Basic recommendations after dental treatment

Today, anesthesia in dentistry is used everywhere for a variety of procedures, from hygienic cleaning to implantation. An anesthetic injection not only provides comfort to the patient, but also significantly facilitates the doctor’s work.

Read in this article:

• How long does tooth freezing last?
• Treatment and removal - is there a difference in pain relief?
• How long does dental anesthesia last?
• What to do to make dental anesthesia go faster
• 4 tips on how to “freeze off” faster
• What to do if numbness of teeth does not go away after anesthesia
• What's the result?

The anesthetic technique is selected taking into account the type of manipulation and implies a certain exposure time. After administration of the drug, the tissues surrounding the tooth are “frozen” and stop responding to any irritants. Sometimes this lasts much longer than necessary and does not allow you to return to your usual rhythm.

Treatment and removal - is there a difference in pain relief?

There are 3 types of anesthesia most commonly used:

• application;
• infiltration;
• conductor.

Freezing during tooth extraction is mainly conductive, since it turns off large nerve trunks and lasts longer, about several hours. Teeth are treated primarily with infiltration anesthesia, the effect of which lasts from 15 minutes to 1 hour.

Applications are used to perform small procedures, often in children. Local application of Lidocaine 10% can only numb the injection site. Therefore, it can hardly be called freezing.

The type of anesthesia is determined based on which area needs to be numbed. For example, freezing when treating teeth on the upper jaw and in the area of ​​the lower incisors is usually infiltrative: an injection is made into the transitional fold area of ​​the diseased tooth.

Attention!

Infiltration anesthesia can also be used when removing upper or lower anterior teeth. Therefore, sensitivity in these places usually returns faster.

The transitional fold is located on the border of the lower part of the gum and the mobile mucous membrane of the cheek or lip. After administration of the medicine, an infiltrate is formed here - a kind of depot, from which the anesthetic quickly spreads to the jaw bone.

As for conduction anesthesia, it is used not only for removal, but also for treatment, especially of molars. This is due to the properties of the structure of the mandibular bone - it is more dense and voluminous. Moreover, the density and dimensions increase closer to the corners of the jaw.

Medicines that are most often used in the dental office

If you need to numb a tooth, the doctor may use different drugs. The list of the most popular includes:

• Novocaine. Has a short period of action.
• Lidocaine and products containing articaine. Provides a medium-duration analgesic effect.
• Bupivacaine, Hirocaine, Ropivacaine. They have a long period of action.

The doctor determines which drug to choose taking into account the complexity of the upcoming treatment procedures. It is important that the patient is not allergic to the prescribed anesthetic.

How long does dental anesthesia last?

On average, the freezing effect lasts 1-2 hours. However, its duration depends on the drug used: for example, injections with Novocaine anesthetize for no more than half an hour, Bupivacaine acts for at least 2 hours. Modern clinics mainly use anesthetics containing Articaine, which freezes tissue for up to 3 hours.

The infiltration anesthesia on the upper jaw will wear off in 45 minutes at most. This is due to the structure of the maxillary bone, which is looser and better supplied with blood.

Freezing after tooth extraction will last longer if the anesthetic contains a vasoconstrictor - a substance that constricts blood vessels and prolongs pain relief.

Methods used in dental practice

How long it takes for the anesthesia effect to disappear depends directly on the method of anesthesia used. The sensitivity of tissues is restored most quickly when using an application. The doctor applies a special gel to the area of ​​upcoming manipulations, which “freezes” for about fifteen minutes.

If the anesthetic medication was administered using a syringe and needle, the area will remain numb for up to one to three hours. The exact time is determined by the location of the treated area, the dose and type of drug.

What to do if numbness of teeth does not go away after anesthesia

Lack of sensitivity can last for quite a long time, especially after the removal of difficult wisdom teeth. Sometimes you have to wait 8 or even 9 hours for “defrosting”.

If all the normal deadlines have passed, and the numbness of the gums, tongue or nose does not go away, you should consult a dentist. It is possible that during the manipulations the nerve that is responsible for the innervation of the mucous membranes of the nose or tongue was damaged.

This happens when extracting figure eights with roots that come close to the mandibular nerve trunk. Fortunately, this situation is very rare, occurring in only 0.5% of patients.

But even if you fall into this half a percent, it is fixable. Over time, the nerve recovers and sensitivity returns. The bad news is that sometimes the recovery process takes several months (but no more than six months), and it is impossible to speed it up.

What to do to quickly forget about dental intervention

Very often, upon returning home, the patient continues to feel numbness in part of the jaw. This condition can cause discomfort and even mild aching pain. In order for tissue sensitivity to be restored as quickly as possible, the following rules should be followed:

• On the eve of planned dental procedures, avoid drinking alcohol , fatty and heavy foods. If a specialist recommends taking any medications, it is important to follow his prescription.
• In the case of treating caries , removing tartar, grinding down the top layer of enamel under a crown, it is permissible to massage the gums. You can also drink warm tea or heated water. These simple methods will increase local blood circulation and create conditions for the speedy release of anesthesia. But, if anesthesia was administered before tooth extraction, there should be no talk of any self-massage - touching the hole with your hands is strictly prohibited. Otherwise, you can damage the blood clot that protects the wound from the penetration of bacteria and germs. This will lead to severe inflammation and bleeding.

Don't be alarmed if the anesthetic continues to work for up to six hours. The situation will normalize on its own. If the numbness does not go away longer, this is a reason to consult a dentist again.

Preparation for the procedure

Before removing a tooth, it is necessary to undergo a computed tomogram (CT ). The device allows you to illuminate the teeth and see the location of the crowns and roots in the gums. CT will make the surgeon’s work easier and save him from a long and complex operation. The procedure is painless. Done quickly.

The choice of tooth extraction technique depends on several factors:

• the presence or absence of inflammation of the soft tissues surrounding the tooth,
• duration of the process,
• location of the third molar in the bone,
• contacting a doctor during periods of exacerbation or remission of the disease,
• degree of tooth crown destruction.

What is local anesthesia?

Local anesthesia allows you to numb the specific area where the intervention is planned. The patient is conscious. And this is actually more than enough even for complex surgical operations.

For local administration of all types of anesthetics, special reusable syringes are used, which have a recess for inserting a carpule - this is a hermetically sealed ampoule with an anesthetic. Unlike disposable ones, carpule syringes have a thinner needle, which allows you to administer the drug slowly and thus eliminate pain. All syringes for reusable use must undergo antiseptic treatment and sterilization using modern ultrasonic and temperature sterilization equipment.

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Byshlyaga Dmitry Yurievich
Byshlyaga Dmitry Yurievich Orthopedic dentist

Extensive practical experience. Regularly undergoes internships and advanced training courses.

Working hours: from 9.00 to 20.00, daily, seven days a week, by appointment

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Asatryan Alexander Aramovich

Asatryan Alexander Aramovich Dentist therapist - orthopedist - surgeon

Extensive practical experience. Regularly undergoes internships and advanced training courses.

Working hours: from 9.00 to 20.00, daily, seven days a week, by appointment

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If the doctor has placed a temporary filling

A temporary filling is made of a fragile material and is placed for several days to close the tooth cavity with the medicine placed inside. The patient’s task is not to damage the temporary filling until the next visit to the dentist:

• teeth are brushed with care; the pressure of the toothbrush on the tooth on which the temporary filling is placed should be minimal;
• It is better to exclude very hot and very cold foods and drinks. You cannot eat hot and cold at the same time;
• The chewing load on the filled tooth should be limited; it is better not to chew food with it, if possible.

Scandonest SVC

If the patient belongs to a risk group (with severe concomitant diseases , in particular cardiovascular pathology ), the use of an anesthetic solution with adrenaline, a vasoconstrictor, should be completely abandoned. In such cases we use Scandonest SVC . This anesthetic exhibits a vasoconstrictor effect, i.e. has vasoconstrictor properties and can therefore be used without adrenaline, which means that the drug does not contain sulfites and can also be used in patients with bronchial asthma and allergic conditions (after an allergy test). Scandonest SVC is a medium-strength anesthetic; provides anesthesia, depending on which part of the jaw the doctor disconnects from pain sensitivity, for 20 - 90 minutes, which sets it apart from the group of other non-adrenaline anesthetics.

Time and prices for the procedure

This complex operation takes about an hour. The duration of the procedure depends on the complexity of the figure eight position and the degree of neglect.

The consultation is free of charge. The final cost can be found out after consulting a specialist.

A detailed price list can be found on the website.

Indications and contraindications

The attending physician (therapist) or orthodontist directs the removal of a molar in the lower jaw. In any case, the patient is sent for a panoramic photo, where the location of the teeth is visible. This procedure facilitates the work of the surgeon who has to deal with a complex operation. Contraindications for removal are as follows:

• Pregnancy and breastfeeding. After such a complex removal, the mother will have to stop breastfeeding, because antibiotics and painkillers can get into the baby along with the milk.
• People of the older generation with a diseased heart, hypertension of the 2nd or 3rd degree should be attentive to their health and not rush into surgery, but it is better to refuse it altogether.
• Malignant formation in the tooth growth zone.

Tooth extraction is also done as a preventive measure in advance, so that later they do not hurt and do not interfere with others.

Modern technologies for administering anesthesia

The pain of the anesthesia itself, as well as its effectiveness, depend 90% on the skill of the dentist. A professional doctor will make every effort and use various techniques to make the patient feel comfortable. However, all people are different, each has their own pain threshold, and that is why an individual approach not only to the concentration of drugs, but also to premedication before the direct administration of anesthesia is very important.

Today, special anesthesia devices have been developed to help doctors. Naturally, they work under the supervision of a specialist. The electronic system is equipped with special pressure sensors - to avoid pain, the anesthetic must be injected very slowly and immediately after puncturing the tissue. The device is equipped with special needles with a very thin double tip, which again reduces pain.

In addition, by administering a small dose of anesthetic, a kind of allergy test is performed - the doctor assesses the condition of the soft mucous membranes (swelling, redness, rash) and the patient’s general reaction, and the pressure force is controlled by the device.

Safe, painless and effective treatment without pain! Treatment is carried out under the supervision of anesthesiologists capable of providing first aid. Special equipment monitors indicators of the general condition of the body.

If there is any threat, the ambulance station is 800 meters from the clinics! You are under the reliable protection of professionals.

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Children

It should be noted separately the features of local anesthesia in children. The technique of local anesthesia in children must be planned so that 100% pain relief is achieved at all stages of treatment, otherwise it will be impossible to carry out the necessary manipulations.

As mentioned above, children under 5 years of age are given an anesthetic without adrenaline (3% scandonest SVC, or septanest 4% SVC).

Children over 5 years old can use an anesthetic with low concentration adrenaline (1:200,000 - Ultracaine DS). The dose of drugs is selected depending on age. Pain relief is performed in children in 3 stages:

• First, a superficial anesthetic gel is applied
• then a small dose (0.1-0.2 ml) of anesthetic is administered;
• after which, after 60-90 seconds (time sufficient for effective anesthesia of the needle path in the soft tissues), the remaining amount of the planned dose of anesthetic is administered.

We wait 5-10 minutes until complete anesthesia occurs. The child, feeling a complete absence of pain, gains confidence in the doctor and gives the opportunity to carry out the necessary intervention.

Tooth eruption problems. Wisdom tooth removal in advance

Many patients think that if the wisdom tooth is not visible on the gum, then there is no need to worry. However, over time, this molar increases in size and begins to interfere with the others. Waiting until the wisdom molar appears can lead to the following problems:

• pain in the tooth and gum;
• caries between molars;
• curvature of the roots of a healthy chewing tooth;
• infection in the place where the molar erupts because it grows incorrectly;
• curvature of the bite.

It is easier for a doctor to pick up and remove a tooth that has not yet come out. So while there is no pain, it is better to have surgery in advance.

The use of anesthesia for health pathologies

• diabetes mellitus, bronchial asthma, allergic reactions: anesthetics without preservatives and with a minimal amount of epinephrine are used. For these problems, medications are selected strictly individually, most often based on the results of additional tests,
• high blood pressure, heart disease: with minimal or no epinephrine. It is also important that anesthetics do not contain adrenaline. For these pathologies, intravenous or xenon sedation can be used,
• pregnancy and lactation: drugs with a low content of epinephrine - in minimal dosages, the active substance does not cross the placenta and practically does not enter breast milk (only in small quantities, but this does not have any negative effect, so after dental treatment you can not skip feeding and no need to express milk). It is important that the drugs cannot be used without the addition of the vasoconstrictor epinephrine - in this case, the vessels remain open and the active substance will quickly spread throughout the body, which increases the risk of its transmission to the fetus or child through breast milk.

Removal of a wisdom tooth on the lower jaw

Most people of conscious age go to the dentist because of problems with their lower wisdom teeth.
They often interfere, put pressure on neighboring molars, and cause discomfort or pain after eating. Most often, wisdom teeth in the lower jaw appear between the ages of 20 and 25, although the timing varies from person to person; for some, they may appear at the age of 16, for others closer to 40 years. In most cases, the appearance of figure eights is accompanied by various complications that require their removal. Malocclusion, difficulty in teething, tumors and trauma to the mucous membrane and much more.

Sedation and anesthesia - is it safe?

Yes, if they are carried out by professional doctors who have extensive experience and have undergone appropriate training (and a license is also required to perform general anesthesia - this requires an anesthesiologist-resuscitator), then the procedure will be completely safe. In addition, for complex and long-term implantation, the use of sedation is even preferable - you are less tired, you do not need to focus on keeping your mouth open for several hours and fixing your head in a certain position. For you, 3-4 hours of surgery passes in an instant. You will be under the supervision of specialists, and before the operation you will undergo a fairly extensive list of tests for high-quality preparation for treatment and selection of the most suitable, safe drug.

1 Zoryan E.V. Errors and complications when performing local anesthesia in dentistry, 2007.