Controlling Dental Pain

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Fear of pain is the main reason people avoid seeing the dentist. The good news is that there is a wide array of medicines and techniques -used alone or in combination -that can reduce or eliminate pain and control anxiety during most procedures.

Medicines and other applied, direct techniques
Topical anesthetics -Topical anesthetics, applied with a swab, are routinely used to numb the area in the mouth or gums where the dental work will be done. The topical anesthetic is given prior to injection with a local anesthetic, such as Lidocaine.

Lasers -Some dentists are now using lasers to remove decay within a tooth and prepare the surrounding enamel for receipt of the filling. Lasers might cause less pain in some instances and result in a reduced need for anesthesia.

Electronically delivered anesthesia (also called transcutaneous electrical nerve stimulation [TENS]) -This is an alternative to the dreaded shot of anesthesia. Adhesive pads are placed on the face, and a battery-powered device sends electrical impulses to the treatment area to numb it. The patient controls the level of stimulation through a hand-held unit. Another form of electronically delivered anesthesia is called cranial electrotherapy stimulation. During this technique, electricity is passed into the brain, which causes relaxation. Again, the patient controls the intensity of the current, increasing or decreasing it to control the pain as needed. Advantages of these approaches are that as soon as the device is switched off, the effect is instantly reversed. The patient is able to drive and resume normal activities immediately following the dental visit.

Nitrous oxide (also called laughing gas) -This gas, which is inhaled by the patient through a rubber face mask, helps people feel relaxed and is one of the most common forms of sedation used in the dental office. Effects wear off quickly after the gas is turned off. This is the only form of sedation under which patients can drive after the procedure and can eat food within a 12-hour period of the procedure. With IV, oral and general anesthesia, the patient cannot drive following the procedure or eat after midnight the night before the procedure.

Intravenous sedation -This form of pain and anxiety control involves injecting a sedative into a vein of a patient's arm or hand. This approach is usually reserved for patients undergoing extensive dental procedures or for the extremely anxious patient. Dentists need to monitor the oxygen level of patients receiving IV sedation and might need to give such patients additional oxygen during the procedure. With IV sedation, the patient is awake but very relaxed. If you think you might be interested in IV sedation, ask your dentist if he or she is licensed to administer intravenous sedatives.

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Last Updated: 9/25/2007

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