Comparison of dental anesthetics. Drugs and types of local anesthesia in dentistry. Contraindications to anesthesia may be

Toothache familiar to many, it is difficult to endure, but some people put off visiting the dentist for fear of getting even more unpleasant sensations. As a result, you will have to meet with the doctor, but you will need more difficult treatment due to complications. Therefore, if a tooth is sick, you should not pull, because today there are new types of anesthesia in dentistry that allow you to quickly and painlessly eliminate the problem.

Anesthesia in dentistry makes treatment comfortable

Indications

Anesthesia is the reduction or complete loss of sensation in certain areas or throughout the body. The condition occurs due to the introduction of a drug that prevents the passage of a pain impulse from the nerve to the brain centers in the area of ​​intervention. In dentistry, anesthesia is required so that a person does not feel pain during rehabilitation.

The calm state of the patient allows the procedure to be carried out qualitatively on the required scale.

Dental anesthesia is performed when performing procedures:

• treatment of complex caries;
• depulping;
• tooth extirpation;
• other surgical interventions;
• preparation of teeth for the installation of prostheses;
• in the treatment of dental anomalies.

Sometimes, even with average caries, freezing of the tooth is used, since the area of ​​​​the enamel layer bordering the dentin is also sensitive, so patients often experience pain during manipulations in this area.

Types of anesthesia

Anesthesiology distinguishes two types of anesthesia in dentistry: it can be local, and general anesthesia is also used. The drug type of anesthesia of the teeth differs, when the anesthetic is injected, the drug temporarily blocks the flow of an impulse to the centers of the brain. Through certain time it collapses and sensitivity returns. TO non-drug method painkillers include:

• anesthesia with sound (audioanalgesia);
• electronarcosis, the loss of sensation occurs through exposure to electric current(electroanalgesia);
• apply innovative technologies- computer anesthesia: hypnosis.

General anesthesia is rarely used, it is usually used during surgery in maxillofacial area. But modern methods able to fully eliminate pain at the local level.

Local anesthesia

For the most part, it is carried out local anesthesia, it is safer for human health, does not harm the body. Previously, Novocaine and Lidocaine were widely used, and today modern, more quality drugs. Local anesthesia in dentistry involves several methods of drug administration, they differ in the breadth of the impact on the site of intervention.

Application

The method allows you to practically instantly anesthetize the surface of the gum area, it is used:

• for tissue preparation to prepare the patient for injection;
• opening of abscesses on the mucosa;
• during procedures on the edge of the gums;
• when cleaning from tartar;
• during tooth grinding.

Application anesthesia - superficial application of an anesthetic

Gel is applied cotton swab, and there is also an anesthetic in the form of a spray, it is applied by spraying.

infiltration

A method common and familiar to all patients of the dentist is an injection. The doctor injects an anesthetic into the gum at the root apex and after 2 minutes the surgical field will be frozen. Duration of exposure: about an hour the patient does not experience pain.

The method is effective and comfortable, allowing the doctor to work calmly. Used:

• in the treatment of dental canals during the removal of the nerve bundle;
• extirpation of teeth;
• pulp operations.

Infiltration intraosseous anesthesia

Conductor

This type of procedure allows you to block the entire nerve branching, so anesthesia extends to a significant area, covers several teeth and soft tissues. The duration of anesthesia is two hours. It is used during volumetric operations on large molars and gums, when draining a purulent abscess.

The upper jaw is subjected to tuberal and palatine anesthesia, when necessary, they are supplemented with an incisive one. Below, a mandibular or torusal method of anesthesia is required.

Intraligamentary (intraligamentous)

It is used in the treatment of children as an alternative to mandibular anesthesia, as it causes numbness and increases the risk of injury to the soft tissues of the oral cavity. In the case of an intraligamentous injection, the drug is injected into the periodontal ligament located between the root of the tooth and the alveolar wall. During the procedure, numbness does not occur, so biting is excluded. In adults, the method is not always effective, and it cannot be done if there is a purulent periodontal pocket.

Intraosseous

Produced at difficult removal tooth. First, the gums are anesthetized, after the onset of local numbness, the medicine is injected into the interdental space in the spongy layer of the bone. The patient immediately feels the result, but its duration is short. Moreover, the sensitivity of the tooth disappears along with part of the gum.

stem

Anesthesia is carried out strictly in the hospital, the injection is carried out at the base of the skull, in this case, the nerve branches on the upper and mandible.

Applicable:

• with injuries;
• during operations;
• with severe pain;
• with trigeminal neuralgia.

Pain relief has a longer duration of action due to the introduction of a vasoconstrictor.

Capsules for carpool anesthesia

Some patients worry if anesthesia is harmful? Pain relief procedures are dangerous for those who have contraindications to its implementation. And also in the treatment of teeth, it is worth choosing a competent professional, then there will be no threat to health.

Contraindications

Before starting treatment, the dentist finds out if the patient has chronic diseases or intolerance to medications. When anesthesia for dental treatment is contraindicated:

• with allergies to anesthetics;
• in the presence of acute pathology of cardio-vascular system history (if the patient
• suffered a stroke or heart attack no more than six months ago);
• at hormonal changes and failures in the endocrine system;
• at high sugar in blood;

IN advanced cases at endocrine disorders treatment is carried out in a hospital. A serious approach requires the use of anesthesia when working with children and pregnant women.

Allergy - contraindications for anesthesia

Local anesthesia drugs

Modern dentistry practically abandoned novocaine, due to its lack of effectiveness, besides, the remedy does not affect the lesion. New ones are being released now local anesthetics, the result of which occurs instantly, they are less toxic.

The drugs are used:

• Lidocaine. For external anesthesia, a 10% solution in the form of a spray is suitable, injections are made with a 2% concentration of the drug.
• Ultracain. Often used in dental treatment, especially in people with allergies and bronchial asthma. The pharmaceutical industry produces the drug in the form of: "Ultracain DS forte" and "Ultracain DS" with epinephrine, the additive increases the duration of the effect of the main drug. "Ultracain D" does not contain preservatives and epinephrine.
• Artikain. Indicated for infiltration and conduction methods of introduction. The tool is not used to treat children under 4 years old, during pregnancy it is allowed in special cases.
• mepivacaine. It is intended for conduction anesthesia, it is allowed in the treatment of children and pregnant women.
• Ubistezin. Combined remedy contains Epinephrine, 2 times more effective than Lidocaine. Recommended for administration to the elderly as it does not cause surges blood pressure and acceleration heart rate, is an analogue of Ultracaine.
• Septanest. Injections are used with caution in diabetes, tachycardia, bronchial asthma.
• Scandonest is a two-component drug that contains adrenaline to prolong the effect. It contains no additives or preservatives.

For dental purposes, a carpool syringe is used.

Effective drugs for anesthesia

In this case medications are produced in special cartridges, ampoules with a finished dose of medicine. The thinnest needle is screwed onto them, which is inserted into the tissue. This approach ensures compliance antiseptic conditions, and the patient does not experience vivid discomfort. For those who are afraid of an injection, the area before the introduction of the needle is anesthetized with a spray.

Pediatric dentistry and anesthesia

IN given period acceptable drugs for children are Mepivacaine and Articaine. All of the above methods of dental anesthesia are applicable, except for intraosseous and stem anesthesia.

Anesthesia for children - only the safest

1. The child's body is sensitive to medications, so completely safe anesthetics For childhood Not yet. After using injections, there is a risk of developing complications:
2. psychogenic nature. Due to age, the baby is not yet able to control emotions, often being frightened of a needle, the child may lose the creation. To prevent complications, the doctor's task is to divert the attention of a small patient.
3. Allergies. The situation rarely occurs, but its development cannot be ruled out, usually the body does not respond to the anesthetic, but to the antioxidants that make up it.
4. Medication overdose. Excess drug in the child's body leads to its reaction to toxins.

But the dose in modern dentistry is calculated individually for each child. Therefore, such a development of events is practically excluded.

Possible Complications

Sometimes complications may develop during analgesic measures, the most common include:

• allergic reactions occur with intolerance to the components of the drug;
• with excessive dosage, toxic poisoning develops;
• if the needle insertion technique is violated, nerve injury and loss of sensitivity are possible;
• lockjaw chewing muscles if a nerve or muscle tissue is affected;
• broken needle, rare;
• due to damage blood vessel bruising or bruising is formed with a needle;
• infection of nearby tissues occurs when the doctor does not comply with aseptic and antiseptic conditions;
• biting of tissues in the mouth as a result of loss of sensation.

Usually when modern anesthesia complications are extremely rare, and pain and burning at the injection site is not a pathology.

A few tips for a dentist patient:

• For the freezing of the painful area to be effective, before visiting dental office refuse to drink alcohol. They are powerless from a toothache, and they are quite capable of reducing the effect of an anesthetic drug.
• If it is difficult to cope with excitement, before going to bed you can take a tincture of soothing herbs, motherwort or valerian, you can take a tablet of Afabazol.
• When not acute pain, treatment is planned, you should not go to the dentist during menstruation. For a woman, this is a period when nervous excitability is increased, sensitivity to drugs increases. And also menstruation can provoke bleeding after tooth extraction.

General anesthesia

Under general anesthesia imply complete loss sensitivity at which varying degrees disturbances of consciousness. This procedure rarely used during dental intervention, since the method is not safe, not every clinic receives permission to conduct general anesthesia. Its use is only permitted under medical indications, usually its use is justified in operations.

General anesthesia in dentistry is a last resort

During the rehabilitation of teeth and elimination inflammatory processes, including in children, inhalation anesthesia is now used.

The gas is represented by nitrous oxide, at a certain concentration of it in the body, a person loses consciousness, when the surgical stage is reached, manipulations are carried out.

Indications for carrying out:

• allergic to medicines local impact;
• mental illness;
• panic conditions during dental procedures.

There are also contraindications to anesthesia:

• diseases of the respiratory system;
• serious disorders in the work of the heart and blood vessels;
• severe pathologies of the kidneys and liver;
• drug intolerance.

The procedure is carried out under the guidance of an anesthesiologist.

Do not be afraid of visiting the dentist, medicine has stepped forward, dental treatment with anesthesia has become completely painless procedure. Timely rehabilitation will prevent the development of complications, will become the key not only to health oral cavity but also general well-being.

The problem of pain in dentistry is always important and relevant. Most patients put off a visit to the dentist, fearing the pain of the upcoming manipulations. However, today there are modern drugs and methods of anesthesia that allow you to completely eliminate possible pain.

What are the types of anesthesia?

There are two main types of anesthesia: general and local. General anesthesia (or anesthesia) is rarely used in dentistry. With this type of anesthesia, the patient "falls asleep" for the duration of the procedure, i.e. is unconscious and does not feel anything. Anesthesia can be used for extensive operations in the oral cavity or in pediatric dentistry. However, due to the presence a large number contraindications and possible complications after anesthesia, preference is always given local anesthesia.

Local anesthesia is the familiar to all of us “prick in the gum” or “freeze”. This causes a temporary shutdown pain sensitivity only in certain areas of the oral cavity. Tactile sensitivity during local anesthesia is usually preserved, the patient may feel touch or pressure on the tooth and gum, vibration, etc. But pain is completely absent.

To anesthetize a tooth upper jaw it is enough to make several injections in the gum next to the tooth (the so-called " infiltration» anesthesia). In order to relieve pain lower tooth, sometimes it is required to inject an anesthetic near the mandibular nerve (this is " conductive» anesthesia). During conduction anesthesia, half of the lower jaw and tongue “go numb”. In addition, there is the so-called application» anesthesia, in which only the mucous membrane of a certain area is anesthetized (by applying a special spray or gel with an anesthetic). This anesthesia is used most often before infiltration, so that the injection of the needle is painless.

What drugs are currently used for local anesthesia?

In modern dental clinics ah (including in our Le Dent clinic) carpool anesthetics are used latest generation. They are called carpool because the drug is not in ampoules, but in special disposable cartridges (carpules) that are inserted into a metal carpool syringe. The thinnest disposable needle is screwed onto the syringe.

Thanks to all this carpool anesthetics have a number benefits:

• Absolute sterility of the drug and a guarantee against the ingress of foreign substances into the anesthetic, because the doctor does not need to open the ampoule and draw the drug from the ampoule into a syringe, i.e. there is no contact of the anesthetic with air;
• Accurate dosage of all components of the anesthetic. As a rule, the karpul contains not only the anesthetic itself, but also additional substances: vasoconstrictors (adrenaline or norepinephrine), as well as drugs that protect the anesthetic from destruction.
• A minimum of discomfort from the injection due to the fact that the carpool needle is much thinner than the needle of a conventional disposable syringe.

The previously used lidocaine and novocaine have already become a thing of the past due to a large number of shortcomings (low efficiency, frequent allergic reactions, etc.). Now they are used extremely rarely (mainly in public clinics). In modern dental clinics, preparations based on articaine and mepivacaine are used for local anesthesia.

Artikain is the most modern and effective anesthetic for local anesthesia. Various manufacturing companies produce carpool anesthetics with articaine under different names (« Ultracaine”, “Ubistezin”, “Septanest”, etc.). The composition of the carpula, along with articaine, usually includes a vasoconstrictor (adrenaline). It is necessary in order to prolong the effect of anesthesia and reduce the absorption of the anesthetic into the general bloodstream. Our clinic uses the original German drug with articaine "Ultracaine" with different dosages adrenaline (the most appropriate dosage is selected for each patient).

mepivacaine
It's a different kind of anesthetic. A vasoconstrictor is usually not included in the carpula with mepivacaine, because. mepivacaine itself has the ability to constrict blood vessels. However, the effectiveness of this drug is slightly lower than that of articaine. But this drug can be used for anesthesia in children, people with hypertension and in other patients for whom the administration of adrenaline is contraindicated. In these cases, a drug based on mepivacaine is used in our clinic. French production entitled " Scandonest».

Despite all the advantages modern anesthetics, there is always a risk of allergic reactions to any drug. Therefore, you should always warn your doctor about the presence of a tendency to allergies and about allergic manifestations in past. If you want to completely protect yourself from a possible allergic reaction for anesthesia, you can pre-take a blood test for hypersensitivity to the drugs used in the clinic.

Do not be afraid and postpone a visit to the clinic, because today you can cure or even install an implant without experiencing any pain!

Many people associate dental manipulation with terrible pains, discomfort, so visits to the dentist are postponed until a critical moment. Other patients do not have big amount time for extensive procedures.

To date, several methods and preparations are used in dentistry that can completely eliminate sensitivity, save time, and provide quality treatment teeth.

Local anesthesia in dentistry - advantages and disadvantages

Often, local anesthesia is used during the treatment/extraction of teeth. It is not as dangerous to health as general anesthesia, and thanks to it, you can almost completely get rid of pain. After its application, sensitivity to touch remains, which is often causes discomfort. To minimize such inconvenience, the patient is prescribed sedatives 1-2 days before manipulation.

Before proceeding with the treatment / extraction of teeth, the doctor conducts a conversation with each patient on the subject the presence of certain pathologies(including chronic).

To get the maximum effect from anesthetics, patients should remember a few rules:

• A few days before menstruation, during it you should not plan a visit to the dentist.
• Alcohol and drugs do not mix well. From alcoholic beverages you need to refrain one day before the start of treatment procedures
• At feeling unwell it is better to postpone manipulations with teeth.

There are several types of local anesthesia:

1. Infiltration.

Relevant in such cases:

• Pulp manipulation.
• Extraction of the dental nerve.
• Closing channels with fillings.
• Therapeutic measures on the anterior teeth.

Before the injection, the doctor treats the required area with a solution that creates a slight numbing effect. After that, by means of an injection, the drug is injected into the area near the root. The patient practically does not feel pain when the needle is inserted.

2. Conductor.

Required in the following situations:

• The previous type of anesthesia did not work well or didn't work at all.
• The doctor plans to treat several teeth at once that are nearby.
• The patient will surgical intervention on the lower dentition.

With the type of anesthesia under consideration, the drug is administered closer to the nerve. overall effect lend themselves underlip, gum and tongue from the side of the lower jaw.

3. Intraligamentous.

The injection site is the periodontal area. Doctors use a similar type of anesthesia for the treatment of caries, pulpitis, when removing teeth mainly in small patients. Children are not always able to adequately respond to numbness in the oral cavity: they can bite through their cheek or lip. Therefore, the use of intraligamentous anesthesia will be an excellent solution.

4. Stem.

• Have a place to be severe pain caused by trauma to the teeth / jaw, neuralgia.
• The patient needs surgical treatment.

This type of anesthesia is often used in hospitals, and the drug is injected through the scalp(near the spring). The effect of the drug strong and long lasting.

5. Application.

With this anesthesia needles and syringes are not used. The main tool is gel/spray which is applied to the gums.

Doctors apply this species pain relief when needed

• Achieve numbness of the zone, where they plan to inject.
• Eliminate stones on crowns.
• Handle gum edges.
• opened b abscess.

In some cases, due to the unprofessionalism of the doctor or for other reasons, during / after anesthesia, the patient may experience the following negative phenomena:

• Needle breakage during injection. It happens with sudden movements of the operated. It will not be difficult for the surgeon to remove the chip from the gum.
• Hematoma.
• Swelling due to an allergic reaction for a medication.
• Loss of sensation. The result of a needle hitting a nerve.
• Spasm of chewing muscles that occurs against the background of damage to blood vessels / muscles. This complication does not require additional measures: within 3-4 days it disappears.
• Infection. May occur when working with pathological tissues. Through the needle, microbes are transferred to a healthy area.

Modern anesthetics for anesthesia in dentistry - advantages and disadvantages of drugs for local anesthesia

Most dental clinics these days have switched to articaine drugs. In terms of their effectiveness, they are several times superior to Lidocaine and Novocain.

The main advantage of such anesthetics- the possibility of influencing the inflamed areas. Novocaine, Lidocaine similar situations practically useless.

Often, painkillers, in addition to articaine, contain adrenaline / epinephrine, which contribute to vasoconstriction, and help increase the strength of the drug.

Often, when treating teeth, doctors use the following anesthetics:

1. Ultracain.

The homeland of this medication is France. It is produced in three variations: with epinephrine (the concentration of which may vary), and without it. However, the absence of a vasodilator reduces the duration of pain relief to 20 minutes. You can even inject the drug for children (from 4 years old), pregnant women.

Each release form has its own contraindications(allergic reactions, errors in the work of the heart, lungs, malfunctions in hormonal system organism). Choose suitable look Ultracaine can only be a doctor.

2. Ubistezin.

The composition is almost does not differ from the previous anesthetic. It is produced in two forms, which differ in the concentration of epinephrine. Average duration actions - 40 min. It can be applied to patients who have heart pathologies, have problems with high blood pressure.

Often, Ubistezin is used when removing, filling teeth. The country of origin of the drug is Germany.

Consists of articaine, adrenaline, preservatives. It is forbidden to apply the anesthetic in question to allergy sufferers, but during pregnancy, lactation, children after 4, it is suitable.

Septanest works maximum 45 minutes.

4.Skandonest.

Due to the absence of preservatives and medicines that cause vasoconstriction this drug ideal for the following situations:

• Diabetes.
• Work failures thyroid gland.
• Heart disease.

5. The German analogue of Scandonest is Melivastezin .

Benefits of carpool anesthesia in dental treatment - indications and contraindications

The constituent component of the considered type of anesthesia - a special syringe where you can insert a medicine cartridge (karpulu). On the one hand, such an ampoule is tightly closed with a metal cap, on the other hand it has a rubber stopper.

When placing a container with anesthetic in a syringe, the rubber component should rest against the piston, and the doctor pierces the metal component with a disposable needle. The syringe itself can be used several times. Carpules, needles change every time.

Positive aspects of carpool anesthesia:

• Easy portability due to the parameters of the needle: its thickness is 2 times less than usual.
• Standard dosage. Each vessel contains 1.7 ml of the drug. It is easy to control the amount of the injected substance.
• Ease of injection. Due to the flexibility and strength of the needle, it is easier for the doctor to get to the desired area with minimal discomfort for the patient.
• Sterility. For each manipulation, disposable needles and new, sealed cartridges are used.

The disadvantages of this type of anesthesia are also available:

• Price. Compared to other types of anesthesia, this one will cost more.
• Inability to add to the ampoule additional drug(for example, a vasoconstrictor).

Is general anesthesia used in dentistry?

This type of anesthesia can be prescribed in the following cases:

• The patient is afraid of dental treatment and he has a strong sensitivity to pain.
• Local anesthesia does not give the desired results / is prohibited for health.
• The operator plans to work with a large area in the oral cavity(implantation of several teeth, complex surgery, etc.).
• There is a strong urge to vomit.
• The patient is diagnosed severe violations in work central nervous system.

There are 2 ways to apply general anesthesia:

• Intravenous. Works almost instantly.
• Mask. Popular among young patients, but its effect is short-lived.

General anesthesia in dental treatment simultaneously facilitates and complicates doctor's work. The surgeon can safely carry out various manipulations without worrying about unnecessary movements on the part of the patient, which can harm him. However, the doctor must adapt to the sleeping person: because he will not be able to open his mouth wider, or turn his head.

For the patient, this type of anesthesia is also controversial. Being in a state of pain sleep, he will not feel discomfort. If you need to treat several teeth, you can save a lot of time.

On the other hand, about general anesthesia negatively affects brain cells, it can provoke skin rashes, itching and other pathological phenomena.

In addition, this type of anesthesia has many contraindications. Therefore, the decision on general anesthesia can only be made by an appropriate specialist.

Features of anesthesia in the treatment of teeth in pregnant women

When anesthetizing the oral cavity in pregnant women, the doctor must make a choice in favor of the drug, which contains vasoconstrictor substances. This will slow down the penetration of microparticles into the placenta.

Often in such cases they use Ultracain or Ubistezin.

Sedation in dentistry - how to prepare a patient for dental treatment?

Through the manipulation partial/full sleep of the patient is achieved during dental treatment.

Indications for the use of sedation:

• The need for lengthy surgical procedures. For example, the patient came from another city, or he is too busy a person and is not able to set aside several hours every day for visits to the dentist. Local anesthesia does not remove discomfort + the operated person is always conscious. General anesthesia is not suitable for everyone, and it does not affect the state of health in the best way. In this case, sedation is ideal, which will relax, calm the patient and will enable the surgeon to work productively.
• Dentistry in children. If the child is too young, visits the dentist for the first time, he may resist any commands. In such cases, inhalation sedation is used, with a low vapor concentration.
• Fear of dental treatment.

Sedation features:

• Does not replace anesthesia. Be sure to use a local anesthetic.
• Check-up before sedation: ECG, blood test for infections, antibodies. With existence chronic pathologies in the anamnesis, additional studies may be prescribed.
• A sedative can enter the body in 2 ways: intravenously, through a mask (relevant for children).
• It is not allowed to consume food, drinks (including water) for 6 hours before the start of the procedure.
• The patient does not fall into deep sleep. Often, the injected drug causes a slight drowsiness.
• The procedure should be carried out under the supervision of an anesthesiologist, which will monitor the heartbeat, pressure of the operated.
• Sedation is prohibited for alcohol/drug addiction, serious injuries heads.

“A well-supported patient does not require anesthesia” - this well-known ridicule of dentists has lost its relevance when dental practice began to use anesthesia in the treatment of teeth. Today, going to the dentist no longer causes tremors in the knees, tantrums and tears. Remove a tooth, a nerve, fill the canals, put crowns, perform an operation on the pulp - perform any dental procedure now you can do it without pain and fear.

Types of anesthesia in dental practice

Anesthesia is used when it is necessary to reduce or completely block the sensitivity of the body. Depending on the clinical situation, individual features body, anesthesia can be performed in 3 options:

1. Local - specific areas of the oral cavity are subject to anesthesia.
2. General (anesthesia) - a complete blockage of the body's susceptibility to pain.
3. Combined.

Dental procedures under local anesthesia: types, features, contraindications

Local anesthesia is divided into several categories:

Attention! So that the therapy of diseased teeth using a local anesthetic goes without side effects, the patient must inform the specialist about hypersensitivity to painkillers, how he felt during the last visit to the dentist, whether local anesthesia was used then. According to these criteria, as well as the characteristics of human health and the severity of the problem, the specialist will determine the most harmless method of local anesthesia.

Video - Why do anesthesia for dental treatment?

Contraindications to local anesthesia

1. Hypersensitivity (allergy) to pain medication. If a person doubts a possible allergic reaction, then before doing anesthesia, the person must undergo allergic test in a specialized center.
2. Recently past illnesses heart (heart attack, stroke).
3. Diseases of the endocrine system.

The use of general anesthesia in dentistry

The expediency of this type of anesthesia is justified if:

1. The patient has a pronounced fear - dental phobia. A person experiences real horror and panic while sitting in a dental chair.
2. A person needs to undergo an extensive form of dental treatment.
3. The patient is allergic to local anesthetics.
4. The patient has neurological disorders e.g. cerebral palsy, autism, schizophrenia.

With this type of anesthesia, a person’s consciousness turns off. General anesthesia is not as safe as local anesthesia, it can disrupt the functioning of the body, lead to such side effects, How:

• nausea, vomiting;
• arrhythmia;
• bronchospasm;
• temporary increase or decrease in pressure;
• convulsions;
• stop breathing.

In connection with possible appearance side effects, resorting to anesthesia is prohibited:

1. During pregnancy.
2. With tonsillitis, bronchitis and other diseases of the respiratory system.
3. With heart disease.
4. In old age.
5. When under the influence of alcohol or drugs.
6. With an exacerbation chronic diseases, diseases in the acute period.

Attention! General anesthesia complicates the work of a specialist, because during it the doctor inserts a special tube that allows the patient to breathe normally, but makes it difficult for the doctor to work.

Combined anesthesia as an alternative to general anesthesia

If general anesthesia is contraindicated for the patient, and local anesthesia is not an option for a person suffering from panic disorder, then he can be offered combined anesthesia.

Its essence: the specialist gives the patient a sedative. The consciousness of the patient is preserved, however, the person quickly calms down. Then the doctor performs local anesthesia in the chosen way and only then proceeds to dental manipulations.

Attention! The advantage of combined anesthesia over general anesthesia is its safety and the absence of side effects.

Anesthesia in dentistry for pregnant women

Treating bad teeth for a woman in position is a must. It is impossible to endure pain and discomfort throughout pregnancy, expectant mothers should be attentive to their health and, if necessary, carry out dental treatment rather than postponing it for later. Otherwise, a diseased tooth can cause infection of the body of a woman and fetus, lead to serious complications, including miscarriage.

Treatment of diseased teeth in pregnant women is carried out only with the use of anesthesia. A woman in position is forbidden to endure pain, as this can lead to severe stress, adrenaline rush, which can provoke an increase in the tone of the uterus.

Attention! To relieve pain during dental procedures in pregnant women, only local anesthesia (injections) is used.

Most often, with local anesthesia of teeth in women in position, injections with a solution of " Lidocaine". Although this drug penetrates the placenta, it is excreted very quickly and does not harm the fetus.

Also, for anesthesia of teeth in pregnant women, the drug " Novocaine”, only in a smaller dosage than usual. Well-established and drugs such as " Mepivastezin», « Ultracaine". They do not cause side effects, do not cross the placenta, and have an excellent anesthetic effect.

Conducting pediatric anesthesia in dentistry

In the treatment of diseased teeth in children, specialists resort to the following methods of anesthesia:

Dental treatment with anesthesia important process, which allows the doctor to effectively carry out the manipulation, and the patient does not experience pain, fear and anxiety. Depending on the type of anesthesia, the characteristics of the patient's body, the doctor chooses desired method anesthesia. The patient's task is to tune in a positive way, inform the doctor about the characteristics of the body, the presence of allergies and diseases, and reliably and fully answer the specialist's questions. Only then the outcome of treatment will be positive, without side effects.

Previously, dentists of the past did not care much about the feelings of patients in the chair.

Today, there are many methods of local anesthesia that allow you to treat teeth of any complexity without pain and fear.

Modern painkillers make it possible to block discomfort not only for adults, but also for children.

At the same time, they can be administered both by injection and without the use of a needle.

Local anesthesia is the introduction of an anesthetic drug, due to which sensitivity gradually decreases in a certain area that needs dental manipulations. The active substances block the impulses that the nerve endings transmit to the brain.

In this case, the patient remains conscious and does not feel pain even during surgery. Blocking of nerve endings causes only a feeling of numbness of the area into which the drug was injected.

Indications

Perhaps it is easier to list dental procedures that are performed without anesthesia. Local anesthesia is applied:

• during the treatment of advanced caries;
• before removing the root system or the tooth as a whole;
• during the treatment of periodontitis;
• in the treatment of inflammatory processes and purulent foci;
• for the treatment of neuritis of the facial nerve;
• when it is impossible to carry out complex operations under general anesthesia.

It is worth noting the personal desire of the patient to resort to local anesthesia, even in cases where it is possible to do without it. Pain relief suppresses the feeling of fear of unpleasant sensations.

Functional features and their positive and negative qualities.

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Contraindications

The drug for local anesthesia should be selected for each patient individually. After all active funds painkillers, as in other drugs, have certain contraindications.

Therefore, before giving an injection, a professional in his field must make sure that the patient does not have an allergic reaction to any medications and concomitant diseases.

Local anesthesia is not suitable for patients:

• who have had a stroke or heart attack less than six months ago;
• with individual intolerance to painkillers.

Dentists adhere to some restrictions if:

• the patient suffers from thyroid disease, diabetes, which makes it impossible to use drugs containing vasoconstrictor components;
• have a history of heart disease or arterial hypertension. IN this case patients are contraindicated in local anesthesia, in which Epinephrine is present at a dosage above 1:200,000;
• needs treatment bronchial asthmatic. The anesthetic drug in this case should not contain sodium disulfide, which is a preservative.

Varieties

It is possible to anesthetize a certain part of the oral cavity by injection or by influencing the nerve endings in a way that does not imply a puncture of periodontal tissues.

Application

This method makes it possible to temporarily anesthetize the area being treated, due to the surface treatment of the oral mucosa with an ointment or spray. The drug is applied to the tissue by applying gauze swab to the gum

Application anesthesia allows you to achieve an instant effect. Sometimes, this type of anesthesia is used to reduce the discomfort from a future injection.

However, most often spray or ointments are used before professional cleaning or opening of abscesses located on the surface of the gums.

infiltration

The introduction of the drug is carried out by injection into the upper region at the root of the tooth. In this case, the injection is made both with the lingual (internal) and outside gums.

The introduced composition in this case is distributed in internal cavity teeth gradually.

This method of anesthesia is used by specialists most often. Dentists using infiltration anesthesia carry out the treatment of caries, pulpitis and other dental diseases.

For more information about infiltration anesthesia in children, see the video.

Conductor

Pain relief is achieved through the administration of current membership into the surrounding tissues of the nerve, due to which the pain impulses transmitted to the brain are blocked. Anesthesia spreads not only through the tissues, but also along the length of the nerve itself.

As a rule, in dentistry, the technique is used for manipulations in the lower part of the oral cavity.

Intraligamentary (intraligamentous) local

The injection is made into the periodontal ligament. Gingival puncture is carried out on both sides of the mucosa.

The difference between intraligamentous injection anesthesia is instant action drug. Therefore, intraligamentary anesthesia is often used in pediatric dentistry.

It should be noted that the drug is administered both through a needle and a reduced cartridge. For the treatment of diseases of the oral cavity in adults, the technique can be combined with other methods of anesthesia.

Intraosseous

Anesthesia is used for short-term dental manipulations, since, in comparison with other methods of anesthesia, its duration is not long-term.

The injection is made into the spongy bone between the two neighboring teeth. main feature techniques - the patient's cheeks and lips do not go numb. Therefore, at the end of the drug, there are no unpleasant sensations and a feeling of discomfort.

To reduce the sensitivity of the injection, dentists usually perform a preliminary application anesthesia.

In the video, see how anesthesia is performed using intraosseous anesthesia.

stem

This method of anesthesia is carried out only in a hospital setting. dental department. Anesthesia has the longest duration of action.

In addition, the injection is carried out not in the oral cavity, but in areas of the base of the skull. Blocking of impulses of nerve endings is carried out immediately throughout the lower or upper jaw.

Indications for such strong anesthesia are:

• complex surgical interventions;
• injuries of the facial bones;
• neuralgia;
• intolerable pain syndrome.

For children

All drugs used in pediatric local anesthesiology are harmful to one degree or another. small organism. Younger patients are especially sensitive to the action of painkillers.

Previously, Lidocaine and Novocain were used to block nerve impulses. Today, Mepivacaine and Arikain have the smallest list of side effects.

If we talk about the types of anesthesia used, then mainly in pediatric dentistry, the application, intraligamentary, infiltration and conduction methods are used.

Note! Due to fears and due to the unformed psyche, during the injection in the dental chair, the child may lose consciousness. Do not write off the reaction child's body on the unprofessionalism of a specialist.

Preparations

In modern dentistry, the following drugs are used:

1. Ultracain. The drug is produced under three types of labeling: "D", "DS" and "DS Forte". The last two are distinguished by an increased concentration of the vasoconstrictor component - epinephrine. Under the label "D", the French manufacturer produces a product without preservatives and vasoconstrictors.
2. Ubistezin. Composition active ingredients the drug is an analogue of "Ultracaine". The anesthetic is produced in Germany and is available in various dosage variations of the main components.
3. Septanest. It has a significant concentration of preservatives. Therefore, its introduction is often accompanied by an allergic reaction.
4. Skadonest. The composition of the drug includes up to 3% Mepivacaine. Vasoconstrictors and preservatives are completely absent in the anesthetic produced in France, and therefore the drug is suitable for patients who need restrictions on the composition.

Possible Complications

An ordinary, at first glance, injection can turn around unpleasant consequences. Among them are:

1. Needle fracture. Despite the fact that the injection tool element is made of durable metal, with sudden movement the patient, part of it may remain in the mucosa or periosteum. It should be noted that the probability of removing a small metal fragment without complications is much higher than when extracting a part of an element inserted to its full length.
2. Possibility of infection. Modern dentistry has reduced the likelihood this complication to a minimum through the use of disposable syringes. However, anesthesia of a pre-infected area of ​​​​the oral cavity can result in infection of a healthy area due to pushing pathogenic bacteria anesthetic.
3. Hematoma or bruise. The complication is the ingress of blood vessels into the tissues, which is most often observed during conduction anesthesia.
4. Swelling of tissues. A complication occurs with individual intolerance to the components of the drug.
5. Loss of sensation. Sometimes, blocking the transmission of impulses to the brain nerve endings delayed for several days or weeks against the background of nerve damage.
6. Burning or pain during the administration of the anesthetic. An unpleasant temporary reaction is absolutely safe for the patient's body.
7. Spasms of masticatory muscles or trismus. A complication is the inability to fully open the oral cavity. The phenomenon occurs due to damage to the muscles or vessels located in the infratemporal fossa and, as a rule, passes without any intervention in 2-3 days.
8. Soft tissue injury. Due to the lack of sensitivity of the tongue and some facial muscles, patients, especially children, may bite their lip or cheek. Therefore, until the complete end of the drug, it is recommended to refrain from eating.

At least a day before visiting a specialist, you should stop taking alcoholic beverages. Ethanol, which is the main component of these products, reduces the effectiveness of many methods of local anesthesia.

If on the eve of a visit to the dentist there was severe stress, at night it will be useful to receive sedative- extract of Valerian or Afobazole.

With dental treatment, it is better to wait in case of weakness during SARS. It is undesirable to carry out dental manipulations on the days of menstruation. During this period, increased nervous excitability is observed.

In addition, surgical intervention in critical days» for patients can result in prolonged bleeding.