Dental Anaesthetic: Dosage, Medications & Pain-Free Options With The Wand

Anaesthetic is a common drug given during different dental procedures. Most people have had some kind of dental procedure performed where they’ve had to get anaesthetic injected – if you’ve had a filling, chances are, you’ve had anaesthetic. The two most common types of anaesthetic are local and general; these terms are descriptive of how much the drug is localised. Under general anaesthetic, you are asleep for procedures and completely “under” – this is necessary when having major dental surgeries, like getting wisdom teeth out – and local, which is administered for minor surgeries and procedures, such as getting a filling or root canal.

While typically, most people respond well to anaesthetic, some may experience side effects or even allergic reactions. Today we share what those side effects and reactions are and why they’re caused, and give you a breakdown of everything you can expect when getting anesthesia – local or general. For those that have never received this drug, this article is here to help you prepare!

How Does Anaesthetic Work?

In brief, local anaesthetic works by stopping nerve signals to the brain, which stops you from feeling any sensations from the area injected and close to the surrounding area. On top of being injected, local anaesthetics can be administered a number of different ways, such as topically applied via an ointment, spray or drops, with a special device called ‘The Wand’ (we will touch more on this later) and it can also be inhaled. At Admire Dentistry, we offer pain-free local anaesthetic options and send any patients who need general anaesthetics to the hospital.

General anaesthetic works by using a combination of muscle relaxants and sedatives to put you in a sleep-like state. When your procedure is over, reversal drugs are administered to wake you up and provide pain relief. The most common way of receiving general anesthesia is through an IV injection; however, in some cases general anesthesia can be inhaled.

Side Effects & Reactions to General Dental Anaesthetics

Everyone has a different experience in waking up from General anesthesia; some feel fine and are alert, whereas other may exhibit the following symptoms:

• Nausea or vomiting
• Dizziness and feeling weak or faint
• Feeling cold or shivering
• Headaches
• Itchiness
• Bruising and soreness
• Difficulty peeing
• Aches and pains

These are normal symptoms that tend to disappear after a few hours. However, some people are more at risk to the effects of anaesthetic due to their age, medical history, certain medications, lifestyle, and allergies. These people may have a higher risk of postoperative confusion, pneumonia, stroke and heart attack.

Anaesthesia allergy is an extremely rare condition where mild to severe symptoms are experienced soon after anaesthesia is administered. Mild reactions can show symptoms ranging from a rash, to swelling, a cough or acute shortness of breath, and severe reactions (such an anaphylaxis) can induce severe shortness of breath, cardiac arrest, and respiratory failure. The tricky thing with anaesthesia allergies is that it can be difficult to narrow down the drug which is the cause of the allergic reaction, as there is a combination used. It can also be difficult to recognise a patient experiencing an allergic reaction under anaesthetic; however, anaesthetists are highly skilled individuals who have been trained to recognise this.

Ingredients in General Anaesthetic

There are many different formulas of anaesthetic that use various medications. The staple medication types usually remain consistent (induction, analgesics, muscle relaxants, inhalation anaesthesia, and antiemetics). These all contribute to the sleep-like state your body goes into while under general anaesthetic. Here’s a breakdown of what these medications do.

Medication Included

• Induction Medication: Induction medications are used to produce unconsciousness. Typically, thiopentone or pentothal and propofol are used.
• Analgesics: These are used to provide pain relief. These are painkillers and usually derive from opiates or narcotics.
• Muscle Relaxants: These induce muscle relaxation, as the name suggests. Muscle relaxants work to relax large muscles without affecting the functioning of the heart or intestines. They also work to support sedatives; previously, large doses of sedatives were used, which was a more dangerous process. The types of muscle relaxant used includes suxamethonium (or succinylcholine), pancuronium, atracurium, vecuronium, and rocuronium.
• Inhalational Anaesthetics: These are typically administered throughout a procedure to keep you unconscious. Common inhalation anesthetics include enflurane, isoflurane, sevoflurane, and desflurane.
• Antiemetics: These medications help reduce risk of vomiting and nausea and include droperidol, Stemetil, Gravol, and ondansetron.
• Other medications are often used in the mix as well. Medications like diazepam and midazolam (depressants) reduce anxiety and memory of the procedure.
• Reversal drugs counteract the effect of certain medications to bring your body into more of an awake state. Drugs like naloxone counter the effects of opiates or narcotics; flumazenil counters benzodiazepine (a mild tranquiliser); and neostigmine, reverses the effects of most muscle relaxants. Another common medication given includes epinephrines. These are medications that increase your heart rate, the most well known being adrenaline. Some people can have adverse reactions to these drugs, which include anxiety, restlessness, tremors, weakness, dizziness, sweating, heart palpitations, nausea and vomiting, headaches, and sometimes even respiratory difficulties.

Why is Adrenaline Included?

Adrenaline is often used in both general and local types of anesthesia. In local anesthetics, it is frequently combined with lidocaine (also referred to as lignocaine) to enhance the duration of the anesthetic effect, decrease toxicity, and to achieve vasoconstriction (a narrowing or constriction of the blood vessels) to lessen bleeding while performing dental procedures.

Two Types of Local Anaesthetic

Lidocaine and articaine are the most common drugs used when looking to numb a localised area. Articaine is said to be more effective and is the most commonly used. It has better success penetrating bony tissue and has a longer duration of anaesthetic effect. This drug is particularly more effective in dentistry, especially is needing to work around the mandibular bone area.

Lidocaine is another gold standard anaesthetic drug. It’s fast acting in its nerve-blocking capabilities, taking effect after only a few minutes, and is long-lasting (continues working from half an hour, up to three hours depending on the dosage).

Common Doses

Doses always depend on the weight, height and health of the patient; however below is a general guide to how much of each local anaesthetic is provided in relation to the amount of adrenaline used – as you can see, it’s not very much!

• Lidocaine 2% and 1:100,000 adrenaline.
• Articaine 4% and 1:100,000 adrenaline.

Overall, there are a lot of factors that anaesthetists have to consider before administering these potent drugs to you. While it may concern you, the idea of receiving doses of sedatives, opioids, muscle relaxants, adrenaline and other drugs you may not have heard of, just know that this is something anaesthetists are highly trained in.

Pain Free Technology

You can rest assured that, next time you’re getting a dental procedure at Admire Dentistry, you really won’t feel a thing! Our dentists are able to use state-of-the-art technology called ‘The Wand’, which enables you to receive anaesthetic without a syringe, so you can enjoy a pain-free experience while at the dentist. You can go into your procedure with full confidence and peace of mind. Benefits of using The Wand include:

• Less pain than the standard local anaesthetic methods using a syringe
• More precise application
• Reduced anxiety when visiting the dentist
• Ability to resume normal activities post appointment without a numb face

Still worried about going to the dentist? We also offer Nitrous Oxide Gas to ease any anxiety. You can also check out our easy steps for conquering your fear of the dentist!

Admire Dentistry is your modern, technology-focused, environmentally-friendly dental clinic of the future. Sign up to our new clinic by contacting us for your first check up, and browse through all the services we provide for our patients. If you’re keen to learn more about teeth care, read through our regularly updated blog.