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Common Problems Faced during Dental Anesthesia

There are several common problems found in dental anesthesia and I saw quite a few of these during my years of work in the dental field. Both general anesthesia and local anesthesia are used in dentistry. More complaints seem to stem from local anesthesia, though. Listed below are common problems found with both types of anesthesia.


The most common general anesthesia used in a dental office is Nitrous Oxide, also called laughing gas. The patient is not put into a sleeping state for as long a period of time or as deeply as that of a surgical patient in the hospital. A hospital surgical patient is kept NPO, without food and drink, after midnight for early morning surgery. This time is shortened for a dental patient to within two to three hours prior to the appointment. If the patient has a weak stomach, it is wise to extend the time frame. Some patients opt to receive only enough Nitrous Oxide to make them comfortable during the procedure without being totally sedated.


A dentist applies a topical anesthic to numb the skin, followed by an injection containing Epinephrine to totally block the area of the tooth. The injection site, type of injection used, and your metabolism rate all play a part in the degree and duration of the numbness of the area.

Patients with a slow metabolism rate will feel the effects of the injection for a longer period of time. If the patient does not normally drink coffee, they can speed the metabolism of the injection up by drinking strong coffee after the procedure. Likewise, patients who are heavy coffee drinkers, and particularly those with high metabolism rates, may never feel fully numb for the procedure. Therefore, it is best to avoid coffee prior to a dental procedure appointment.

Articane HCl metabolizes slower than other local anesthetics. Therefore, if your dentist chooses to use Articane HCl you will feel the effects of the injection longer. The dentist may choose Articane HCl when performing a lengthy procedure. Dentists moved away from using Novacaine due to allergic reactions in many patients. They began using Lidocaine HCl. It is the active ingredient in Xylocaine HCl. The injections now used contained Epinephrine.

The human body varies in individuals and the art of dental anesthesia is not an exact science, measurable in increments from the tooth to be treated. It depends on how close to the sensory nerves the dentist actually was in injecting the area to be blocked. It is possible for your dentist to use the same injectable on different occasions and the patient to have varying results.


Root canal work, crown preparation or any extensive work on the upper teeth requires a palatal injection of local anesthetic. The roof of the mouth has a much greater nerve supply than other areas of the mouth. Outside of asking for Nitrous Oxide or asking the dentist to use Articane HCl for less involved procedures, there is nothing the dentist can do to alleviate the pain.


The fifth cranial nerve, the trigemenial nerve, splits in three branches after leaving the skull. These three divisions are opthalmic, maxillary, and mandibular. If the patient’s dentist hits the back portion of the fifth cranial nerve where the divisions split away from each other, you will experience blurred or double vision. The effect will subside as the injection is metabolized.


All oral local anesthetic injectables pierce one or more muscles as the needle enters while being administered. The patient may not notice any discomfort with muscles that are seldom used. However, if the muscle involved is one frequently used in chewing or the patient has Bruxism, the patient probably will notice pain. How long the pain persists depends upon how much work the muscle is subjected to.


Epinephrine, the active ingredient in the local anesthetic injectables, can cause heart palpitations in patients with high blood pressure, diabetes, congenital heart defects, and other heart abnormalities.


Many people have a fear of dentistry work. Though most combative patients are children, this problem can arise with adult patients. If the patient does not have medical issues preventing the use of Nitrous Oxide, it is the best for the patient and the dentist to use the general anesthesia. It can be far less traumatic to children to be admitted to the hospital to be fully sedated by an anesthesiologist specializing in pediatrics than to have the work done in the office. Many children have been known to bite or hit the dentist.

Dental procedures are not always painless but most of the common problems faced with anesthesia are temporary, minor, or can be alleviated. Good oral hygiene and health should be among a person’s top priorities. Good oral hygiene will lessen the need for dental procedures requiring anesthetics. When a procedure does need to be done, talk with your dentist about any past problems you may have experienced to make the new procedure more comfortable.