Application anesthesia in dentistry. What is topical anesthesia? Complications caused by surface anesthesia

This article will tell you:

what is application anesthesia;
why is it needed;
what are the contraindications for this method anesthesia.

AT dental practice many anesthetics are used. The use of each pain medication is determined by the clinical situation and age category patient. Modern anesthetics effectively eliminate the pain that occurs during dental interventions. Analgesics can be administered by injections deep into soft tissues, but there is also superficial anesthesia - application anesthesia, in which the integrity of the tissues is not disturbed.

Application anesthesia in dentistry, it is implemented by applying an anesthetic drug to the mucous membrane or tooth tissue. The drug penetrates to a depth of up to three millimeters, blocking nerve impulses in the area of application. The effect of such anesthesia is not very strong, and applications cannot be dispensed with for operations with dental nerves. However, they are quite effective if you need to perform an operation on soft tissues or to provide preliminary pain relief when it is planned to treat the child's teeth. Deep injection of anesthesia involves an injection, which can be painful for the baby. And if you anesthetize the injection site before the injection, the child will not feel pain.

Pediatric dentists most often resort to the application method of anesthesia, since superficial preparations are less harmful and do not cause either pain or fear, unlike other painkillers, for which syringes are used. Surface pain relievers come in the form of gels, sprays, solutions, etc. The doctor applies the drug to the desired area with the help of cotton swab or other handy tool. To enhance action medicinal substances the dentist can mechanically rub the anesthetic into the area to be treated.

Cleaning of tartar in contact with gum tissue.
Extraction of mobile milk teeth and pathologically mobile permanent teeth.
Treatment of sensitive teeth.
Removal of casts from the dentition in a patient with increased gag reflexes.
Anesthetize the injection area before the injection.
Treatment of the mucous membranes of the oral cavity.
Intervention in periodontal tissues.

Given these indications, we can say that application anesthesia is suitable for patients of any age. Most of application preparations are non-toxic, and are safely used in the treatment of children (from two years old) and even pregnant women. Concerning general contraindications to the imposition of anesthetic applications, then only intolerance to the components of the treating substance is distinguished among them. But individual preparations may have particular contraindications and be harmful to children, diabetics, people with heart and vascular problems, as well as people with diseases endocrine system. Possible presence Contraindications should be assessed by a dentist prior to the administration of any anesthetic agent.

Types of drugs for application anesthesia

If application anesthesia is planned, the preparations for the procedure may differ according to the principle of action:

Anesthetics. This includes gels, ointments, aerosols based on anesthetics. The principle of their work is to block nerve endings, and suitable anesthetics for any occasion requiring the application of an anesthetic application. The most popular anesthetics include lidocaine, benzocaine, and tatracaine.
Dehydration. Carbonates (salts of carbonic acid) are removed from the dentinal tubules of fluid, thereby eliminating the symptoms of pathological sensitivity of hard dental tissues.
Physiological. Pastes based chemical elements or minerals can block pain. They clog the dentinal tubules, reducing the sensitivity of dental tissues.
Cauterizing. This category includes strong chemicals that eliminate tooth sensitivity. Now they are trying not to use due to high toxicity.

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Advantages and disadvantages of applications

Application anesthesia, like any medical technique, has strong and weak sides. The advantages of the applications are as follows:

performance. The drug begins to work within a minute after its application.
Safety. The application of the drug to the surface of the periodontium eliminates the spread of the active substance outside the required area, as a result of which it minimizes Negative influence painkiller to the body.
Convenient form. Application preparations are very easy to apply to the required surface, and for children they even produce painkillers in the form of sweets to facilitate the work of the doctor and cheer up the little patient.

The disadvantages of the application method of anesthesia include:

Short duration. Depending on the strength of the drug, pain relief can last from ten minutes to half an hour, while anesthetic injections relieve sensitivity for an hour.
limited effect. The scope of application of painkillers is small due to their weak action.
Difficulty in dosing. so that the concentration of the anesthetic does not exceed allowable rate, and the drug has not penetrated into the bloodstream, the dentist must very accurately calculate the required dose, which is not easy to do, especially when working with aerosols.
Vasodilating action. This effect can cause bleeding gums.

Application anesthesia: price

What will be the cost of application anesthesia depends on the drug used. Please note that for home use application anesthetics are not suitable because their incorrect use may cause side effects. If a tooth hurts at home, you need to take an analgesic tablet (Paracetamol, Analgin, Aspirin). And in dental office You will have to pay about fifty hryvnias for application anesthesia.

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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 the 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. Painkillers 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 today can be performed 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 funds are applied to the mucous membrane in place of the nerve endings of the tooth, the pores are blocked and their strong narrowing occurs, which contributes to the closure of the 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 the composition of the medical preparation 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.

Modern dentistry provides patients with a large number of services for the correction of dental defects. However, not all procedures can be considered painless. That is why during the majority of them application anesthesia is used.

What is the procedure?

It consists in the impact of special on the terminal nerve endings of the tooth without the use of a syringe. Naturally, different drugs provide miscellaneous action. Pain relief is superficial. The drug is applied to the desired area in the form of a gel, ointment or spray.

It should be noted that application anesthesia is not always allowed. Therefore, the type of anesthesia should be chosen by the doctor, depending on the operation to be performed, as well as on the characteristics of your body.

Indications for use

Local application anesthesia is usually done in such cases:

in the treatment of caries.
To reduce pain sensitivity in the area where the injection is to be made.
To painlessly remove a loose tooth.
To remove tartar.
In order to restore the natural shape of the crown.
To prevent the action of the gag reflex during the operation to remove the cast from the dentition.

Advantages and disadvantages of the procedure

Application anesthesia has some advantages:

High efficiency of action.
Safety for the patient.
No discomfort during anesthesia. The fact is that the drugs are applied with the help of cotton swab so it doesn't cause any pain.

However, there are also disadvantages. For example, the duration of most drugs is limited to 30 minutes, and the doctor may not have time to do everything necessary for this time period. Despite the safety of the use of drugs, they still penetrate the systemic circulation and can cause side effects. Another disadvantage of using such anesthesia is the inability to control the dosage of drugs that are made in the form of an aerosol.

Contraindications and side effects

Before application anesthesia is applied, it is necessary to study all contraindications that make it impossible to use this method of anesthesia. Among them are the following:

Individual intolerance to the drug or its components.
The occurrence of an allergic reaction.
Acute forms of heart disease and blood vessels, as well as a recent heart attack or stroke.
Diabetes.
Violation of the endocrine system.

The most important side effect of this pain relief is allergies. If the drugs used are dosed correctly, then complications can be avoided. Please note that you can not use such drugs at home. The presented type of anesthesia can be replaced. There are other ways to administer drugs.

Application and infiltration anesthesia There are two types of local anesthesia. In this case, the second of them is used in cases where it is impossible to use the first. differs in that it is administered by injection.

Types of application anesthesia

Before you carry out anesthesia, you need to figure out how it will be done. Most often it is classified according to the mechanism of action. Anesthesia can be divided into four groups:

Moxibustion. For its implementation, a nitrogen solution and other substances are used. However, this method is not always used, as it can severely damage tissues and pulp.
Dehydration. In this case apply special means, which can reduce the sensitivity of tissues to pain by reducing the amount of fluid in them.
Means of physiological action. These include aspirin paste, strontium paste and other substances. After the product has been applied to dental tissue, it blocks the conduction pain receptors in the dentinal tubules. Therapeutic effect in this case very pronounced.
Local anesthetic. It can block the conduction of peripheral nerve endings. Such a substance should be used to treat hard dental tissues.

What drugs are used?

If you need topical anesthesia, the preparations for its implementation should be chosen by the attending physician. There are enough of them. The most common are:

"Dicain" ("Tetracain"). This tool can be sold in the form of ointments, solution or special powder. It is used quite rarely, as it has a high degree of toxicity. For the treatment of teeth in children, it is better not to use it.
"Lidocaine". This is the most common drug that is used in children's and in adult dentistry. It can also be purchased in the form of an ointment and gel. There is also a liquid solution of this drug.
"Pyromecain". The medicine provides a good analgesic effect. It is available in ampoules or in the form of an ointment.
"Benzocaine". The presented drug is sold in the form of an oil or glycerin solution.
Alcohol solution of propolis. This substance is also able to eliminate pain.

Features of the procedure

So, before using a drug, such as a gel, for topical anesthesia, you need to make sure that the patient does not have an allergic reaction to it.

You can apply drugs with a cotton swab. In this case, the substance is either rubbed into the mucous membrane of the mouth, or simply applied to a specific area. If the anesthetic effect was not achieved the first time, then the procedure can be repeated. During anesthesia, it must be taken into account that each tooth differs from the other in the degree of pain perception. Therefore, in each individual case, a different dosage of the drug can be applied.

If the doctor decides to use an aerosol, then it is applied to the required area by spraying. It should be taken into account that the drug will also get to other parts of the oral mucosa. This may be highly undesirable.

If you need to undergo a dental procedure using anesthetics, you should not drink alcohol the day before your visit to the doctor. They can reduce the analgesic effect.

If you have fear at the mere thought of visiting a doctor, then at night you can take mild herbal sedatives. If there are infectious or inflammatory diseases in the body, it is better to transfer the treatment procedure.

Women should not go to the dentist during menstruation. This period is accompanied by increased excitability nervous system, as well as susceptibility to some drugs becomes stronger. This can cause severe bleeding.

In any case, the application (we have already considered the drugs) is very common. But only a qualified doctor can use it. Only he is able to assess the patient's condition, take into account the characteristics of the patient's body and determine the dosage of the drug. Be healthy!

Application anesthesia in dentistry in Latin means attachment. Many people don't like syringes that have sharp needles, especially when pointed at them. Therefore, scientists have developed a non-injection method of local anesthesia.

The emergence of topical anesthesia in dentistry means that it innovative way elimination of pain during dental operations. An anesthetic in the form of an ointment or gel is applied by the orthodontist to the mucous membranes of the oral cavity, the pulp and nearby hard tissues tooth.

Thanks to high percentage diffusion, the gel penetrates into the tissues by more than 2 mm, reaching its goal - the terminal fibers of the nerve endings. The downside is that the effect does not last long - about half an hour. Consequently, this way anesthesia is not suitable for long-term surgical procedures.

Application anesthesia is widely used in pediatric dentistry. Little patients are not afraid of injections and allow anesthesia to be carried out calmly. Plus, it is worth noting that milk teeth pass the drug much more efficiently, as they have a developed network of tubules in the dent. However, the anesthetic is used only for manipulations that leave a living pulp.

To increase the bioavailability of medicines, suction of accumulated saliva is carried out to isolate the required area.

The price of the drug is even lower than that of some injectable anesthetics, and fluctuates around two hundred rubles. That's why medical preparation available to people with different financial backgrounds.

The basis of the anesthetic is made up of three basic ingredients: benzocaine, lidocaine and tetracaine. All three chemicals dull pain by stopping the function of nerve endings.

Indications for use may be:

- simple caries that has not reached the pulp;

- hypersensitivity of dental nerve endings;

- grinding of the tooth surface before a longer operation or crown setting;

- pulpitis. A swab soaked in an ointment is placed at the bottom of carious corrosion, which removes the sensitivity of the nerve tangle;

- removal of dairy and permanent damaged teeth;

- removal of tartar.

However, like all drugs, application anesthesia has side effects that occur extremely rarely, manifesting themselves in the form of allergic reactions and inflammation. With the latter, hoarseness of voice, difficulty in breathing, due to inflammatory processes mucous membranes. allergic reactions consist in the aggressive perception of antibodies to the molecules of the drug, which are allergens. There is itching, swelling and redness of the mucous tissues.

Thus, it is possible to sum up the question what is topical anesthesia in dentistry. This is a painless method of anesthesia that does not involve long-term manipulations. Therefore, they are eligible to be used by experienced qualified orthodontists for short operations. The use of such anesthetics is excellent for the treatment and extraction of milk teeth. This is very useful and effective drug, on the action of which specialists work in the laboratory.

The development of the pharmaceutical industry has made it possible to minimize any discomfort patient during a dental appointment.

Application by a doctor various methods anesthesia guarantees the high-quality and full performance of all the manipulations necessary for the sanitation (improvement) of the oral cavity.

Most clinical cases held local anesthesia, suggesting an impact on peripheral departments nervous system.

During treatment, only the area of medical intervention in the oral cavity is anesthetized and the patient remains conscious. One of the methods of local anesthesia is application, by applying medications on the mucous membranes of the oral cavity.

General ideas about the methodology

The area of the oral cavity is achieved in two ways:

Injection.
By superficial impact on the mucosa without damaging its integrity. Methods for carrying out this manipulation can be:

physical;
physical and chemical;
chemical.

The scientific name of application anesthesia is non-injection terminal anesthesia. She refers to chemical methods temporary reversible decrease in sensitivity only in the surface layers of the oral mucosa.

The essence of this technique is the application, lubrication or rubbing of an anesthetic drug into the tissues to be anesthetized.

The advantages of application anesthesia are ease of implementation, atraumaticity, high efficiency and security. A wide range of modern painkillers allows you to use this technique not only in adults, but also in children.

Mechanism of action

Application anesthesia is the most in a simple way local anesthesia.

Its peculiarity lies in the fact that the impregnation of tissues with an anesthetic is carried out from the surface layers of the mucous membrane, on which the pharmaceutical preparation is applied.

Modern painkillers are available in the form of:

liquid solutions for applications;
ointments;
gels;
pastes;
aerosols;
cachets (tablet forms).

High efficiency and speed of application anesthesia is achieved due to a significant concentration of painkillers contained in local anesthetics. Active ingredients pharmaceutical agent quickly penetrate into periodontal tissues and block the activity of receptors and peripheral nerve fibers.

The mechanism of development of local anesthesia depends on the type medicinal product used for the application.

An anesthetic effect can develop due to:

blockage of microscopic periodontal pores, as a result of which the effect on nerve fibers is stopped;
narrowing of the lumen of blood vessels and pores of the mucous membrane.

Also, local anesthetics include fluoride varnishes, for anesthesia of hard tissues of the tooth.

Indications and contraindications

Application anesthesia is carried out in the following clinical cases:

preliminary anesthesia before injection anesthesia;
removal of milk and permanent mobile teeth (III degree);
orthopedic treatment - during fitting (fitting) of crowns and bridges;
removal of hypertrophied areas of the gums ();
opening of submucosal abscesses;
as part of complex therapy and stomatitis;
relief of a pronounced gag reflex.

Some types of local anesthetics are applied directly to the hard tissues of the tooth.. Such anesthesia is used to treat caries.

Application anesthesia is prohibited for:

if the patient has hypersensitivity to the action of any component local anesthetic;
children under the age of 10 years - when using certain painkillers.

Possible side effect application anesthesia - the development of allergic hypersensitivity varying degrees weights. However, the preliminary collection of general somatic and allergic history, avoids the occurrence of complications during the dental process.

Application anesthesia technique

The high efficiency of local anesthesia is ensured by strict adherence to the algorithm for its implementation:

Preliminary disinfection of the oral cavity - rinsing the mouth antiseptic, for example, a solution of furatsilina.
Isolation and drying of the mucosal area from saliva that needs to be anesthetized (covering with gauze napkins).
Application of a pharmaceutical agent to the mucous membrane. Liquid anesthetics are applied using a cotton or gauze ball soaked in medicinal solution. Gel preparations are spread on the surface operating field thin layer with a spatula. Aerosols are sprayed within a few seconds.
The local anesthetic is left on the surface of the surgical field for 1-3 minutes, after which its remains are removed with a gauze cloth and the sensitivity of the treated area is checked with a needle or probe. If the quality of anesthesia is unsatisfactory, it is repeated.

Despite the wide prevalence and convenience of using painkillers in the form of aerosols, it is undesirable to use them. Disadvantages of such anesthetics: - poor control of the spray area and dosage of the drug, the risk of drug getting into the upper Airways patient, professional allergization of the dentist. In any case, painkillers are best applied with a cotton swab.

Regardless of the type of local anesthetic, the analgesic effect appears 1-3 minutes after its application and lasts 15-20 minutes.

Drugs used for topical anesthesia

The main local anesthetics used in dental practice:

- used in the form of 5-15% aerosol solutions, 2-5% ointments and gels;
Silver nitrate, carbolic and trichloroacetic acids are available in solid form (lapis) or as a solution. They have a cauterizing property, so their use in children is limited;
Septodent (Anekstopulpa) is a fibrous paste that has an anesthetic and disinfecting effect. It is applied to the hard tissues of the tooth for pain relief in caries;
Dikain (Tetracain) - is available in the form of 0.5-4% solutions and ointments. Due to high toxicity, it is not used in children under 10 years of age;
Pyromecaine (Bumecaine) - is available in the form of a 5% ointment and a 2% solution. The intensity and duration of the analgesic effect is not inferior to Dikain, but less toxic;
Anestezin - used in the form of 5-20% oil solutions, ointments, pastes, powders;
Calgel is a dental gel used for painful teething, as part of the complex therapy of gingivitis and stomatitis;
Sensigel is a gel containing fluorinol and potassium. It is used to reduce the sensitivity of teeth, to protect them from external stimuli;
Fluoridine, Bifluorid 12 - fluorine-containing varnishes used for therapy high sensitivity(hyperesthesia), prevention of caries, anesthesia during the removal of dental deposits;
Carbamide, soda gruel, hypertonic solution- means used for hyperesthesia of hard tissues of the tooth. Decreased tooth sensitivity is due to dehydration of their tissues after the application of the drug;
Drill - lozenges for resorption, which have analgesic and antiseptic effects.

You cannot buy and use painkillers on your own. The choice of anesthetic agent is carried out by the dentist, based on the data of the collected anamnesis and taking into account the complexity of the necessary medical intervention.