Types and Uses of Dental Anaesthesia

About the Study

Lidocaine is the most widely utilised local anaesthetic in dentistry (also called xylocaine or lignocaine). The half-life of lidocaine in the body is 1.5 to 2 hours. As of 2018, the most typical application of lidocaine is to numb the region around a tooth during dental operations. For example, more Lidocaine is needed for root canal therapy than for a simple filling. Currently used local anesthesia include prilocaine (also known as Citanest), articaine (also known as septocaine or Ubistesin), bupivacaine (a long-acting anesthetic), and mepivacaine (also called Carbocaine or Polocaine). Drugs used as local anesthetics come in various strengths and have varying half-life. Depending on the circumstance, a combination of these may be applied. Some medications are offered in two variations, one with and one without epinephrine (adrenaline) or another vasoconstrictor to extend the duration of the medication. This regulates tissue bleeding while performing surgeries. Before any anesthetic is administered, the case is typically categorised using the ASA Physical Status Classification System.

The duration and extent of local anesthetic activity are influenced by a variety of factors. Examples of these variables include the way each patient reacts to the medication, the vascularity and pH of the tissues where the medication is supplied, the type of injection used, etc.

Commercial LA used in dentistry practices has a low pH of 3-4, which is beneficial as it will increase the product's shelf life and delay early oxidation. Low pH LAs, however, may cause burning, start more slowly, and have less therapeutic efficacy. Utilizing sodium bicarbonate, the pH of local anesthetic can be raised to promote alkalinity, which lessens pain at the injection site and has a quicker onset. The success rate of buffered local anesthetics is 2.29 times higher than that of non-buffering solutions.

Maxillary anesthesia

To induce dental anesthesia, local anesthetic is placed on the buccal (cheek) side of the maxillary alveolus, where it can diffuse through the delicate cortical plate of the maxilla and further into the pulp of the tooth.

Mandibular anesthesia

The two most popular injection procedures for numbing the mandibular teeth are regional block and infiltration. Various methods are selected based on various considerations.

Aged patients

When anaesthetizing a child's primary or deciduous teeth, infiltration anesthesia is preferred. Similar to the maxillary buccal infiltration, the technique. Make sure the lip or cheek is stretched laterally and inferiorly rather than superiorly, and then insert the needle 45 degrees into the mucco-buccal fold, through the tight tissue.

To be anaesthetized tooth

For pulpal and soft tissue anesthesia of adult mandibular permanent incisors, infiltration anesthesia should be the first option. Due to crossover innervation from the inferior alveolar nerves other side, regional block injections can occasionally be unsuccessful. It is advised to place at least 0.5 mL in the apical portion of the target tooth at each buccal and lingual site. Due to its excellent formulation, infiltration anaesthesia with 4 percent articaine and 1:100,000 epinephrine is increasingly used to obtain pulp anaesthesia of the mandibular permanent first molar.

One of the most popular techniques dentists employ to anaesthetize the mandibular teeth in adults is probably the inferior alveolar nerve block. The objective of this step is to insert a needle close to the nerve before it reaches the mandibular foramen, which is found on the medial side of the mandibular ramus. This is done to stop the inferior alveolar nerve from transmitting nerve signals before it enters the bone through the mandibular foramen.