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Modern painkillers in dentistry. Modern anesthesia in dentistry (anaesthetics)

Pain that occurs during dental treatment is a factor that often becomes decisive for a person deciding whether to visit the dentist. That is why the issue of pain relief in dentistry is constantly studied by doctors and is very important. Modern doctors have a lot of tools and methods to provide high-quality and effective pain relief. Pain-free dentistry is the ideal that doctors strive for.

Features of pain relief

Anesthesia in dentistry is always carried out taking into account the individual characteristics of the patient, the problem that needs to be eliminated, the severity of pain, etc. It is important to know that all practiced methods of pain relief in dentistry require rapid recovery of the patient after. After some time (about half an hour) he can even drive a car.

Both surgical dentistry and therapeutic dentistry practice pain relief that can reduce pain to the required minimum. Initially, the doctor analyzes all the patient’s problems and selects exactly those types of pain relief that are optimal in this case.

Adequate pain relief in dentistry involves eliminating pain to a minimum. However, most dentists are of the opinion that it is not necessary to anesthetize to such an extent that the patient is unconscious during treatment. Moreover, it is very important that the doctor can communicate with the patient during the provision of dental services.

On the other hand, severe pain can cause a shock-like state in the human body. Therefore, severe pain during dental treatment undoubtedly brings harm to a person. Thus, the main task of the doctor who performs pain relief before dental treatment is to do it in such a way that pain relief is as effective as possible and does not pose a danger to the person.

Local anesthesia

Modern doctors practice different types of dentistry. Anesthesia is divided into general , local And combined . Local anesthesia involves numbing only the specific area where manipulations will be performed. A small area is identified in which the sensitivity of the nerve endings is removed by injecting medications. Local anesthesia, in turn, is divided into several types. Application anesthesia (another name is superficial anesthesia) is used when superficial anesthesia is necessary. It is carried out without using a syringe. The doctor applies an anesthetic drug to the area that requires pain relief, using an applicator. Sometimes an aerosol is also used in this case. In this case, only a few millimeters of tissue are numbed. Such anesthesia in dentistry is used only for minor interventions; it is often practiced in pediatric dentistry.

Infiltration anesthesia is anesthesia in which appropriate drugs are administered using a syringe. In this case, soft tissues are saturated. This type of anesthesia is practiced by modern dentists very often, since the procedure is well tolerated by patients and at the same time can effectively relieve a person from pain.

Conduction anesthesia in dentistry allows the doctor to relieve the patient of pain over a relatively large area. For example, this method can numb half of the jaw. This method is optimal for major operations, and is also practiced if complications arise after treatment that require urgent intervention. This procedure is distinguished by a more complex execution technique.

Doctors practice all the described methods taking into account the individual characteristics of the patient, the disease, etc. Thus, during pregnancy, the dentist always uses the most gentle method of local anesthesia.

At the same time, the disadvantage of local anesthesia is, first of all, that the sensitivity of the nerve endings disappears only for a relatively short period of time. As a result, this method can be used if the doctor is treating one tooth. But if several teeth are affected and, accordingly, there is a need to treat them, you immediately have to use other methods.

As side effects of this method, it sometimes appears rapid heartbeat or fluctuations are observed. This occurs under the influence of , which is part of anesthetics for the purpose of vasoconstriction.

General anesthesia

If it is necessary to completely rid the entire body of pain sensitivity, then general anesthesia is practiced. Doctors use anesthesia in dentistry much less often than local anesthesia. The fact is that dentistry under general anesthesia has many contraindications. In addition, a person whose treatment was treated with general anesthesia may later experience side effects that last for several days after the procedure. Reviews indicate that after anesthesia, the patient may notice very rapid breathing, disturbed breathing rhythm, bronchospasm, changes in motor activity, and muscle twitching. In addition, as side effects that dentistry under anesthesia provokes, psychomotor agitation may develop, blood pressure may increase, and in especially severe cases, partial memory loss may occur. This is why general anesthesia is rarely used in pediatric dentistry.

The advantages of general anesthesia include ensuring complete peace and absence of shocks for the patient, and the ability for the doctor to perform a large number of different procedures in one session. When using general anesthesia, the patient experiences much less salivation, so the quality of treatment when filling teeth increases. With general anesthesia, there is a lower risk of developing inflammatory processes after tooth extraction.

The doctor must select anesthesia for teeth taking into account not only the physical, but also the emotional state of the patient. It is sometimes advisable to treat teeth under general anesthesia if a person demonstrates pronounced emotional stress and severe anxiety before the procedure begins. Therefore, dental treatment under general anesthesia is prescribed to those people who show signs of panic in relation to everything related to dentistry. In this case, it is especially often practiced under general anesthesia. In addition, the use of general anesthesia is advisable when performing prosthetics, with very complex dental lesions, and with some chronic concomitant diseases.

In other cases, as a rule, the doctor does not see the need to treat teeth under this type of anesthesia.

If a person has serious diseases of the cardiovascular system, before starting treatment under general anesthesia, he must initially undergo all the necessary examinations, and during dental treatment, only an experienced anesthesiologist should monitor the condition of such a patient. When using general anesthesia during treatment, the doctor should have all the necessary equipment nearby, the use of which may be necessary in an emergency.

Combined pain relief

Combined anesthesia involves a combination of incomplete general anesthesia and very effective local anesthesia. In this case, local anesthesia is performed after the patient has previously received pharmacological drugs for relaxation and sedation. In this case, the patient remains fully conscious. This dental anesthesia is much safer than general anesthesia, and in severe cases can be used even during pregnancy or serious illness. Accordingly, the severe consequences described above are absent with combined anesthesia.

Anesthesia during pregnancy

In modern dentistry, dental anesthesia may not be used at all only if laser treatment is practiced. In this case, the patient does not feel much discomfort when treating the tooth, so anesthesia is not needed when treating teeth with this method. That is why doctors recommend practicing this method of treatment during pregnancy.

However, dentists strongly recommend that pregnant women visit the dentist even if only traditional treatment is possible. Local anesthetics, which are used in modern dentistry, do not have a negative effect on the expectant mother or the unborn child. The most important thing is that the doctor must know about the woman’s pregnancy before starting treatment and select a drug for pain relief taking into account this important point. Most often, it is used as such a drug, which is completely safe and at the same time produces a pronounced effect. The drug is eliminated from the human body relatively quickly and practically does not reach the fetus through the placenta. Therefore, it is used both for filling and for tooth extraction in pregnant women. The use of other drugs is also practiced individually, but only under the strict supervision of a doctor and taking into account the individual characteristics of the woman’s body.

The most important thing is that a pregnant woman should visit the dentist as soon as necessary and be sure to tell the doctor in detail before treatment about all the features of her condition.

Fear of treatment or tooth extraction is largely due to the fact that previously there were no good quality anesthetic drugs. Today, clinics use new generation anesthetics. Painkillers in dentistry completely eliminate pain both during the main actions and at the time of their administration.

Indications for the use of painkillers in dentistry

Anesthesia is required when performing the following manipulations:

What painkillers are used in dental treatment?

The best means for local anesthesia are considered to be articaine anesthetics.. The main substance is much more effective than Novocaine and Lidocaine.

An important feature of Articaine is the possibility of its use in purulent inflammations, when the effect of other drugs is reduced. In addition to the main component, modern anesthetics contain vasoconstrictors.

Adrenaline or epinephrine constrict blood vessels, preventing the drug from being washed out from the injection site. Pain relief time increases.

The drug is an analogue of Ultracaine, their composition is the same. Produced in Germany in two forms depending on the epinephrine content.

Mepivastezin or Scandonest

Available in two forms, it contains adrenaline, as well as preservatives that can provoke an allergic reaction. The effect after administering the drug to the patient occurs within 1-3 minutes. Septanest is acceptable for use in children over 4 years of age.

Included in the group of second generation esters. It is used less and less, since its effectiveness in treating pain is 4-5 times worse than other drugs. Novocaine is most often administered for minor dental operations.

What is pain relief for wisdom tooth removal?

When removing a wisdom tooth, ester or amide anesthetics can be chosen. The action of the former is quick and short-term. These include Pyromecain and Novocain.

Amides include:

trimecaine– injection, pain relief for 90 minutes;
lidocaine– valid up to 5 hours;
bupivacaine– relieves pain 6 times better than novocaine, but it is 7 times more toxic, lasts up to 13 hours;
ultracaine D-S– the effect is 5 times higher than after the administration of Novocaine, lasts 75 minutes, can be used by pregnant women;

Names of modern anesthetics without adrenaline

Pain relievers without adrenaline include:

Articaine hydrochloride. Leader among other anesthetics. Available with or without epinephrine and with increased vasoconstrictor content;
Ubistezin. Patients with an allergic reaction, diabetes mellitus, hypertension, bronchial asthma, heart failure and thyroid disease are prescribed a drug labeled “D”, without adrenaline;
Prilocaine. It is used without vasoconstrictors or with a low content of them. The drug is not prescribed to pregnant women and patients with pathologies of the heart, lungs, or liver;
Trimekain. It has a calming effect and is not used very often in dentistry;
Bupivacaine. It is not used for heart pathologies and liver diseases;
Pyromecaine. It has an antiarrhythmic effect, so it is recommended to administer it to people with arrhythmias.

Pain relief during pregnancy and breastfeeding

The best option for pregnant and nursing mothers is a carpule of Ultracaine and Ubisiesin in a ratio of 1:200000. The vasoconstrictor substance does not affect the fetus because it cannot penetrate the placenta.

Both carpule anesthetics are safe for breastfed children, since the components of the drug do not pass into milk. Scandonest and Mepivastezin without epinephrine are also often used by doctors. They are 2 times more toxic than Novocain and are absorbed into the blood faster.

What drugs are used in pediatric dentistry?

In children, pain relief occurs in two stages. First of all, the dentist performs topical anesthesia, that is, using an aerosol or gel with Lidocaine and Benzocaine, reduces the sensitivity of the mucous membrane, then injects an anesthetic.

In pediatric dentistry, preparations with Articaine are more often used. It is less toxic and is quickly eliminated from the body.

According to the instructions, these drugs can be administered to children from the age of 4 years. When molars are removed, an injection of Mepivacaine may be given.

Contraindications and side effects of local anesthesia

Before starting treatment, the dentist is obliged to ask the patient about possible somatic diseases or an allergic reaction to any drugs.

Contraindications to anesthesia may include:

allergy to the administered drug;
hormonal disorders due to pathologies of the thyroid gland;
diabetes mellitus

How much does dental anesthesia cost in the clinic?

The cost of anesthesia in dentistry is determined based on individual clinic prices, the equipment used and the experience of doctors. The average price for an injection is 800-1200 rubles, an application costs from 100 to 1500, a conduction method costs from 250 to 4000.

List of the most powerful medications for toothache

There are 3 types of painkillers: opiates, analgesics and non-steroidal drugs. The latter are mainly used in dentistry. They cope well with pain, are not addictive, and can be bought without a doctor's prescription.

There are many medications to relieve toothache, but there are 5 most effective ones:

Ketonal. Based on ketoprofen, prescribed after tooth extraction, as anti-inflammatory therapy after implantation and other interventions;
Nurofen. Based on ibuprofen, it is also used in pediatric dentistry, has virtually no side effects;
Voltaren. Used as anti-inflammatory therapy for TMJ;
Nise. Based on nimesulide, relieves swelling and inflammation;
Nolodotak. Based on flupirtine, relieves acute and chronic pain.

Video on the topic

About the use of pain-relieving injections during dental treatment in the video:

Anesthesia in dentistry is a necessary procedure that relieves discomfort during dental treatment. The main thing is to choose the right drug and warn about possible diseases.

Types of anesthesia for dental treatment: what anesthetics and painkillers are used in dentistry?

Many people are afraid to visit the dentist. The doctor's actions are associated with pain and discomfort. Suffering from toothache, patients put off visiting the dentist until the critical moment and often, without time to spare, ask the doctor to perform several extensive procedures at once.

Today in dentistry, several methods of anesthesia are used to remove and treat teeth. An experienced specialist knows which drug will relieve pain best. The patient will not feel pain, and the dentist will have the opportunity to provide dental treatment at the proper level.

Anesthesia methods used in dentistry

Anesthesia during tooth extraction and other dental procedures involves a decrease or complete loss of sensitivity in certain areas of the oral cavity. It is possible to anesthetize the surgical site through the use of pharmaceuticals that interrupt the transmission of pain impulses coming from the sources of pain to the brain.

Thus, it is almost impossible to carry out high-quality treatment of wisdom teeth without anesthesia - therapeutic and surgical actions performed by a doctor will be accompanied by severe pain. That is why all modern dental clinics treat teeth using various types of anesthesia.

General anesthesia

Under general anesthesia, the patient falls into deep sleep, his consciousness turns off. With this method of pain relief, narcotic drugs are administered intravenously or inhaled. During dental treatment, the patient's condition is monitored by an anesthesiologist-resuscitator.

When a person is under general anesthesia, on the one hand, it is easier for the dentist to treat teeth, in particular wisdom teeth. But on the other hand, the doctor constantly needs to adapt to the patient, since he is immobilized and cannot fix his head in the correct position and open his mouth wider. As a rule, with this type of anesthesia, after waking up, a person does not remember what happened to him during the operation.

This type of pain relief is advisable to use in the following cases:

complex surgical operation;
pathological fear of dental procedures;
allergies to local anesthetics.

In many cases, general anesthesia is contraindicated for dental procedures. Before the patient is put under anesthesia, he needs to have his blood tested and undergo an ECG to rule out heart pathologies.

Shortly before dental surgery, the patient must give up smoking and alcohol. A few hours before going under anesthesia, the patient should not eat.

Local anesthesia

Local anesthesia is the safest. The person is conscious, the drug used affects only the peripheral nervous system.

With the introduction of carpule (strictly dosed) anesthesia, the patient begins to feel numbness in the gums, tongue and lips. There are often cases when, with an incorrectly calculated dose of the drug, patients complained that the anesthesia did not work. With the advent of carpules (ampoules with anesthetic), this problem disappeared. After the analgesic is broken down, its effect stops and sensitivity is restored.

Preparations for general anesthesia

Is anesthesia harmful when removing wisdom teeth? Under the influence of drugs, a person does not feel pain, but at the same time his body is subjected to serious stress. First of all, the brain suffers; anesthesia affects the conduction system of the heart; the components of the anesthetic can cause allergic reactions. That is why during the operation an anesthesiologist is present next to the patient, who has all the necessary resuscitation equipment at his disposal.

In dentistry, only intravenous general anesthesia is performed using drugs called Ketamine, Propofol, Sodium Thiopental, etc., which have a hypnotic, sedative and muscle relaxant effect. A person can be put into a state of deep sleep using nitrous oxide inhaled through a mask.

Types of anesthetics for local anesthesia

Today, the strongest anesthetics of the articaine series are considered the best anesthesia used in dentistry for local anesthesia. The main component of the painkiller is several times more effective than Lidocaine and Novocaine.

A distinctive feature of Articaine is the possibility of use for purulent inflammations, when the activity of other drugs is reduced. Many patients in such cases do not understand why the anesthetic does not work. In addition to the main component Articaine, modern drugs contain vasoconstrictors. Due to adrenaline or epinophrine, the blood vessels narrow, preventing the drug from being washed out from the injection site. The strength of anesthesia and the duration of action of the intraseptal anesthetic increase.

Ubistezin is an analogue of Ultracain; the composition of the two drugs is identical. The manufacturing company is registered in Germany. The anesthetic is available in two forms depending on the concentration of epinephrine: Ubistezin or Ubistezin forte.

Mepivastezin or Scandonest

It is not recommended for hypertensive patients to use anesthetics with vasoconstrictor components; for high blood pressure, it is worth selecting drugs without adrenaline and epinephrine in the composition. Mepivastezin (manufactured in Germany) and its full analog Scandonest (France) are prescribed to patients at risk.

These pharmaceuticals do not contain vasoconstrictors, so they are used to relieve pain in children, pregnant women and patients with bronchial asthma. Mepivastezin and Scandonest are also prescribed to patients with adrenaline intolerance.

Dentists have been successfully using Septanest anesthesia for several years. The anesthetic is presented in two forms, each of which differs in the content of adrenaline in the composition. Unlike Ultracaine and its analogues, Septanest contains preservatives, which, according to the instructions for use, can provoke allergic reactions.

After the drug is administered to the patient, the anesthetic effect occurs within 1-3 minutes. Anesthesia lasts for 45 minutes. Septanest can be used as a local anesthetic for children from 4 years of age.

Novocaine belongs to the group of second generation esters. A drug with moderate anesthetic activity is inferior in effectiveness to anesthetics of the articaine and mepivacaine series. It is used less and less, since modern painkillers are 4-5 times better at treating pain during tooth extraction. Novocaine is used for minor dental operations and in the treatment of pain syndromes.

Other types of anesthetics

When going to see a surgeon to have a tooth removed, many people wonder what types of anesthesia are used? Based on their chemical properties, anesthetics are divided into two groups: substituted amides and esters. There are short-, medium- and long-acting drugs. Also, anesthesia in dentistry has its own classification:

superficial;
conductor;
infiltration

Lidocaine has a deep analgesic effect, but it copes with toothache worse than other intraseptal anesthetics. If we compare it with Novocaine, which is widely used in government medical institutions, then the choice of dentists is more likely to focus on Lidocaine.

What medications are allowed during pregnancy?

The best option for pregnant women and nursing mothers is a carpule of Ultracaine or Ubistezin with epinephrine at a concentration of 1:200,000. The vasoconstrictor substance has no effect on the fetus, since it fails to penetrate the placenta. Studies have proven the safety of these carpule anesthetics for breastfed children - their components do not pass into breast milk.

During pregnancy, there is no need to refuse injections with vasoconstrictors. However, in their practice, doctors use Scandonest and Mepivastezin without epinephrine in the composition for anesthesia for women during pregnancy. These drugs are twice as toxic as Novocaine and are absorbed into the blood faster.

Use of anesthesia in children

What anesthesia is used in pediatric dentistry? Dentists anaesthetize children in two stages. First, topical anesthesia is performed, when the doctor, using an aerosol or a special gel with Lidocaine or Benzocaine, desensitizes the area of the mucous membrane where the anesthetic injection will subsequently be made. This type of anesthesia is also used for intraosseous anesthesia.

Children are administered drugs with Articaine as the main component. It is less toxic and is quickly eliminated from the body. According to the instructions for use, such drugs can be used for anesthesia in children over 4 years of age. Also, when molars are removed, an injection of Mepivacaine is often given. In pediatric dental practice, a table with weight and the maximum permissible dose of anesthetic administered is often used.

Types of modern methods of anesthesia in dentistry, drugs for pain relief

Fears associated with pain during treatment and tooth extraction are due to the fact that previously there were no high-quality anesthetic drugs. But today, almost all dental clinics use new generation local anesthetics. Modern drugs make it possible to completely eliminate pain not only during the main operation, but even at the time of their administration.

Anesthesiology in dentistry

Anesthesia is the absolute disappearance or partial decrease in sensitivity in the entire body or its individual parts. This effect is achieved by introducing special drugs into the patient’s body that block the transmission of pain impulses from the area of intervention to the brain.

Types of pain relief in dentistry

Based on the principle of impact on the psyche, there are two main types of anesthesia:

Local anesthesia, in which the patient is awake, and loss of sensitivity occurs exclusively in the area of future medical procedures.
General anesthesia (anesthesia). The patient is unconscious during the operation, the whole body is anesthetized and the skeletal muscles are relaxed.

Depending on the method of delivering the anesthetic to the body, dentistry distinguishes between injection and non-injection anesthesia. With the injection method, the anesthetic drug is administered through an injection. It can be injected intravenously, into the soft tissues of the oral cavity, into the bone or periosteum. In non-injection anesthesia, the anesthetic is administered by inhalation or applied to the surface of the mucosa.

General anesthesia in dentistry

General anesthesia is the complete loss of sensitivity of nerve fibers, accompanied by impaired consciousness. In dentistry, anesthesia for dental treatment is used less frequently than local anesthesia. This is due not only to the small area of the surgical field, but also to the large number of contraindications and possible complications.

General anesthesia can only be used in dental clinics that have an anesthesiologist and resuscitation equipment that may be required in case of emergency resuscitation.

General anesthesia in dentistry is only necessary for long-term complex maxillofacial operations - correction of cleft palate, multiple implantations, surgery after injury. Other indications for the use of general anesthesia:

allergic reactions to local anesthetics;
mental illnesses;
panic fear of manipulation in the oral cavity.

Contraindications:

diseases of the respiratory system;
pathologies of the cardiovascular system;
intolerance to anesthetic drugs.

The anesthetic can be delivered by injection or inhalation. The drug most commonly used by dentists for inhalational general anesthesia is nitrous oxide, known as laughing gas. Using an intravenous injection, the patient is immersed in a medicated sleep; for this purpose, drugs are used that have a sleeping pill, analgesic, muscle relaxant and sedative effect. The most common are:

Ketamine.
Propanidid.
Hexenal.
Sodium hydroxybutyrate.

Local anesthesia in dentistry

In dental treatment, local anesthesia is most in demand, aimed at blocking nerve impulses from the surgical field. Local anesthetics have an analgesic effect, due to which the patient does not experience pain, but retains sensitivity to touch and temperature.

The duration of anesthesia depends on how and with what exactly dentists numb the surgical field. The maximum effect lasts for two hours.

Local anesthesia is used for the following procedures:

turning for a bridge or crown;
pin tooth extension;
implantation;
channel cleaning;
surgical treatment of gums;
removal of carious tissues;
tooth extraction;
excision of the hood over the wisdom tooth.

Types and methods of local anesthesia in dentistry

Depending on what area and for how long the sensitivity needs to be deprived, the dentist selects the optimal technology, medicine and its concentration. The main methods of administering anesthetic are:

infiltration;
intraligamentary;
stem;
intraosseous;
applique.

Infiltration method

Used in dental practice and maxillofacial surgery. The advantage of the method is its rapid action, long-lasting analgesic effect, the possibility of repeated administration during a protracted operation, rapid removal of the anesthetic from the body, and deep analgesia of a large area of tissue. About eighty percent of dental interventions are performed under infiltration anesthesia.

The method is used for the following manipulations:

The anesthetic medicine is injected in layers, first under the mucous membrane at the apex of the tooth root, and then into the deeper layers. The patient feels discomfort only with the first injection; the rest are completely painless.

There are two types of infiltration dental anesthesia - direct and diffuse. In the first case, the immediate site of injection of the anesthetic is anesthetized, in the second, the analgesic effect extends to nearby tissue areas.

The following drugs are used for local infiltration anesthesia in dentistry:

Intraligamentous (intraligamentous) method

It is a modern type of infiltration anesthesia. The dose of the administered anesthetic is minimal (does not exceed 0.06 ml), which makes it possible to treat and remove teeth in pregnant and lactating women.

The anesthetic is injected into the periodontal space using a special syringe and under high pressure. The number of injections depends on the number of roots of the tooth. Sensitivity to pain disappears instantly without causing a feeling of numbness, so the patient can speak freely and does not experience discomfort after the operation.

Restrictions on the use of the method are:

The duration of the manipulation is more than 30 minutes.
Fang manipulations. Due to their anatomical features, it is not always possible to anesthetize them intraligamentously.
Inflammatory processes in the periodontium, periodontal pocket, gumboil.
Root cyst of the tooth.

The intraligamentous anesthesia method is the most painless and safe in dentistry, therefore it is often used in pediatric practice. Ease of implementation, painlessness, safety and high efficiency make the method popular among dentists. The cost of this procedure is higher than the infiltration procedure due to the high prices of injectors.

The following drugs are used for intraligamentous anesthesia during dental treatment:

Stem (conductor) method

The distinctive features of the stem method of pain relief are the power and long duration of the effect. It is used during long-term surgical operations and in situations where it is necessary to block sensitivity in the tissue area of the entire lower or upper jaw.

Indications for conduction anesthesia are:

high intensity pain syndrome;
neuralgia;
removal of cystic formations;
endodontic treatment;
severe injuries to the jaw and zygomatic bone;
curettage;
complex tooth extraction.

The injection is injected into the area of the base of the skull, thanks to which two jaw nerves can be blocked at once - both the upper and the lower. The injection is performed by an anesthesiologist and exclusively in a hospital.

Unlike all other methods of local anesthesia, stem anesthesia does not act on nerve endings, but completely on a nerve or group of nerves. The anesthetic effect time is one and a half to two hours. Novocaine and Lidocaine are considered the basic drugs; in modern anesthesiology, more effective agents are used.

Application method (surface, terminal)

It is used primarily in pediatric dental practice to desensitize the site where the anesthetic injection will be given, which ensures an absolute absence of pain. It is used as an independent method in cases where it is necessary:

For topical anesthesia in dentistry, painkillers are used in the form of spray, ointment, paste and gel. Most often, dentists use ten percent lidocaine in an aerosol as an analgesic. The drug penetrates 1–3 mm deep into the tissue and blocks nerve endings. The effect lasts from several minutes to half an hour.

Intraosseous (spongy) method

It is used for anesthesia of lower molars, during the extirpation of which infiltration and conduction anesthesia are ineffective. Instantly eliminates the sensitivity of one tooth and the adjacent gum area. The advantage of this method in dentistry is strong pain relief with small doses of the drug.

Classical intraosseous anesthesia has not received widespread use in anesthesiology due to the complexity of its implementation and the traumatic nature.

The essence of the method is to inject an anesthetic into the spongy layer of the jawbone between the roots of the teeth. Infiltration anesthesia is preliminarily performed. After numbness of the gums, the mucous membrane is dissected and the cortical plate of the bone is trepanned using a drill. The bur is buried 2 mm into the spongy tissue of the interdental septum, after which a needle with an anesthetic is inserted into the formed canal.

Contraindications to local anesthesia

Before prescribing local anesthesia to a patient, the dentist must find out whether there are any contraindications to its administration. The doctor must take special precautions when prescribing anesthesia for children and expectant mothers.

Contraindications to local anesthesia are:

history of allergic reactions to drugs;
diseases of the cardiovascular system;
suffered a stroke or heart attack less than six months ago;
diabetes mellitus;
hormonal disorders and pathologies of the endocrine system.

Modern anesthetics (painkillers) in dentistry

With the advent of local anesthetics and new generation technologies, the usual Novocaine is almost never used in dentistry, especially in Moscow and other large cities. Despite possible complications and a high percentage of allergic reactions, lidocaine remains the main local anesthetic in regional clinics.

When visiting the clinic, you need to provide the attending physician with a complete and reliable history so that he can eliminate all risks and choose the right drug. Most dental clinics use carpule technology to administer anesthetics, which consists in the fact that the active substance is contained in a special disposable carpule, which, without opening manually, is inserted into a syringe. The dose of the drug in the capsule is designed for one administration.

The basis of modern means for local anesthesia is the drugs Articaine and Mepivacaine. In the form of carpule capsules, Articaine is produced under the names Ultracaine, Septanest and Ubistezin. The effectiveness of drugs based on it exceeds the effectiveness of lidocaine by 2, and novocaine by 5–6 times.

In addition to Articaine itself, the carpul contains adrenaline (epinephrine) and an auxiliary substance that promotes vasoconstriction. Due to vasoconstriction, the period of action of the anesthetic is prolonged, and the rate of its spread into the general bloodstream is reduced.

Patients with endocrine disorders, bronchial asthma and a tendency to allergic reactions in dentistry are usually prescribed anesthetics without adrenaline. If powerful pain relief is required, it is permissible to use Ultracaine D with a minimum concentration of epinephrine.

Anesthesia without adrenaline in dentistry

Mepivacaine is used to treat patients with contraindications to adrenaline in dentistry. A drug with this active ingredient, marketed under the name Scandonest, is less effective than Articaine. But it does not contain epinephrine, so Scandonest is suitable for administration to children, pregnant women, people with heart disease, and individual intolerance to adrenaline.

For diseases of the endocrine system, Scandonest and drugs without adrenaline are more often used. It is unacceptable to use products with vasoconstrictor components for hypertension.

The type of anesthesia dentists use determines not only the degree of painlessness of the medical intervention, but also the list of consequences that will have to be encountered after the operation. Modern means minimize the risks associated with incorrect administration of the drug, incorrect dosage and the occurrence of allergic reactions to the anesthetic.

Previously, dentists of the past were not particularly concerned about the feelings of patients in the chair.

Today, there are many methods of local anesthesia that allow you to treat teeth of any complexity without pain and fear.

Modern painkillers make it possible to block unpleasant sensations not only for adults, but also for children.

Moreover, they can be administered either by injection or without the use of a needle.

Local anesthesia is the administration of an anesthetic drug, due to which sensitivity in a certain area requiring dental manipulation is gradually reduced. The active substances block the impulses that nerve endings transmit to the brain.

In this case, the patient remains conscious and does not feel pain even during surgery. Blocking the nerve endings only causes a feeling of numbness in the area into which the drug was injected.

Indications

It is perhaps easier to list dental procedures that are performed without pain relief. Local anesthesia is used:

during treatment of advanced caries;
before removing the root system or the tooth as a whole;
during the periodontitis treatment;
in the treatment of inflammatory processes and purulent foci;
for the treatment of neuritis of the facial nerve;
when it is impossible to perform complex operations under general anesthesia.

It is worth noting the patient’s personal desire to resort to local anesthesia even in cases where it is possible to do without it. Pain relief suppresses the feeling of fear of unpleasant sensations.

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Contraindications

The drug for local anesthesia must be selected individually for each patient. After all, existing painkillers, like other drugs, have certain contraindications.

Therefore, before giving an injection, a professional must make sure that the patient does not have an allergic reaction to any medications or concomitant diseases.

Local anesthesia is not suitable for patients:

have had a stroke or heart attack less than six months ago;
with individual intolerance to painkillers.

Dentists adhere to some restrictions if:

the patient suffers from diseases of the thyroid gland, diabetes mellitus, which does not make it possible to use drugs containing vasoconstrictor components;
there is a history of cardiac pathologies or arterial hypertension. In this case, local anesthesia containing Epinephrine at a dosage higher than 1:200,000 is contraindicated for patients;
A bronchial asthmatic needs treatment. The painkiller in this case should not contain sodium disulfide, which is a preservative.

Varieties

You can numb a certain area of the oral cavity by injection or by influencing the nerve endings in a way that does not involve puncture of periodontal tissue.

Appliqué

This method makes it possible to temporarily numb the area being treated by superficially treating the oral mucosa with an ointment or spray. The drug is applied to the tissue by applying a gauze pad to the gum.

Application anesthesia allows you to achieve an immediate effect. Sometimes, this type of pain relief is used to reduce the discomfort from a future injection.

However, most often sprays or ointments are used before professional cleaning or opening of abscesses located on the surface of the gums.

Infiltration

The drug is administered by injection into the upper area at the root of the tooth. In this case, the injection is given both from the lingual (inner) and outer sides of the gums.

In this case, the introduced composition spreads into the internal cavity of the tooth gradually.

Experts use this method of pain relief most often. Dentists use infiltration anesthesia to treat caries, pulpitis and other dental diseases.

For more information about infiltration anesthesia in children, see the video.

Conductor

Pain relief is achieved by introducing the active composition into the surrounding nerve tissue, due to which pain impulses transmitted to the brain are blocked. Anesthesia spreads not only through the tissues, but also along the length of the nerve itself.

As a rule, in dentistry the technique is used for manipulations in the lower part of the oral cavity.

Intraligamentary (intraligamentous) local

The injection is carried out into the periodontal ligament. The gums are chipped on both sides of the mucous membrane.

The difference between intraligamentous injection anesthesia is the immediate effect of the drug. Therefore, intraligamentary anesthesia is often used in pediatric dentistry.

It is worth noting that the drug is administered both through a needle and a reduced cartridge. For the treatment of oral diseases in adults, the technique can be combined with other methods of pain relief.

Intraosseous

Anesthesia is used for short-term dental procedures, since in comparison with other methods of pain relief, its duration is not long-term.

The injection is made into the cancellous bone between two adjacent teeth. The main feature of the technique is that the patient’s cheeks and lips do not go numb. Therefore, after the end of the drug’s effect, there are no unpleasant sensations or discomfort.

To reduce the sensitivity of the injection, dentists, as a rule, perform preliminary application of anesthesia.

In the video, watch how pain relief is performed using intraosseous anesthesia.

Stem

This method of pain relief is carried out only in an inpatient dental department. Anesthesia has the longest period of action.

In addition, the injection is carried out not in the oral cavity, but in areas of the base of the skull. Blocking of impulses from nerve endings is carried out immediately throughout the entire lower or upper jaw.

Indications for such strong pain relief are:

complex surgical interventions;
facial bone injuries;
neuralgia;
unbearable pain syndrome.

For children

All drugs used in pediatric local anesthesiology, to one degree or another, cause harm to the small organism. Younger patients are especially sensitive to the effects of painkillers.

Previously, Lidocaine and Novocaine were used to block impulses from nerve endings. Today, Mepivacaine and Aricaine have the shortest list of side effects.

If we talk about the types of anesthesia used, then mainly in pediatric dentistry they use application, intraligamentary, infiltration and conduction methods.

Pay attention! Due to fears and an immature psyche, a child may lose consciousness during an injection in the dental chair. You should not attribute the reaction of a child’s body to the unprofessionalism of a specialist.

Drugs

The following drugs are used in modern dentistry:

Ultracaine. The drug is produced under three types of labeling: “D”, “DS” and “DS Forte”. The last two are distinguished by an increased concentration of the vasoconstrictor component - epinephrine. Under the “D” label, the French manufacturer produces a product without preservatives and vasoconstrictors.
Ubistezin. In terms of the composition of the active ingredients, the drug is an analogue of Ultracaine. The anesthetic is produced in Germany and is available in various dosages of the main components.
Septanest. It has a significant concentration of preservatives. Therefore, its administration is quite often accompanied by an allergic reaction.
Skadonest. The drug contains up to 3% Mepivacaine. Vasoconstrictors and preservatives are completely absent in the anesthetic produced in France, and therefore the drug is suitable for patients who need restrictions on the composition.

Possible complications

A seemingly ordinary injection can result in a number of unpleasant consequences. Among them are:

Needle fracture. Despite the fact that the element of the injection instrument is made of durable metal, if the patient moves suddenly, part of it may remain in the mucosa or periosteum. It is worth noting that the probability of removing a small metal fragment without complications is much higher than when removing part of an element inserted along its entire length.
Possibility of infection. Modern dentistry has made it possible to reduce the likelihood of this complication to a minimum through the use of disposable syringes. However, anesthesia of a pre-infected area of the oral cavity may result in infection of a healthy area due to the pushing of pathogenic bacteria by the anesthetic.
Hematoma or bruise. Complications result from blood vessels entering the tissues, which is most often observed during conduction anesthesia.
Swelling of tissues. A complication occurs when there is an individual intolerance to the components of the drug.
Loss of sensation. Sometimes, blocking the transmission of impulses to the brain by nerve endings lasts for several days or weeks due to nerve damage.
Burning or pain during the administration of the anesthetic. An unpleasant temporary reaction is absolutely safe for the patient’s body.
Spasms of the masticatory muscles or trismus. The complication is the inability to fully open the oral cavity. The phenomenon occurs due to damage to the muscles or blood vessels located in the infratemporal fossa and, as a rule, goes away within 2-3 days without any intervention.
Damage to soft tissues. Due to the lack of sensation in the tongue and some facial muscles, patients, especially children, may bite their lip or cheek. Therefore, it is recommended to refrain from eating until the effect of the drug has completely worn off.

At least a day before visiting a specialist, you should stop drinking alcoholic beverages. Ethyl alcohol, which is the main component of this product, reduces the effectiveness of many local anesthesia techniques.

If there was severe stress on the eve of a visit to the dentist, it would be useful to take a sedative at night - Valerian or Afobazole extract.

It is better to postpone dental treatment if you are weak during ARVI. It is not advisable to perform dental procedures on the days of menstruation. During this period, increased nervous excitability is observed.

In addition, surgery during “critical days” for patients can result in prolonged bleeding.

It is no secret that many people associate a dentist with the worst nightmare in life. Removal of teeth at the first problems, pain during treatment, many complications, violation of the aesthetics of a smile - today, all these points are a thing of the past.

Modern dentistry is able to restore a tooth completely destroyed by caries. Complex endodontic procedures are carried out using the latest equipment, knowledge and experience. The use of laser, ultrasound, and ozone helps to cope with many pathologies of the oral cavity.

One of the main components of modern dentistry is its painlessness. Depending on the type of treatment and the patient’s wishes, local or general anesthesia is used.

From this article you can learn more about pain management methods in dentistry.

What is anesthesia?

– lack of sensitivity in a particular area of the body or in the body as a whole. Pain relief is achieved through the action of special medications.

Types of anesthesia in dentistry:

Used during complex surgical operations. This method is often preferred when treating teeth in young children. There are 2 methods of administering anesthesia: using inhalation or intravenous injection. After the medicinal substances enter the body, the person is plunged into deep artificial sleep. He completely lacks consciousness and pain sensitivity. During treatment, in addition to dentists, a resuscitator and an anesthesiologist are present in the office.

Local anesthesia

It is used in most dental procedures and is divided into infiltration and application.

Application anesthesia is achieved through the use of special gels, ointments, sprays. The drugs are applied directly to the gum mucosa. Local anesthetics include: lidocaine, tetracaine, bumecaine, anesthesin.

After application, the drug quickly penetrates the periodontal tissue, blocks nerve endings, resulting in high-quality pain relief. The advantages of the method include: safety, minimal number of complications. The disadvantages are: short period of action, lack of deep pain relief.

Infiltration, conduction, intraligamentous, intraosseous anesthesia refer to injection local anesthesia. They are used in the treatment of teeth and surgical operations of hard and soft tissues in the area of the jaw apparatus. The drug can be injected under or periosteum, into the submucosal, spongy tissue of the upper or lower jaw. There are intraseptal, mandibular, torusal anesthesia.

The drug is administered with a special dental carpule syringe with a thin disposable needle. To make the injection less painful, the doctor pre-treats the injection site with an anesthetic gel or spray.

The patient can independently choose the method of pain relief. Depending on the presence of contraindications, the dentist supports the patient’s decision or refuses it, arguing his point of view from a scientific point of view.

Some people are terrified of dental treatment, so they choose general anesthesia. Despite the advantages of this method, a person must be aware of all its disadvantages. Anesthesia can be given for a period of no more than 1.5 hours, but most often it is used for 30 -40 minutes. In principle, this time is enough for the doctor to treat 1 tooth. To sanitize the oral cavity completely, it will be necessary to immerse the patient in anesthesia more than once or twice. That is why, if treatment can be carried out using local anesthesia, it is worth giving preference to it.

Side effects of general anesthesia: nausea, headache, dizziness, vomiting, sudden increase or decrease in blood pressure. Children experience capriciousness, tearfulness, unreasonable joy, delight, hysterics, and lethargy. Inappropriate behavior is very frightening for parents. However, do not worry, within 24 hours the baby’s condition will completely return to normal.

Before treatment under general anesthesia, it is necessary to undergo a preliminary examination: take a detailed blood test, urine test, conduct an ECG, and obtain a certificate of consent from a cardiologist. The health certificate must reflect all chronic diseases that the patient suffers from. You should not hide any facts, because they can cause the development of unpleasant complications during treatment.

Who should be wary of general anesthesia?

The risk group includes:

Persons suffering from hypertension and hypotension;
Children under 3 years old;
Patients with prolonged low-grade fever (slight increase in temperature) of unknown etiology;
People with a tendency to allergic manifestations;
Persons suffering from cardiac, renal, liver failure;
Patients with blood diseases.

Your doctor will tell you more about contraindications after conducting a preliminary diagnosis and reviewing your medical history.

Indications for the use of anesthesia in dentistry

Despite people's fear of dentists, not all procedures are accompanied by pain. Removal of dental plaque, treatment of superficial caries, fluoridation and teeth whitening - is carried out without the use of anesthetics and is completely painless!

Anesthesia is necessary for the following manipulations:

Treatment of medium and deep caries.
Nerve depulpation, root canal filling.
Opening abscesses.
Tooth extraction.
Resection of the root apex.
Flap operations, open and closed curettage.
Implantation of a dental implant;
Carrying out operations during orthodontic treatment.

Drugs used for local injection anesthesia: Ultracain, Scandonest, Septanest, Ubestezin. Anesthetics have a high therapeutic effect, a fast and long-lasting effect, are not absorbed into the blood and do not have a general effect on the body. In case of pregnancy, chronic diseases, allergies, the anesthetic is selected by the doctor individually.

Anesthesia in dentistry during pregnancy and breastfeeding

During pregnancy and breastfeeding, a woman’s body is subject to double stress. It is not surprising that it is at this moment that the teeth of young mothers begin to rapidly deteriorate.

Is it possible to treat teeth and gums while expecting a baby or breastfeeding?

Yes, dentists give an affirmative answer and allow the use of modern anesthetics in pregnant and lactating women. The safest drugs are Ultracain DS and Ubistezin. Medicines do not pass into the blood, breast milk, or placenta and cannot harm the baby.

Anesthesia in pediatric dentistry

When treating a child's teeth, local or general anesthesia is used.

Safe drugs with minimal side effects are chosen as injection local anesthesia. The doctor injects Ultracaine, Scandonest, Articaine with a special carpule syringe. Within a few minutes, the drug begins to act, the young patient’s jaw goes numb, and the dentist calmly begins treatment.

Topical anesthesia with gels, sprays and ointments is used if necessary:

Anesthetize the injection site;
Treat superficial or medium caries;
Remove hard dental deposits;
Remove loose baby tooth.

General anesthesia is used if immediate dental treatment is required, but none of the dentists can find an approach to the young patient. Indications for general anesthesia may include: mental illness, phobias, chronic depression, seizures and hysterics.

Prices for pain relief in clinics in Moscow and the region

Depending on the clinic, the availability of modern equipment and the experience of doctors, prices for treatment and services vary significantly.

Approximate cost of pain relief in dentistry:

The price of application local anesthesia within 1 tooth ranges from 50 to 1000 rubles.
The price of injection local anesthesia within 1 tooth ranges from 150 to 3800 rubles.
The cost of sedation varies from 3,000 to 15,000 rubles.
The price of general anesthesia ranges from 4,000 to 30 thousand rubles.

Question and answer

What is sedation in dentistry?

Sedation - allows you to calm the patient and relax him. The method is widely used in children. During treatment using xenon gas, a person’s consciousness is preserved, but he feels maximum relaxation and peace. Xenon anesthesia is used in patients suffering from dental phobia and experiencing significant emotional stress in connection with the upcoming medical dental intervention.

Why is adrenaline present in anesthetics?

Adrenaline and epinephrine constrict the blood vessels at the injection site and prevent the drug from leaching into the blood. Due to this action, the time and strength of pain relief increases.

Are there drugs without adrenaline?

Scandonest and Mepivastezin are adrenaline-free anesthetics that do not contain vasoconstrictors or preservatives. They are used for dental procedures in patients at high risk (bronchial asthma, allergies, vascular, nervous, cardiac pathologies).

What sedatives can be used before visiting the dentist?

Sedative medications help relieve the patient's anxiety. The disadvantage of soothing tablets and drops is their cumulative power. For the drug to work, it is necessary to take the medicine in a course for 2 - 3 weeks, until you visit the doctor. Safe herbal sedatives include: tablets and drops of Valerian, Motherwort, Peony.

Anesthesia or local anesthesia in dentistry allows you to treat teeth without pain, which provides comfort for the patient and ease of work for the dentist. Please note that in this article we will talk specifically about anesthesia, not anesthesia. Anesthesia is a complete shutdown of a person’s consciousness; in dentistry this is now commonly called “dental treatment in a dream.” This can only be carried out by anesthesiologists.

This article will focus specifically on anesthesia (sometimes also called local anesthesia). This type of anesthesia acts only on a limited area and is usually carried out by the dentist himself.

Many of us often delay visiting the dentist because... They have been afraid of them since childhood, but “advanced” caries can cause serious complications that may even require surgical intervention. The smaller the destruction and the earlier the patient consulted a doctor, the better, faster and less painful the treatment can be.

pulpitis and periodontitis;
diseases of the cardiovascular system and joints, because caries is a source of infection;
chronic allergic reactions;
if the tooth is completely destroyed, this will affect the quality of chewing food and, as a result, may lead to gastrointestinal diseases

In dentistry, the following types of local anesthesia are distinguished; below we will briefly consider each of them:

Appliqué
Infiltration
Conductor
Intraosseous
Intraligamentary (intraligamentous)
Stem
Combined.
Computer

All modern methods of pain relief in dentistry have their own characteristics, indications and contraindications.

In pediatric dentistry, the same types of local anesthesia are used, but for very young patients (2-3 years old), who simply will not allow the dentist to work, we give short-term anesthesia, for example, with propofol. This is a very modern and safe drug.

Application anesthesia

Allows you to anesthetize superficial soft tissues: skin and mucous membranes to a depth of approximately 1 - 3 mm. The drug quickly penetrates the tissue and temporarily disables the nerve endings located there. During the procedure, a high concentration of local anesthetic is used in the form of a gel, aerosol or emulsion. The drug is applied to the dried mucous membrane or the solution is sprayed onto it using a spray bottle.

Local topical anesthesia in dentistry (in other words, anesthesia without an injection) is used:

to numb the needle point before injecting;
for removing baby teeth;
when removing small soft tissue tumors.

Pain relief for stomatitis in children using special pastes and gels is also an application.

Infiltration of tissues with anesthetic solution

Infiltration used in dentistry much more often than other types. Tissue anesthesia occurs using a syringe or needleless injector. Sensitivity to pain is switched off after just a few minutes, and the duration of exposure depends on the type of anesthetic, its dose, and the presence of vasoconstrictor components in the composition.

The method, in addition, has some variations: intraosseous and intraligamentary anesthesia, they are also quite often used in dentistry. For them you need to use a special syringe.

Conductive anesthesia in dentistry

Conduction dental anesthesia is used much less frequently than infiltration anesthesia. An anesthetic solution is injected near the peripheral nerve trunk, and the entire area for which it is responsible is anesthetized. The desired effect occurs 10-15 minutes after the injection and lasts for 1-2 hours.

It is used when you need to numb a large area at once or if infiltration does not work. Unlike infiltration anesthesia, a smaller amount of anesthetic is used here, but in a higher concentration.

Torusal and mandibular anesthesia are performed on the lower jaw.

In this case, the lower alveolar and lingual nerves are switched off, so during the action of the anesthetic the patient feels numbness in the entire half of the lower jaw, lip, chin and tongue. Tuberal anesthesia in dentistry is often accompanied by the formation of a hematoma. It was this inconvenience, combined with the complexity of the technique and the high likelihood of complications, that forced dentists to abandon this type of anesthesia.

Intraosseous

To administer an anesthetic solution intraosseously during injection, the doctor perforates the dense outer cortical plate of the jaw bone and injects the solution into the spongy substance itself, where the terminal branches of the dental plexus are located. The effect appears within 1-2 minutes, the teeth and alveolar process are numbed. This manipulation is performed using a special syringe with a short, large-diameter needle and is a type of carpule anesthesia in dentistry.

Intraligamentary

Intraligamentary anesthesia involves the dentist injecting a solution into the periodontal ligament, which connects the tooth root to the bone alveolus. In this way, you can anesthetize only one tooth and do it with a record small amount of anesthetic, which is why this type of anesthesia remains very popular. It should be noted that the injection into the periodontium is quite painful and minor discomfort remains in the tooth for 24 hours after it is performed.

Trunk anesthesia in dentistry

This type of anesthesia is rarely performed in dentistry. This technique is also called (according to the author) “according to Bershe-Dubov”. This technique is used for severe pain in the patient, for the treatment of serious injuries and operations on the jaw and zygomatic bone, as well as for neuralgia, and only in a hospital setting.

An anesthetic injection is given at the base of the skull (brain stem), and the pain relief spreads through both trigeminal nerves and their branches. This allows you to immediately disconnect the mandibular and maxillary nerves. The effect of stem anesthesia lasts quite a long time.

Combined anesthesia

Combined or sedative anesthesia in dentistry is used more and more often. In order for the treatment to be not only painless, but also completely comfortable, it is not enough to simply eliminate pain, it is necessary to cope with fear and emotional stress. It is this effect that potentiated analgesia can achieve. It is a combination of superficial sedation and local anesthesia, carried out with the participation of an anesthesiologist. This is one of the best types of anesthesia for children in dentistry at the moment.

Superficial sedation is a state of stunning, slight depression of consciousness. In this case, the patient does not experience fear or anxiety before the upcoming intervention, but remains conscious. Of course, the advantage of this pain relief is not only its comfort. Anxiety and fear, among other things, cause a significant decrease in the pain threshold. That is, eliminating negative emotions allows you to achieve a good level of pain relief with smaller doses of anesthetic.

What is computer anesthesia?

Computer-controlled anesthesia is carried out by a special electronic system, which consists of a system unit and a handpiece. The needle has a special design that allows you to pierce soft tissue and perforate the cortical plate of the bone absolutely painlessly. Another advantage is the dosed administration of an anesthetic drug: the amount and speed of this process is controlled by a computer.

Carpule anesthesia

To perform carpule anesthesia in dentistry, special instruments are used - carpule syringes. They are a reusable metal device that has a body, a plunger and a needle that is much thinner than a regular injection needle. The drugs are supplied in special carpules and placed in the syringe body.

Local anesthetics in dentistry are divided into:

Novocaine;
Anestezin;
Dicaine.

Lidocaine;
Pyromecaine;
Trimecaine;
Prilocaine;
Mepivacaine;
Articaine;
Etidocaine;
Bupivakakin.

In addition to the main analgesic component, most anesthetics contain vasoconstrictors, such as, for example, adrenaline or epinephrine. Due to the effect of vasoconstriction at the injection site, the washout of the anesthetic occurs more slowly. This allows you to increase the strength and duration of pain relief.

To carry out anesthesia in pediatric dentistry, drugs must be selected with the lowest level of toxicity, but at the same time effective. The choice in this case falls on drugs of the amide group: ultracaine and scandonest in children's dosages. The first of these is, in principle, considered the best anesthetic in dentistry. The analgesic effect of ultracaine occurs quickly and lasts a long time.

You should not endure pain and refuse anesthesia in dentistry while breastfeeding. Local anesthetics are excreted in small quantities in milk, which means they can enter the child’s body. In this case, it is recommended to express several portions of milk before visiting the dentist and not to breastfeed the child for 24 hours after dental treatment.

If a woman decides not to treat or remove a diseased tooth, then sooner or later complications will arise that will require emergency treatment, which can have an even greater impact on the baby.

If you are planning a pregnancy, be sure to visit the dentist in advance, because... Doctors categorically do not recommend treating teeth during pregnancy using anesthesia, especially in the first trimester. Because It is in the first trimester that the main organs of the child are formed, and the use of anesthetics or anesthesia drugs can negatively affect the further development of the baby.

Anesthesia without adrenaline

To enhance the effect, vasoconstrictor drugs are added to the anesthetic solution - this increases the duration of action and reduces the level of absorption of the drug into the blood. But accidental entry of the vasoconstrictor itself into the bloodstream is associated with serious side effects.

This is why anesthetics without adrenaline are used for pain relief in dentistry for pregnant women, in pediatric practice and in the treatment of patients with diseases of the cardiovascular system.

Contraindications to dental anesthesia are:

Allergic reactions to substances included in anesthetics;
History of cardiovascular diseases;
Diabetes mellitus;
Pathology of the endocrine system organs;
Some types of severe injuries of the maxillofacial area.

Side effects of anesthesia in dentistry

If the doctor is a professional in his field, complications during local anesthesia in dentistry are very unlikely. There are some points that worry patients afterward and, in principle, are a variant of the norm: swelling of the lip or swelling of the cheek, pain in the gums or even a headache for several hours.

However, all these symptoms should go away within 1-3 days after treatment. If you see that the situation is not improving or even worsening, contact the dentist who performed the procedure.

Rarely, more serious complications may occur, including:

Allergic and toxic reactions. The body's increased sensitivity to medications is due to an allergic predisposition. May manifest as urticaria, Quincke's edema, anaphylactic shock, etc.;
Trauma to blood vessels from an injection needle, which may result in hematomas and bruises;
Pain and burning at the injection site (quite common and considered normal);
Lockjaw. Spasm of the masticatory muscles. Occurs when muscle fibers or nerves are damaged;
Loss of sensation. Occurs when a nerve is damaged during injection;
Damage to soft tissues. If sensitivity is lost, the patient may bite his tongue, lip, or cheek;
Infection. If antiseptic rules are not followed.

Advice for patients

Pain during anesthetic injection and treatment will depend on several factors:

from your sensitivity;
professionalism of the dentist and equipment of the clinic;
on the degree of tooth destruction and the depth of caries.

do not drink alcohol the day before, this may worsen the effect of the anesthetic;
if you have a cold, cough, or runny nose, it is better to postpone your visit until you have fully recovered;
Women and girls are not recommended to visit the dentist during menstruation, because... during this period, blood clotting worsens (by the way, do not be surprised if the anesthesiologist asks you this question before surgery; operations are not performed during menstruation.
choose your clinic carefully! Now their choice is very large, but very few comply with important requirements and all antiseptic requirements!

If you choose a clinic, pay attention to:

Legal name and registration documents, the same name must be in the contract for the provision of services.
Keep all receipts and receipts for payment, pay only through the cashier (also keep track of the legal name of the clinic on them).
Go to the clinic’s website (certificates, licenses and certificates of specialists should be presented there), read reviews on the Internet, talk with friends.
Visit the clinic itself and make an initial appointment.
If you plan to treat your teeth “in your sleep”, i.e. under anesthesia, be sure to check the availability of an anesthesiologist on the clinic staff!
Please note that the doctor must wear new gloves and print out all the disposable instruments with which he will carry out treatment and examination!!! In addition, the clinic must have air sterilizers.
Be wary of dental offices located on the ground floor of residential buildings; it is better to give preference to large clinics with good equipment, but remember that expensive does not mean quality.