Preparations for application anesthesia in dentistry. Application anesthesia in dentistry. What drugs are used

Just ten years ago, the need to visit the dentist in most people caused a feeling of fear and discomfort. Today the situation has changed, and even small patients are happy to go to a meeting with a dentist. Such a radical change is associated with the latest advances in medicine, which made it possible not to feel pain during dental procedures. The so-called application anesthesia is gaining more and more popularity among doctors and patients every year.

What is topical anesthesia

Application anesthesia is a procedure for pain relief in dentistry, performed by a doctor by applying to a specific place in oral cavity special painkillers on the nerve endings of the tooth, while anesthesia is superficial. Anesthesia in dentistry can be achieved by the use of anesthetic drugs or by physical and chemical influences. The procedure does not involve the use of a syringe for anesthesia.

At use medications, the agent is applied with a swab or by direct application to the site of anesthesia. Pain relievers may have the consistency of an ointment, gel, or spray. With the physico-chemical method of exposure, the method of cooling or cauterization can be used.

In most cases, anesthesia in dentistry is achieved by using special drugs. Application anesthesia can be produced today various means, which differ not only in appearance and method of application, but also by the strength of anesthesia. Often such products have additional aromatization, which makes the procedure more comfortable for the patient. The use of application anesthesia is not always allowed, therefore, the decision on the possibility of its use is made by the doctor, taking into account the complexity of future manipulations and the characteristics of the patient's body.

Existing methods of anesthesia

Today, in dentistry, application anesthesia involves several methods. anesthesia:

Methods of anesthesia that are not associated with the use of anesthetic drugs for local anesthesia, are used in dentistry much less frequently.

Moxibustion

The cauterization procedure involves superficial anesthesia through the use of aggressive drugs. To such funds relate:

• Nitric acid;
• carbolic acid;
• zinc chloride;
• silver nitrate.

When applying funds to the mucous membrane in place nerve endings the tooth is clogged pores and their strong narrowing, which contributes to the closure of nerve endings from external influences. The cauterization procedure has been known since ancient times, but in modern medicine is used quite rarely, which is more associated with the high toxicity of drugs and severe tissue damage when it enters potent means on the mucosa.

Dehydration

Anesthesia by dehydration involves the use of special agents for anesthesia that have a dehydration effect. As such drugs carbonate or bicarbonate is used:

Often this type of anesthesia is used when brushing teeth or minor manipulations with them.

Physiological impact

With this method, anesthesia is achieved by applying special pastes, the components of which act on receptors and block the transmission nerve impulses. These pastes include: kinds:

• aspirin;
• glycerophosphate;
• strontium.

Such pastes are often used for therapeutic purposes in the treatment of teeth with problematic enamel, dentitis.

Advantages and disadvantages

Anesthesia aims to minimize pain during dental procedures. To virtues procedures include the following:

• speed of action of anesthesia;
• uniform distribution over the cells of the mucosa;
• effectiveness and efficiency of action;
• high degree of security for the client;
• the minimum level of discomfort during anesthesia.

The disadvantage of anesthesia by the method of application anesthesia is considered to be an insignificant duration of the effect. Max Time anesthesia is 30 minutes. This time is very often not enough for the doctor to carry out all the manipulations. Drugs used in machine anesthesia are considered safe compared to traditional anesthesia. Despite the high degree of safety for humans, the drugs still penetrate the human bloodstream and can cause side effects.

Another of the significant disadvantages of anesthesia is the impossibility of controlling the required dosage of the drug.

In what cases is topical anesthesia used?

Application anesthesia is used when performing the following procedures:

What are the contraindications

There are a number of specific contraindications in which the use of topical anesthesia prohibited. This list includes the following contraindications:

• individual intolerance to the components of the anesthetic drug;
• propensity to develop allergic reactions;
• recent heart attack or stroke;
• acute diseases hearts or blood vessels;
• Availability diabetes;
• disturbances in the work of the endocrine system.

The most common side effect of application anesthesia is the occurrence of an allergic reaction to the action of the drug. In order to exclude similar situation needed correct dosage drug. It is forbidden to use painkillers for application anesthesia at home on your own.

What are the drugs for local anesthesia

Today, there is a huge offer of concentrated anesthetics used in application anesthesia on the medical drug market. Although independent application such drugs are prohibited, it is worth having information about the painkillers used by the doctor.

Most often in dentistry, drugs are used that contain the following: Components:

Often included in medicinal product includes an antiseptic, flavors, various anti-inflammatory components. Today there are quite a large number of anesthetic drugs.

"Diplan LH"

The drug for application anesthesia is film, which contains antibacterial and analgesic components. The film is glued to the immediate place of anesthesia.

The film consists of two layers impregnated with lidocaine and chlorhexidine. The analgesic effect after applying the film can be observed after 1 minute. After surgical manipulations, the film can be left at the site of application, since after 12 hours the layers of the film will resolve themselves.

"Topex"

The drug is available in the form of a gel, which allows you to apply it directly to the site. anesthesia. To obtain an analgesic effect, it is enough to wait a period of time of 1-2 minutes.

"Disilan"

The drug is available in the form spray, main active substance which is benzocaine. Anesthesia when using an anesthetic is observed for a short time, which is no more than 15 minutes. The advantage of the drug is considered to be a small concentration of benzocaine, which allows the use of the drug in children from 5 years of age.

"Desensetin"

The drug belongs to the category of fast-acting anesthetics. The main active ingredient is lidocaine. After application, the effect of anesthesia appears within 10 minutes.

How does pain relief work

Application anesthesia shows good effect anesthesia only if all the requirements of the technology are met. Before direct application of the drug, the doctor dries the mucous membrane and the surface of the tooth.

medicinal product, depending on the type, rubbed to the place of anesthesia, or it is irrigated. At correct application anesthetic and dosage, the total depth of anesthesia should reach 3 mm. The duration of anesthesia depends on the concentration of the main active substance.

As a rule, the duration of action of the anesthetic is from 10 to 30 minutes. It is allowed to reapply the substance for more lasting effect anesthesia.

With application anesthesia, a number of side effects effects. The use of an anesthetic for some time leads to a loss of sensitivity of the mucous membrane, so people very often injure it as a result of biting.

Despite more comfortable conditions with application anesthesia, compared with traditional anesthesia, some patients experience a psychological imbalance, as a result of which dental phobia may develop.

• on the eve of a visit to the doctor is not allowed to use alcoholic beverages;
• the procedure should not be carried out in the presence of inflammatory or infectious diseases;
• women are not recommended to do anesthesia in the first days menstrual cycle;
• the doctor before anesthesia should make sure that the patient has no allergic reactions to the drug.

Some dental procedures involve the preliminary administration of an anesthetic to reduce sensitivity and the ability to freely perform medical manipulations.

But the injection method is not suitable for all patients due to allergies or hypersensitivity to injections. In such cases, it is more appropriate to use topical anesthesia in dentistry.

What is topical anesthesia?

The application method of anesthesia is a procedure that involves the local application of a concentrated anesthetic to the soft tissue area where medical manipulations are planned to be performed.

In this case, no injections of anesthetic drugs are used.

To block impulses to nerve endings, they can be used as medications, and physical and chemical influences (cauterization with nitrogen, dehydration, etc.).

Main advantage application anesthesia It consists in a quick action, which is achieved due to the instant penetration of the active substances of the agent into the periodontal tissues.

After rubbing into the mucous membrane, the anesthetic is rapidly distributed over the cells, blocking the sensitivity of the nerve endings.

Where is it applied?

Application anesthesia is used on the mucous and skin at the following medical services:

Thanks to low content toxins in the composition of the drugs used and the convenient method of application, the application method is preferred in pediatric dentistry.

Little patients are most afraid of injections, sometimes because of fear they have to postpone healing process. BUT topical application funds in the form of a cream or gel does not cause children negative emotions.

Indications for its use

Application anesthesia is widely used in dentistry.

• professional cleaning oral cavity;
• any manipulations with the periodontium;
• opening of purulent capsules on soft tissues;
• treatment of stomatitis, gingivitis and other diseases of the oral cavity;
• removal of the neurovascular bundle of the pulp;
• extraction of molars or milk teeth;
• fixation of prosthetic structures.

When taking bite or tooth impressions, some patients experience vomiting reflex. In this case, it is also appropriate to use topical anesthesia.

How is the procedure in dentistry?

The procedure for anesthesia by the application method is carried out in the following order:

Kinds

There are several types of application anesthesia, the distinctive quality of which lies in the mechanism of action of the active components:

The right to choose the type of application anesthesia remains with the specialist, who takes into account the characteristics of the patient's body and the state of his health.

Used drugs

It is possible to achieve the effect of stopping the sensitivity of dental and periodontal tissue using preparations that include the following active substances:

Release form

Preparations for topical anesthesia are available in different form, each of which has the advantages of using on a specific area of ​​\u200b\u200bthe skin or mucous membrane. For solutions dental problems most the best option considered a gel, as it is more resistant to saliva washout.

In addition to the gel on the market, funds are presented in the form of:

• ointments;
• solution (alcohol / water);
• cream;
• spray;
• aerosol;
• powder;
• lozenges;
• film plate.

Before using any remedy, you must read the instructions for use to exclude the manifestation of side effects as a result of an overdose.

Most Popular Tools

The range of painkillers used for topical anesthesia is quite wide. This makes it possible to choose the appropriate option in each individual case.

The main disadvantage of the application technique is the difficulty in determining the dosage, but this does not apply to the drug Diplen LH. The agent is produced in the form of a film with a sorption capacity.

The product consists of several layers (hydrophobic, hydrophilic) impregnated with Lidocaine and Chlorhexidine.

It is enough to stick the film to a certain area of ​​the gums, within one minute the desired effect (anesthetic, antibacterial) occurs. If an injection is planned, then the puncture is made directly through the film.

The product is available in the form of a spray, used in dentistry for procedures whose duration does not exceed 15 minutes. The active ingredient is benzocaine, a small concentration allows the drug to be used to block gum sensitivity in children (over 5 years old).

Release form - gel. Topex is applied during the application method of anesthesia on the gums 1-2 minutes before the start medical procedures. This option allows you to eliminate a small dental problem. The active substance is benzocaine.

Spray based on lidocaine, available in 15 ml bottles. The tool has an excellent thixotropic property, quickly acts on the receptors of the treated area. It can be applied pointwise, the aromatic additive makes the procedure pleasant.

Anesthetic gel Lidoxor, in addition to the main component - lidocaine, contains extracts medicinal plants, fragrance. Available in 3 flavor categories: citrus, green apple, wild berry. The agent begins to act already 1-2 minutes after the treatment of the problem area.

Application infiltration anesthesia

With application anesthesia, the needle is not used, the agent used is applied cotton swab or finger directly on the treated area.

The active components of the drug penetrate deep into the tissues by about 3 mm. This is enough to perform a quick simple operation on a tooth or gum.

The infiltration method of anesthesia involves the use of a needle to inject an anesthetic.

This method provides more prolonged action drug, so it is used to perform complex and lengthy manipulations.

If the patient experiences discomfort from injections, then a decision is made to use a combined anesthesia scheme: first, using the application method, the sensitivity in the puncture zone is reduced, then more effective drug.

Given the specifics of dental treatment, as well as the nature of the development of the disease, depending on the location of the incisors and molars, we can conclude that infiltration anesthesia will be more efficient for upper jaw.

Puncture into a porous surface alveolar process creates less discomfort for the patient than dense fabric mandible. In turn, application anesthesia is more often used to solve dental problems in the lower dentition.

Advantages and disadvantages of topical anesthesia

The main advantage of topical anesthesia is fast action components of the drugs used.

In addition, the method has a number of other positive factors:

When choosing a method of anesthesia, it is worth considering not only positive sides methods, the shortcomings deserve no less attention.

Among the main ones:

• the difficulty of complying with the dosage (when using more funds active ingredients drugs enter the systemic circulation, causing allergic reaction);
• painkillers have vasodilating effect, and this increases the risk of bleeding;
• the scope of the application method is limited due to the lack of a deep analgesic effect.

Contraindications

Before using this or that drug, it is necessary to study the contraindications indicated by the manufacturer.

In the case of the application anesthesia technique, specialists distinguish following restrictions:

During pregnancy, the use of any medication should be agreed with the attending physician. The most acceptable method of anesthesia is application anesthesia.

In this form of drug use, the active components do not enter the general bloodstream, which eliminates their effect on the formation of the fetus. When applying a gel or paste to the oral mucosa, nerve endings are blocked, which reduces sensitivity.

Besides modern facilities have virtually no side effects, and chemical substances quickly excreted from the body, without harming either the woman or the child.

But, according to scientists, the action application anesthetics on pregnancy and children under 2 years of age has not been studied enough. Therefore, it is worth resorting to surface anesthesia only in extreme cases.

Side effects

The most common side effect of drugs used for topical pain relief is allergic manifestations:

The risk of complications increases if the recommended dosage is violated.

Despite the high quality of anesthetics, it is not recommended to use them on their own at home.

When the drug enters Airways may be observed:

• hoarseness of voice;
• difficulty breathing.

In the process of restoring full sensitivity of the oral mucosa, soft tissue injury may occur as a result of uncontrolled biting.

Application anesthesia is a method of pain relief applied without the use of injections. Here, the anesthetic is applied directly to the area that needs to be anesthetized. It can be both the mucous membrane and the surface of the skin, depending on which area it will be applied. this technique. If you are offered to use, for example, topical or, but you don’t know what it is, don’t worry, all these names are synonymous with application anesthesia and refer to the same type of anesthesia.

As we have already said, the technique of application anesthesia is successfully used in various branches of medicine. Let's take a closer look at where you can encounter it.

Application anesthesia in cosmetology

In cosmetology, there are a number of enough unpleasant procedures that require anesthesia in order to create the most comfortable conditions for the patient. But at the same time, the use of injections in this case is not at all necessary, and application anesthesia comes to the rescue. If you do hair removal, artistic tattooing, Botox injections, piercings and other painful cosmetic manipulations, most likely the vulnerable spot will be treated with an anesthetic, which will significantly reduce discomfort from procedures.

In otorhinolaryngology

Here, the technique is applied to carry out small surgical interventions, as well as during various manipulations in the nasal cavity.

In ophthalmology

Here, this technique is used to measure intraocular pressure, in case it is necessary to extract a foreign object, with gonioscopy, with various, more or less simple surgical interventions on the cornea of ​​​​the eye and with a disease such as conjunctivitis.

In urology

Here, such anesthesia is successfully used when installing a urinary catheter, the urethral mucosa is processed. It is also possible to use this technique for other unpleasant procedures that accompany the treatment of diseases of the genitourinary tract.

In gynecology

Here, most often, a local anesthetic is treated with a portion of the cervix in the treatment of its erosion.

Application anesthesia in dentistry

We will talk about the use of local application anesthesia in dentistry in more detail, since this technique is used most often in this area.

Mainly, application anesthesia is common in pediatric dentistry, since this method is the most painless and causes the least fear in children. Application anesthesia preparations for children during dental treatment are available in the form of gels with a variety of pleasant tastes (for example, fruit, berry), which makes the anesthesia procedure not only painless, but also pleasant.

Indications for the use of such anesthesia in dentistry, except for childhood:

• The so-called "pain before anesthesia", that is, a local anesthetic is applied to the place where, subsequently, an injection with a more serious medicine will be given
• Suturing
• Opening of abscesses located on the surface
• Removal of mobile teeth in periodontal disease
• Dressings
• Punctures
• Removing tires
• For ulcers and erosions

Methodology

• The mucous membrane must be dry before applying the anesthetic, so it is usually blotted with a cotton swab or dried in other ways.
• The anesthetic is applied to a bandage swab and applied to the desired place for about 30-40 seconds (the time during which anesthesia occurs)
• If the medication is released in the form of an aerosol, it is sprayed to the right place at a distance of 2-3 cm.
• Typically, application anesthesia lasts about 15-20 minutes.

Preparations for application anesthesia

Anesthetics that are used to carry out this particular technique are available in various forms. It can be either a gel, or a liquid, or an aerosol. According to the technology of impact on the body, drugs are divided into cauterizing, dehydration, local and physiological effects.

Most often this method is used:

Very often in dentistry, a gel called Empla is used. It can be applied every ten minutes for an hour.

Possible complications and side effects

Even such a seemingly simple and safe method There are a number of side effects to be aware of.

First of all, it is worth noting that if you are allergic to any of the drugs used, this is an absolute and most important contraindication to the use of this technique.

It is allergy that is the most important side effect after such anesthesia. It can manifest itself in the form of a rash, redness, as well as swelling of the skin and mucous membranes. AT rare cases it is possible to develop a more severe reaction - anaphylaxis.

As a side effect, damage to the skin and soft tissues is also possible, especially if the dosage of the drug is incorrectly calculated. That is why the use of topical anesthesia at home is highly discouraged.

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Application anesthesia is most often a viscous substance that is rubbed into the skin in the form of an ointment, gel or spray with an aerosol. The analgesic effect is the result of exposure to chemical elements, medical preparations and the anesthetics contained in them on the nerve endings of the tooth root.

Scope of application anesthesia

Application analgesia (anesthesia) is used to reduce the susceptibility at the injection site and for an analgesic effect on slime layer. Application anesthesia is used mainly by dentists to eliminate caries, remove loose milk or molars teeth, open mucous inflammations, get rid of tartar, when soldering crowns and general prostheses bridge type that are attached to the gums. It is also used to reduce nausea during impression making and to reduce pain with many diseases of the mucous layer of the oral cavity (gingivitis and stomatitis pathologies).

This method of anesthesia is practically harmless and extremely effective for the patient. The analgesic effect of this remedy begins in just a couple of minutes and does not go away within an hour.

According to the nature of the analgesic effect, anesthetic drugs are divided into 4 types:

1. Means that have features that allow you to cauterize the necessary areas (acidic nitrogen, zinc chloride solution, potassium hydroxide, carbolic acid, dissolved silver nitrate, etc.). But all of them have not gained wide distribution in the field of applied dentistry due to the fact that they have a pronounced toxicity and high risk damage the pulp area and other tissues involved in the formation of the tooth cavity.
2. Dehydration substances (sodium, potassium, magnesium and other carbonate and hydrocarbonate materials of mineral origin). These medicines reduce the vulnerability of hard parts of the tooth to painful reactions by removing fluid from there.
3. Preparations of physiological effects (pastes from fluorine, strontium, aspirin, sulfidine; paste from calcium glycerol subphosphate and others). These drugs, when in contact with the tissues of the tooth, have a special effect on the receptors of the dentinal passages, preventing the reception of a pain signal. These and other biologically related chemicals have a pronounced therapeutic result. Therefore, they are used in the treatment of a qualitative increase in the susceptibility of the hard zone of dental tissue.
4. Local anesthetics (Platonic liquid, Shinkarevsky's substance, Hartmann's liquid, Groshikov's solution, etc.). When covering hard areas of dental tissues, these drugs block the conduction of external nerve endings. In this situation, the anesthetic is almost always applied in liquid form.

Features of the use of certain drugs

Application medications, when using which the analgesic result is obtained due to the effect of temperature-lowering substances (for example, ethyl chloride), are not used in dentistry because of the danger of their getting into the respiratory organs, as well as interaction with too sensitive teeth, a sudden drop in temperature which can cause incredibly severe pain.

The main disadvantage of using aerosol anesthetics is the large area of ​​anesthetic spray, which entails almost complete impossibility exact dosage. due to high concentration medicines and their characteristic effect on vasodilation, being in the blood, they accumulate there to toxic volumes as rapidly as in subcutaneous injection. More to the cons this method Usually, the psychological inconvenience of patients due to a long-term decrease in the susceptibility of the mucosa, as well as a high chance of biting tissues in the oral cavity, especially in preschoolers, is considered. local anesthetic while it can be anything.

The doctor can eliminate pain when a tissue is punctured with a needle using methods such as: distracting the patient's attention with something; squeezing the soft tissues supported by the palm during an injection; asking the patient to deep breath before injection; injection of small volumes of anesthetic only in the area of ​​​​the intended entry of the needle.

Indications for the use of topical analgesia

Application anesthesia (analgesia) is a subtype of local analgesia.

It is used when dental procedures not to use general anesthesia. Application anesthesia in the dental field is considered to be an effect in which the mucous layer of the oral region is impregnated with a local anesthetic. This tool causes a change and inhibition of the activity of nerve endings, which entails a blockage of pain and spasmodic sensations.

Usually this species anesthesia is used in the following cases:

• extraction of tartar and harmful plaque;
• operational actions at the border of teeth and gums;
• disclosure of inflammation;
• analgesia of the injection site;
• extraction of the affected pulp;
• disclosure of suppuration;
• pulling out milk teeth;
• fixing bridge implants and crowns, acting as substitutes for part of the tooth.

Drugs that are intended for application analgesia have various forms: liquid, gel, viscous ointments, aerosol preparations, sprays.

The anesthetic drugs used in topical analgesia include:

• tetracaine (dicaine); applied in the form of powders for sprinkling, liquids and ointments. This tool is poisonous because its use is limited;
• lidocaine drug; used in the form of liquids, gel and ointments;
• pyromecaine solution (otherwise it is called bumecaine); produced in the form of ointment, gel and liquid ampoules;
• anesthetic drug (benzocaine); most commonly sold as glycerin or oily liquids;
• an alcoholic solution of a propolis substance that has an analgesic effect.

How Anesthesia Works

Cauterization is carried out with a thirty percent solution of silver nitrate. Active substances remove water from tissues, thereby reducing susceptibility and eliminating pain.

Pastes based on strontium, sulfidine, aspirin, and fluorine have a physiological effect. Means of local analgesia reduce the conductivity of nerve endings, stopping pain syndromes. Surface anesthesia is quite effective for minor operations.

This area is represented by a huge selection of anesthetics. home salient feature application analgesia consists in the fact that the tissues are pre-treated with a disinfectant, dried and eliminate the possibility of salivary discharge at the site of application of this type of analgesia.

The analgesic effect is usually manifested after spreading, rubbing or applying an anesthetic to the tissues.

The duration of analgesia with this method of anesthesia is usually no more than 25 minutes, the depth of the anesthetized tissues is no more than 4 mm, the result is felt after 3 minutes.

Since anesthesia goes only to a shallow depth, then, if necessary, the manipulations are repeated.

The effect can be enhanced if an agent with a strong penetrating effect (Dimexide, Lidazine, and others) is added to the anesthetic. During application analgesia of the hard tissue of the tooth, it must be remembered that the tooth region has a different susceptibility in some areas. To side effects analgesia must be taken very seriously. The same applies to contraindications.