Anesthesia during caries treatment. How to painlessly treat cavities in teeth?

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Many patients associate the treatment of carious lesions on the teeth with a very strong pain. Borrowing and cleaning the caries cavity are uncomfortable procedures that discourage patients from visiting the dentist. What is anesthesia for caries treatment? What are the types of anesthesia and how long does it last? Can anesthesia be given to every patient?

Caries – general characteristics

Tooth decay is a disease caused by bacteria. In the human mouth, more than 300 species of bacteria have their habitat, and their total number is up to 50 billion. Most of the bacteria that make up the physiological flora of our mouth are not harmful to the structure of the teeth. They break down sugars or produce organic acids. The moment bacteria break down sugars, acid forms in the mouth that lower the natural pH in the mouth. Then, the enamel is demineralized, in which calcium ions are washed away. In this case, the tooth surface becomes porous and a white spot appears on the enamel, which is the beginning of caries. It may darken under the influence of food dyes. At this stage, the tooth decay process can be stopped and then drilling of the teeth will not be needed. However, if the affected tooth is neglected, more harmful bacteria will enter its interior, which will very quickly begin to damage the dentin. This creates a cavity called a carious cavity.

What is worth knowing about caries? Check: Tooth decay and its prevention

How to recognize carious lesions?

Dental caries can usually be diagnosed without any problems. First of all, the patient complains of pain. Pain occurs initially with eating, especially when the food is broken up by the tooth with caries. In the next stages of the development of caries, when the dentin is damaged, they can hurt practically all the time. Especially when a nerve is exposed or damaged. It is also worth remembering that preventive visits to the dentist are very important because the teeth can be attacked by caries that you cannot see at first glance. Modern technologies used in dental offices enable the diagnosis of such caries and the quick implementation of treatment. In such diagnostics, the following are used:

1. microscope – with a very high magnification of the tooth image, the dentist is able to see the smallest changes on the enamel;
2. intraoral camera – it is a tool that allows you to detect early caries even in hard-to-reach interdental spaces;
3. diagnostic laser – is a tool that allows you to assess whether the white spot that appeared on the tooth is a discoloration or demineralisation of enamel, or maybe a cavity that requires treatment.

Do you know who is particularly at risk of carious lesions? Read: Tooth Decay – Who Is Especially At Risk?

How does tooth decay develop?

The development of caries on a tooth has its stages and the treatment stage depends on the stage of its advancement. Initial caries is not visible to the naked eye and should be diagnosed using a microscope or laser. Initial caries is usually a small white spot on the enamel. In the next stage, caries is visible within the tooth enamel. At this point, you should immediately go to the dentist’s office, because the implementation of treatment at this stage significantly reduces the pain and the duration of the procedure. When the caries affects the dentin, the patient develops pain. The final stage of caries development is the moment when the caries reaches the pulp of the tooth. In this case, changes often appear at the root apex. Caries at this stage of the disease causes a very severe toothache that is difficult to combat even with painkillers.

What are the causes of tooth decay in children? Find out: Caries in children. Causes, symptoms, treatment

What is anesthesia for dental treatment?

In short, anesthesia is pain relief. The first dental anesthesia in the world was performed in 1944 by a Boston dentist, Horace Wells. For anesthesia, he used a nitrous oxide compound, commonly known as laughing gas. However, the first demonstration of anesthesia ended in a fiasco, because his patient was a well-built man, who additionally did not shy away from stimulants. Despite their failure, it was Wells and his apprentice Morton who were recognized as the fathers of anesthesia.

Do you know what local anesthesia is? Read: Local anesthesia

Anesthesia during caries treatment – types

There are three basic types of anesthesia in the treatment of teeth. These are: local anesthesia, general anesthesia or sedoanalgesia. General anesthesia, i.e. anesthesia, is used very rarely, only in exceptional cases. Sedoanalgesia, on the other hand, allows the patient to be kept in a long-term state of unconsciousness, without being anesthetized. This method is commonly called “stupid Johnny”. This method has a calming and relaxing effect, is completely safe and ensures retrograde amnesia of the procedure. It is used especially in patients struggling with hypertension. The most common type of anesthesia in caries treatment is local anesthesia. Local anesthesia can be divided into three different types:

1. surface anesthesia – in this type of anesthesia, a layer of anesthetic gel or spray is applied to the surface of the mucosa. The agent used for this anesthesia usually contains lignocaine, which is a popular anesthetic;
2. infiltration anesthesia – in this type of anesthesia, the dentist inserts the needle shallowly near the tooth, from where the anesthetic enters the anesthetized tissues. A variation of this type of anesthesia is also intraligamentary anesthesia, which is administered into the periodontal gap;
3. regional anesthesia – this is a type of anesthetic in which the anesthetic is administered to the area of ​​a larger nerve, which anesthetizes several structures. After using this remedy, the patient feels numbness on the lower lip, chin and tongue.

How is anesthesia going? Find out: What does general anesthesia look like?

Anesthesia – how to prepare?

In dentistry, general anesthesia, i.e. anesthesia, is used very rarely, so you should not prepare yourself in any particular way before visiting the office. Local anesthesia does not require prior preparation from the patient. Only in the case of chronic diseases or a recent heart attack or cerebral hemorrhage, you should inform your dentist immediately. The dentist should receive written information from the attending physician about the disease, its course and treatment.

Anesthesia in dental treatment – indications

A dozen or so years ago, anesthesia was used very rarely in the treatment of caries. Currently, the indications for the use of anesthesia are practically all procedures performed in a dentist’s office. Interestingly, anesthesia in the treatment of caries can also be used in pregnant or breastfeeding women. In addition, studies have shown that failure to use anesthesia to treat teeth in a pregnant woman may cause worse complications or side effects than its use. Of course, the dentist should consider the type of local anesthetic, and in the case of a pregnant woman, it is usually a preparation that does not contain a vasoconstrictor.

Contraindications to anesthesia in the treatment of caries

In general, there are no contraindications for the use of anesthesia in the treatment of caries. The only contraindication that should always be considered is the patient’s allergy to any component of the sensitizing agent. Despite the lack of contraindications, special care should be taken in the case of people struggling with various chronic diseases. There are numerous contraindications to the use of anesthesia containing a vasoconstrictor in diseases such as:

1. hyperthyroidism;
2. bronchial asthma;
3. diabetes;
4. atherosclerosis;
5. heart defects and diseases;
6. renal dysfunction;
7. glaucoma;
8. epilepsy;
9. neurosis;
10. circulatory failure.

Anesthesia and possible complications

The use of anesthesia can cause side effects and complications. The most dangerous complication resulting from hypersensitivity to a given component is anaphylactic shock. In the event of shock, the airway may become blocked, cardiac arrest and consequently lead to death. Another type of reaction to an anesthetic is a toxic reaction, which manifests itself in numbness of the tongue, blurred vision, and muscle twitching and cramps. Nerve damage is another possible side effect of anesthesia in caries treatment. The effects of nerve damage include: decreased or increased sensitivity to stimuli, disturbed sensation, or complete loss of sensation. These types of symptoms are not permanent and fortunately pass after a few or several days. However, it happens that a damaged nerve shows symptoms for up to 10 months. Additionally, after anesthesia, swelling or pain may appear in the area of ​​the puncture. It is not uncommon for a hematoma or abscess to appear as a result of tissue inflammation. A vasoconstrictor can also cause side effects such as palpitations, anxiety, weakness, fainting, and severe sweating.

How to reduce the risk of complications after anesthesia? Check: The risks associated with anesthesia can be reduced

Duration of anesthesia

The duration of anesthesia depends on the type and amount of anesthetic used. Typically, the strength of anesthesia should wear off about an hour to two after the procedure. It happens, however, that the anesthesia lasts up to 5 or 6 hours. You should not worry about this, as the weakening of the anesthetic is also affected by human metabolism.

The state of health of the patient after anesthesia

In some cases, after the use of anesthesia, alarming symptoms may appear, which should be consulted with a doctor. If the anesthesia lasts for a long time and does not go away, there may be nerve damage. In such a situation, an appropriate drug should be used, which will allow the nerve to regenerate quickly. In addition, after anesthesia, there may be severe pain and swelling in the injection area. If the swelling continues to increase and the pain does not lose its intensity, see your doctor immediately as this may be associated with tissue inflammation or a hematoma.

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