Unlike general anesthesia, in which the patient falls into a deep medicated sleep and does not react to external stimuli, local anesthesia is a method of anesthesia by blocking innervation at the site of surgical intervention. It is this type of anesthesia is used in dentistry for treatment, prosthetic teeth, treatment of gum diseases.
The peculiarity of local anesthesia is that it 100% eliminates pain sensations, but at the same time retains sensory perception. That is, the patient can feel shocks, vibrations, pressure. In some cases, tactile sensations are perceived by patients as unpleasant. The task of the dentist is to use the optimal method of anesthesia, which will provide the patient with protection not only from pain, but also from discomfort and stress in the process of treatment.
The use of anesthesia in dentistry
Treatment in dentistry in most cases involves minimally invasive and invasive manipulations, which can be painful for the patient. The use of local anesthesia in dentistry solves this problem. Local anesthesia has made treatment comfortable for the patient and simplified the doctor’s job.
Local anesthesia in dentistry is used:
- in the treatment of dental caries and its complications (pulpitis, periodontitis), non-carious lesions of teeth;
- in surgical treatment of periodontitis (curettage, elimination of gingival recession, gingivoplasty, directed tissue regeneration);
- dental prosthetics;
- tooth extraction;
- osteoplasty, implantation;
- tooth-preserving surgical operations (root amputation, hemisection, root apex resection);
- removal of tumors, cysts, tissue resection in the treatment of periostitis, pericoronitis, abscess opening.
Methods of local anesthesia
At the moment there are such types of anesthesia in dentistry:
- application;
- infiltration;
- conductive;
- intraligamentary;
- trunk.
Application local anesthesia is used for superficial anesthesia (gingiva, mucosa). Application anesthetics are produced in the form of gel, spray based on benzocaine, lidocaine.
In the treatment of caries, pulpitis, a number of operations in the oral cavity is used infiltration anesthesia in dentistry – several injections of anesthetic into the gingival tissues, under the skin in the area of intervention. It is ineffective in the treatment of chewing teeth of the lower jaw, where it is preferable to use conductive or intraligamentary anesthesia.
When performing complex surgical operations on the lower jaw is used conductive anesthesia in dentistry – injection of the drug in the area where the nerve is located, allowing for a small dose of anesthetic anesthetize a large area.
Intraligamentary anesthesia – injections into the circular ligament of the tooth.
The rarest method of local anesthesia is trunk anesthesia, in which the drug is injected into the base of the skull, as a result of which all nerve endings related to the trigeminal nerve are blocked. This method is used in hospital conditions in exceptional cases (neuralgia, high pain sensitivity in the patient, etc.).
Local anesthesia: materials and methods
In dentistry, for the purpose of local anesthesia, preparations of amide and ether series are used. Consider the most common preparations.
The use of ultracaine
Utracaine is a low-toxic anesthetic based on tifen. The effectiveness of the drug is 2 times higher than lidocaine, 6 times higher than novocaine, and at the same time ultracaine is safe in 99.4% of cases, reduces blood pressure. It does not contain parabens, which can have a toxic effect and cause allergic reactions. In the composition of ultracaine there is adrenaline, which contributes to the constriction of blood vessels, prolonging the effect of the anesthetic, as well as antioxidants that prevent its oxidation.
Benefits:
- Strong fast-acting anesthetic agent of medium-low toxicity;
- prolonged action – 1.5-2 hours or 5-6 hours (depending on the technique of anesthesia);
- possibility of use in the treatment of children of preschool age (over 4 years) and in pregnancy;
- good tolerance of the components of the drug (allergic reactions are extremely rare – 1 time per 100 thousand cases, toxic reactions to adrenaline and sodium disulfate present in the drug – in 4.3% of cases).