March 26, 2015

From the desk of Dr. Fass

We’ve certainly come a long way since the early days of Novocaine. That was the first widely used drug for numbing a local area for dental procedures. Novocaine had some drawbacks, not the least of which was some severe allergic reactions in some patients.

Lidocaine was the next popular anesthetic drug . It has almost no known allergy potential and is very effective for both local infiltration (just a few teeth) and block injections (the whole side of a lower jaw and tongue). To make lidocaine last long enough to be effective, it usually has a drug called epinephrine added. This is identical to our body’s own adrenaline. It shrinks blood vessels, thereby keeping the anesthetic in the area longer without the blood flow taking it away.

Other anesthetics and systems can help the dentist work more effectively, or control pain better. Marcaine is often used after surgery and can prolong the numbness for up to 8 hours to keep you comfortable through the first hours following a procedure. A newer drug, Articaine, can diffuse through bone and get lower teeth numb without the need to numb the tongue. In fact, many offices have made Articaine their standard anesthetic. It works quickly, leads to profound numbness in local areas, and has greatly reduced the need for the block injections that lasted so long after the appointment was over.

Another new addition is a drug called Onset. When anesthetics are packaged for dental use, they are formulated in an acidic solution to prolong shelf life. When injected, the acid causes a mild burning sensation at first. The body needs to neutralize it before the drug can work and numb the nerves. Onset gives us a system that neutralizes the anesthetic in the cartridge. This eliminates the acid burn during the injection, and allows the numbing effect to happen much quicker, in fact almost immediately in some cases.

Your dental team is always on the alert for new modes of treatment to make your dental care better and more comfortable. Anesthetics are no exception to this quest.