Pain Control

By Brian J. Gray, DDS, MAGD, FICOI

Many patients face their dental appointment with a degree of apprehension. Research has shown that the most common cause of this fear is pain ... the fear that at some time during their dental treatment they are going to be hurt.

A dentist has available a variety of drugs known as local anesthetics, which are the safest and most effective drugs in all of medicine for the prevention and management of pain resulting from dental and surgical procedures.

Local anesthetics, commonly called Novocain (Novocain is no longer used, having been replaced by newer, safer, and more effective drugs) by patients, are drugs which, when injected near a nerve, prevent stimulation from reaching the brain where it would be interpreted by a person as pain.

The injectable local anesthetics used today in dentistry provide complete pain control close to 100% of the time. The duration of the numbness varies from drug to drug -- some providing short durations, with others providing pain control for up to 12 hours. A doctor will select a drug for a patient that is appropriate for the type of dental procedure they are having done.

In order to prevent pain during dental treatment, local anesthetics usually need to be injected. For many people, this is the most uncomfortable part of the entire dental appointment.

It need not be.

Local anesthetics can be administered quite comfortably. Dentists and dental hygienists take pride in their ability to administer local anesthesia painlessly.

The following are some of the procedures a doctor might use to make this procedure more comfortable:

  1. Place the patient in a reclined position during the injection.

  2. Place a topical anesthetic (a gel or spray) on the patient's gums where the injection is to be given. This should remain in contact with tissues for at least one minute.

  3. Use of a distraction technique, such as pulling or shaking the lip as the needle is slowly inserted.

  4. Injecting the local anesthetic drug slowly. This is critical to a painless injection.

  5. Permitting the local anesthetic drug time to work. Most local anesthetics will provide pain control within approximately five minutes after their injection.

If an individual is fearful of receiving a local anesthetic injection, they should tell the assistant or the doctor BEFORE the procedure starts. The use of conscious sedation (such as laughing gas) can work wonders to make this procedure more comfortable for the patient.