Local Anesthetics

Author: Dr. Alison Vitelli-Berger, DMD, FAGD

Numbing!  This is a frightening thought for a lot of our patients. But, what a difference it has made in the last century for the dental field. Local anesthetic was successfully introduced in the dental field in 1943 when lidocaine formulation was stabilized. Since then, we administer local anesthetic on a daily basis for routine dental procedures. There are two main families of local anesthetic: amides and esthers. Nowadays, the most prevalent one are the amides, which have shown decreased adverse reactions, such as allergies.  Some formulations of local anesthetics include epinephrine (adrenaline) as a vasoconstrictor.  This serves as a conjunctive additive to increase the effectiveness of the administration and duration of the anesthetic solution within the tissue. Scientific advancements have provided a great array of options available to dental professionals in order to achieve profound anesthesia with minimal doses.

As with any chemical introduced into the body, safety precautions have to always be taken, specially for medically compromised patients. Caution is always followed for patients who suffer from hypertension, diabetes, glaucoma, kidney and liver dysfunction, and pregnancy, among others.  Also, uncontrolled infections can be very challenging to anesthetize due to the acidic environment of the tissue, which may require a buffered formulation of the local anesthetic.

All these details may sound very technical, but I hope it helps you see how intricate our bodies are, and how amazing scientific advancements are to allow us to provide our patients with the best care possible.