Is there something besides novicaine used to numb mouths for dental procedures?

Someone recently mentioned a gel dentists use instead of a shot. Has anyone ever done this? I do not like my throat getting numb from the shots.

Is there something besides novicaine used to numb mouths for dental procedures?
The gel is not nearly as potent as the shot.
Reply:You can use other things, but they're not as strong and the effect isn't as deep. If you're getting just minor drilling, it's a workable option. The numbness goes away rather quickly, too.





You can also have gas or heavy sedation, which can put you out. But I'd rather have the shot, all things being equal.
Reply:I am a dentist.





The gel to which you refer is nothing more than benzocaine, a topical anesthetic found in most over the counter medications like Anbesol and Orajel. Of course, we get it in higher concentration. It is used to numb the soft tissues to attenuate the pain of the needle penetrating.





Keep in mind, though, that the majority of the pain from the shots is not due to the needle penetrating the soft tissues. In fact, dental needles generally come as 27-gauge and 30-gauge, and are thus far narrower than anything a physician would use to give you an injection, and even further narrower than needles used for starting IV's or taking blood. Thin needles make for less painful injections. The bulk of the pain from the shots we give comes from two things: 1. the volume of the anesthetic being deposited into the tissues, and 2. the temperature of the anesthetic. Each carpule of anesthetic contains 1.8cc's of fluid. When we give you the injection, the tissues have to make room for those 1.8ccs. How is space made? Tearing. Sometimes it is the periosteum tearing from the bone, which is particularly painful, or it is simply tissue tearing apart. The best way to alleviate this pain is by giving a slow injection that allows the tissues to stretch rather than tear. The temperature of the anesthetic, which is a good 20+ degrees lower than the tissues into which we inject it also causes pain. Some dentists keep their anesthetics slightly warmed.





Novocaine is typically no longer used by dental professionals for anesthesia, as better drugs with more desirable properties have been introduced to us. As far as I can remember, lidocaine 2% with 1:100,000 epinephrine has been the drug of choice. There are others, however--articaine 4% with 1:100,000 epinephrine being a good alternate.





Would you believe that cocaine is also a local anesthetic, closely related to the "caines" I mentioned above? In fact, it has very desirable properties as a local anesthetic. Unlike Lidocaine, cocaine is not a vasodilator, and thus does not promote dispersion of the drug from the area to be anesthetized. Of course, we can't very well have cocaine available for ready abuse, which is why we're stuck using drugs like Lidocaine combined with epi for vasoconstriction purposes.