How dental anaesthesia works?

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FOR many, the prospect of visiting a dentist invokes fear and anxiety. Thankfully, pain-free dentistry is possible for everyone.

This is particularly important for children, people who are very anxious, and people who have special needs. Here are some ways your dentist can provide pain-free dentistry, as well as some methods for managing dental anxiety.

What we use

Dentists use a variety of different anaesthetics for different purposes. The type they use depends on what they need the specific anaesthetic to do. Here are three pain control items we commonly use at dental offices, how they work, and what they’re for:

Topical anaesthetic

Topical anaesthetic is applied to a specific area of soft tissue to numb it. It’s commonly referred to as numbing gel or jelly. Dentists usually apply it with a simple cotton swab or cotton roll. In order to work effectively, dentists let the gel sit on the surface it’s numbing for a few minutes.

Generally, dentists use topical anaesthetic to numb the cheek or gums before an injection of local anaesthetic in order to make the injection more comfortable. It works great on the surface of the mucosa or gums, but it can’t reach the nerves deep under the gums or within the teeth. Whenever dentists need to drill into teeth (like they do when placing fillings), they need to use more than just a topical anaesthetic. It’s possible that your dentist won’t use topical anaesthetic for every procedure.

Local (injected) anaesthetic

Dentists use local anaesthetic by injecting it directly into the area they want to numb. A local anaesthetic temporarily deactivates the nerves in a specific part of the mouth. After administering it, dentists can perform a variety of procedures in that area without the patient feeling it.

Dentists inject local anaesthetics through a thin needle, usually after applying a topical anaesthetic to the area. The patient seldom, if ever, feels pain from the prick of the needle used for the injection. At worst, they may feel a brief, slight pressure at the point of insertion.

Lidocaine is the most commonly used local anaesthetic among dentists, but there are several other common varieties as well. Along with the anaesthetic itself, injections often include a small amount of epinephrine, (which your body already makes for itself in larger quantities), to constrict the blood vessels around the injection site and help the anaesthetic work effectively and last longer.

Dentists use local anaesthetic for dental procedures that would be painful without it, like root canals, extractions, or fillings. Contemporary local anaesthetics effectively numb any area that invasive dental procedures could affect.

Nitrous oxide (laughing gas)

Nitrous oxide, or “laughing gas”, is a colourless, odourless gas commonly used to reduce anxiety in patients during dental procedures. Although it’s technically not an anaesthetic, it does have some pain control properties. It’s called “laughing gas” for the euphoric state it imparts when it’s inhaled.

Dentists administer it via a breathing mask that fits over the patient’s nose. The patient breathes in a mixture of the gases that’s usually around 30 per cent nitrous oxide and 70 per cent oxygen. The gas begins working within minutes. Dentists easily reverse the effect after treatment by switching to 100 per cent oxygen.

Nitrous oxide doesn’t put patients to sleep, but it does have an effect on the nervous system. It’s used primarily as a means of relaxing anxious patients, but it also has some analgesic properties that help control pain. Nitrous oxide is considered reliable and safe because the effects are mild and easily reversed. It’s ideal for dental procedures because patients under its effects remain conscious and can respond to questions. Dentists can also easily control the amount of nitrous oxide administered to the patient. Dentists use nitrous oxide in conjunction with, not instead of, local anaesthetics.

Why we use it

Procedures like fillings, crowns, and root canals involve drilling into a tooth to remove decayed tooth material. In the case of root canals, dentists even have to remove inflamed or diseased pulp tissue and nerves. Fortunately, anaesthetics allow dentists to perform these procedures safely and effectively in the controlled environment of the dental office while your body doesn’t know that’s what’s happening.

Without anaesthetics, many dental procedures would be quite painful, even though they’re being performed correctly.

Anaesthetics numb your mouth’s nerves to keep them from transmitting pain signals to your brain. You don’t interpret the procedure as painful. After the dentist finishes the procedure, your mouth won’t either. Many dental procedures may cause minor aches and pains for a couple days after they’re completed, and sometimes injection sites can be sore as well. This discomfort is also natural, and is usually the result of the needle penetrating through gums or mouth muscles during the injection. 

Dr Sharon Robinson, DDS has offices at Dental Place Cosmetix Spa, located at shop #5, Winchester Business Centre, 15 Hope Road, Kingston 10. Dr Robinson is an adjunct lecturer at the University of Technology, Jamaica, School of Oral Health Sciences. She may be contacted at 876-630-4710. Like their Facebook page, Dental Place Cosmetix Spa.

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