomake needle insertion painless. Sometimes it is indicated for the removal of 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 anesthesia is the most common way. In this case, the painkiller during the extraction of teeth is administered by injection. Usually 2-3 injections are needed on one and the other side of the diseased tooth.
- Conduction anesthesia is the introduction of an anesthetic into the area of the nerve. 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 when the patient is hypersensitive. In this case, the medicine is injected 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 calm the patient, increase the pain threshold, relax.
Preparations for infiltration anesthesia
Anesthesia in dentistry is most often performed using injectable solutions. The most common for this is Lidocaine or Novocain in ampoules. It is with these medicines that anesthesia is carried out in all budgetary clinics. For this, special syringes with a thin needle are used. But, in recent years, more and more new technologies are being used. For example, private medical centers have switched to carpool anesthesia. Its feature is the use of disposable medicine cartridges. Besides,the needle for such injections is taken very current, which ensures that there is no pain during the injection.
In addition to Novocaine and Lidocaine, articaine and mepivacaine have recently been used in dentistry. Based on these substances, there are several drugs:
- "Ultracain";
- Scandonest;
- Ubistezin;
- Septanest.
Novocain drug in dentistry
This anesthetic was synthesized in the early 20th century. And for many years, Novocain in ampoules became the most common pain reliever for any surgical intervention. It is inexpensive, therefore, a drug available to everyone, a package costs 30-40 rubles. But, in recent years, it has become less and less used due to the high risk of side effects.
Instructions for "Novocaine" warns that after its introduction, a drop in blood pressure, dizziness, weakness or allergic reactions may occur. In addition, sometimes it is not very effective, so it is administered in conjunction with other drugs. Most often, Novocain is combined with adrenaline, but such a mixture is contraindicated with high blood pressure. The low efficiency of this drug, as well as the loss of its functions in the presence of purulent inflammation, led to the fact that it is now used very rarely in dentistry.
Using Lidocaine
This is the most common anesthetic, widely used not only in budgetary dental clinics, but also in private ones. He's prettyeffective, completely removes sensitivity for about 1-2 hours. However, 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, and heart rhythm disturbances occur. Often there is also numbness of the lips and tongue, which can lead to accidental injury.
In order for this drug to work well and not cause negative reactions, it must be administered in the correct dosage. Sometimes it is not sold in ampoules, but in powder, so you need to know how to properly dilute Lidocaine for injection in dentistry. Most often, a 0.5% solution is used, but 1-2% can be used for conduction anesthesia in difficult cases. The dosage is determined individually according to the severity of the patient's condition.
Ultracaine preparation
This remedy is based on the strong anesthetic articaine. Additionally, the composition of the drug includes epinephrine. It is an analogue of adrenaline, which has a vasoconstrictive effect. It is needed to prolong the duration of the drug. Ultracaine is considered safer and more effective than the previously common 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 of500 rubles for a pack of 10 ampoules.
Among the side effects after "Ultracaine" headaches, nausea and muscle twitches are most often observed, but this happens rarely. Even less common is a drop in blood pressure or arrhythmia after the administration of the drug. "Ultracain" is available in several forms, differing in the dosage of the active substance and epinephrine. The most popular is "Ultracain D", which does not contain additional components, so it rarely causes side effects.
Ubistezin drug
The price of this pain reliever is slightly higher than other similar drugs. But, it is common in dentistry due to its high efficiency. In addition to articaine, the composition of the drug "Ubistezin" 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, tissue ischemia or neurological problems can develop after an injection that is not properly administered.
The price of "Ubistezin" is quite high, as it is sold mainly in large packaging. 50 cartridges cost from 1,500 to 2,000 rubles, so they are purchased at the main dental clinics. This drug is allowed to be used even in pediatric dentistry. Its advantage is the rapid onset of the analgesic effect andgood tolerance. But, it is contraindicated to use the drug for arrhythmia, tachycardia, the presence of allergic reactions.
Pain relief with Septanest
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 impaired breathing and heart function often develop.
However, the drug is quite popular. Instructions for use for "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: Alfakain, Brilokain, Cytokartin, Primakain.
Scandonest preparation
This is an anesthetic based on mepivacaine. It does not contain adrenaline, preservatives and other harmful ingredients. It is used for intolerance to articaine or adrenaline. This drug can be used in the elderly, patients with diabetes, hypertension, bronchial asthma, and even in pregnant women. In addition to the analgesic effectmepivacaine has the ability to constrict blood vessels, so no additional injection of adrenaline is required. An analogue of the drug "Scandonest" is the anesthetic "Mepivastezin".
Contraindications to the use of painkillers
Usually all anesthetics have the same contraindications for use. They should not be used in patients with the following pathologies:
- polio;
- meningitis;
- malignant tumors;
- heart failure;
- diabetes mellitus;
- serious blood pressure problems;
In addition, drugs based on articaine are not used for joint diseases, osteochondrosis or spondylitis, pathologies of the nervous system.
Need for general anesthesia
Sometimes it becomes necessary to treat a patient under general anesthesia. This is necessary if the usual painkiller does not help during tooth extraction, for example, with a lower pain threshold or fear of dentists. General anesthesia is also used in patients with various psychological or neurological disorders, as well as with an increased gag reflex. When extracting a tooth, this is rarely required, since this procedure is short, but during long-term treatment, complex surgery or complete implantation, general anesthesia is necessary. It uses trichlorethylene, administered through a breathing mask or injectable drugs: Ketamine, Propanidide, Hexenal.
Reviews on anesthesia in dentistry
Dental care is now much more comfortable than before. Pain is usually not felteven when removed. At the same time, many patients note that they received effective pain relief with the help of the usual "Lidocaine". But there are those who do not tolerate this drug. And those who were injected with modern anesthetics note that they have a better analgesic effect. A lot of positive feedback about the drug "Ultracain", patients note that nothing is felt even during a complex operation.
