A high number of people choose not to visit the dentist for regular check-ups and cleanings because they suffer from dental anxiety. At East Van Dental, we understand the dentist office can be a scary place, and so we take extra measures to ensure all our patients are as comfortable as they can every time they come in. This includes comfort aids for patients to make their visit more enjoyable and less anxiety-provoking. These include:
Sedation dentistry: An excellent way of decreasing patient anxiety for those who are afraid of the dentist. There are currently 4 levels of sedation:
- Minimal: Oral medication in pill form (Ativan, Rezipan) is provided prior to treatment. This type of sedation does not cause sleep but rather dulls the senses so that the patient is fully awake, yet more relaxed.
- Moderate: The patient is fully conscious but may not remember the procedure. Slurring of words following the procedure is also common.
- Deep: The patient is close to a state of unconsciousness, but can still be woken if needed.
- General Anesthetic: Generally used during longer medical procedures. The patient is in a deep sleep throughout the procedure and shortly afterwards.
It is very important that we have your medical history up to date so that we are aware of any medications you are taking and any potential allergies before we administer any sedation.
Topical Anesthetic in Dentistry:
A fruit-flavored ointment can be applied directly on the skin or inside the patient’s mouth to numb the area the dentist will be working on. Typically a topical ointment is used to relieve pain when administering the local anesthetic before procedures.
Topical anesthetic reduces the slight discomfort associated with insertion of the needle. It is effective to a depth of 2-3mm. Although its application is beneficial for reducing patient discomfort during the initial phase of local anesthetic administration, it may be a disadvantage in children if the taste is disagreeable to the patient. Also, excessive length of application time may increase apprehension of the approaching procedure.
It is available in gel, liquid, ointment, patch and pressurized spray forms. The most common topical anesthetics used in dentistry are those containing benzocaine or lidocaine.
Benzocaine (ethyl aminobenzoate) is an ester local anesthetic. It is available in up to 20% concentrations. It is not known to produce systemic toxicity but can produce local allergic reactions especially after prolonged or repeated use. It exhibits poor solubility in water and poor absorption into the cardiovascular system, thus it remains at the site of application longer, providing a prolonged duration of action. Systemic toxic (overdose) reactions are virtually unknown. Benzocaine is reported to inhibit the antibacterial action of sulfonamides.
Lidocaine is available as a solution or ointment up to 5% concentration and as a spray up to 10% concentration. It has a low incidence of allergic reactions but is absorbed systemically and application of excessive amounts of topical lidocaine may absorb rapidly into the cardiovascular system leading to higher local anesthetic blood levels with an increased risk, especially in the pediatric patient, of overdose reaction. Thus a minimal amount of topical gel should be applied to the tissue and a metered spray is suggested if an aerosol preparation is selected.
Local Anesthetic in Dentistry:
Medicine is injected into the gum or inner cheek to numb a part of the patient’s mouth for the duration of the procedure. It is very common for patients to feel numb for a couple of hours after the anesthetic is administered. Take care when eating or drinking during this time. Please contact the office immediately if pain is experienced after the numbness subsides.
Lidocaine is the most common local anesthetic that our dentists at EastVan Dental Clinic use. There are many others. They all have names ending in “-caine.” Many people think of Novocain as the classic numbing drug. But Novocain actually is not used anymore. Other drugs last longer and work better than Novocain. These drugs also are less likely to cause allergic reactions.
The numbing drug is only one part of what’s injected. The liquid in the injection also can include:
- A type of drug called a vasoconstrictor. This drug narrows your blood vessels. This makes the numbness last longer.
- A chemical that keeps the vasoconstrictor from breaking down
- Sodium hydroxide, which helps the numbing drug work
- Sodium chloride, which helps the drugs get into your blood
There are two kinds of numbing injections. A block injection numbs an entire region of your mouth, such as one side of your lower jaw. An infiltration injection numbs a smaller area. This is the area near where the injection was given.
If you need local anesthesia in order to have your dental treatment done, our Vancouver Dentist will dry part of your mouth with air or cotton. Our Commercial Drive Dentists then will swab the area with a gel to numb the skin.
Then, our Dentist in East Vancouver will slowly inject the local anesthetic. Most people don’t feel the needle. Instead, the sting they feel is caused by the anesthetic moving into the tissue.
An injection of local anesthesia can last up to several hours. After you leave our dental office in East Vancouver, you may find it difficult to speak clearly or eat. Drinking from a straw can be messy. Be careful not to bite down on the numb area. You could hurt yourself without realizing it.
Local anesthetics are the most common drugs used in the dental office. Side effects are very rare.
One possible side effect is a hematoma. This is a blood-filled swelling. It can form when the injection needle hits a blood vessel.
The numbing medicine sometimes causes numbness outside of the targeted area. If this happens, your eyelid or mouth can droop. You will recover when the drug wears off.
If you are unable to blink, you may need to have your eye taped shut until the numbness wears off. The anesthetic usually lasts for only a couple of hours. In some people, the vasoconstrictor drug can cause the heart to beat faster. This lasts only a minute or two. Tell your doctor if this has ever happened to you.
Finally, the needle can injure a nerve. This can lead to numbness and pain for several weeks or months. The nerve usually heals over time.
It is rare to have an allergic reaction to a local anesthetic. Be sure to tell our dentist about all of the medicines you take. This should include over-the-counter drugs and also any herbs or vitamins you take. Also, tell our dentist about any reactions you have had with medicines, no matter how minor the reaction was. Some drugs can interact with local anesthetics.
Local anesthesia can lead to a short-term problem with the operation of wheelchairs that use “sip and puff” technology. If your mouth is numb, you may not be able to create a tight seal around the straw that controls your wheelchair. Make sure that you have someone with you who knows how to use the manual controls on your wheelchair until your numbness wears off.