ANESTHETICS, ANALGESICS & SEDATION
Anaesthetics reduce or eliminate discomfort. Anaesthesia works to numb the area where your dentist is working. A local anaesthetic will temporarily block the generation and conduction of nerve impulses. This is commonly called freezing. An anaesthetic solution is injected into the area surrounding the nerve which blocks the action of the nerve. The action of the blood stream will eventually carry the solution away. There will be a sensation of warm water flowing to the area as the anaesthetic is reversing.
The most common type of local anaesthesia is Lidocaine mixed with a percentage of epinephrine (adrenaline). Epinephrine constricts the blood vessels causing the heart rate to increase and blood pressure to rise. If the dental patient has a history of high blood pressure or a serious heart condition, the dentist may use an anaesthetic that does not contain epinephrine. If is very important to provide your dentist with a complete and up-to-date medical history.
General anaesthetic will render a patient unconscious during the procedure. This type of anaesthetic may be used for the removal of wisdom teeth or other more extensive surgical procedures. General anaesthetics may be administered only by qualified professionals with training in anaesthesiology. A preoperative physical examination may be necessary and postoperative visits during the recovery stage. It is important to know that the patient should not have anything to eat or drink at least 8 hours prior to the procedure. He/she can brush their teeth in the morning, but they need to spit out the water after rinsing. The patient may become nauseated during the procedure and there is a risk of aspiration during the anaesthetic. The vital signs will be monitored before, during and after the procedure. The recovering patient should not walk alone or drive an automobile. He/she should be accompanied to and from their appointment. Any unusual side effects need to be reported to the dentist immediately.
Analgesics and Sedation
Dentistry today is virtually pain free, however, client comfort in a dental office is provided by using various methods of pain control. Analgesics are drugs that dull the perception of pain. They are available in non-narcotic and narcotic forms. Commonly used analgesics are aspirin and ibuprofen. Along with relieving pain, these analgesics contain anti-inflammatory properties that will reduce swelling and help eliminate fever. Mild non-narcotic medications are used to relieve low intensity discomfort. If you are experiencing more than moderate pain, your dentist may prescribe a stronger analgesic that may contain a narcotic such as codeine. These are combination drugs like Tylenol #3 which is a mixture of acetaminophen and codeine. Occasionally a dentist may prescribe analgesics that have a longer lasting effect like Percodan or Demerol. Since these drugs carry a potential for addiction, the dentist will prescribe them in limited amounts and only in extreme circumstances.
Sedatives are sometimes used to relieve a patient’s anxiety. Sedatives can be administered orally, by injection or inhalation. Conscious sedation reduces the patient’s level of consciousness. Nitrous oxide (laughing gas) or Valium is a form of conscious sedation. Nitrous oxide and oxygen are inhaled by the patient through a face mask or nasal prong. The patient will become very relaxed yet remain conscious and there are usually no side effects. You will become very relaxed yet remain conscious. This type of sedation may be recommended for patients who have a high perception of pain sensitivity or if they have a sensitive gag reflex. This treatment is not recommended for a patient who has a respiratory condition, is a young child, has multiple sclerosis or is emotionally unstable.