Numbing: Anesthesia, Sedatives, and Pain Medications

By: J. Shahangian, DDS, MS- San Diego Board Certified Pediatric Dentist

Numbing Your Mouth
I will use an anesthetic to numb your child’s mouth to pull out a tooth, or to take out a cavity.

I will rub a cotton ball dipped in a “local anesthetic” on your child’s gums on the area where I will be operating.  The local anesthetic will numb the surface of the mouth and gums.  Sometimes, I may need to apply more local anesthesia, and may have to give your child a small injection of more powerful medicine to really numb the area of the mouth.  The shot may sting a little, but it is only because the local anesthetic that was rubbed on.

The more powerful anesthetic is called Lidocaine or Novocain.  I may inject this anesthetic with a very fine needle.  In about two minutes, your child’s mouth will feel slightly tingly, and eventually will go numb.  Your child may experience a feeling of having a swollen or fat lip and mouth, but this is just a side effect of the anesthetic.[1]

Anesthesia
The rapid advancements in dentistry have almost made pain a thing of the past.

Powerful anesthetics alleviate patients of discomfort during the dental procedures and also post-operation.

Dosages of anesthetics vary from person to person, with some people requiring higher doses than others.

List of pain-killing medications:

• Analgesics – These pain killers are the common over the counter medications such as aspirin and ibuprofen.  Analgesics are prescribed after tooth extractions or root canals because they alleviate mild pain and discomfort.
• Anesthetics – Anesthetics are used to numb the area where I will operate.  There are two main types of anesthetics: topical or injected.  Topical anesthetics are dipped in a cotton swab and are placed on the area where I will operate.  I usually use topical anesthetics.  I may also inject an anesthetic such as Lidocaine or Novocain.  The injections numb the nerves and prevent the nerves from sending pain signals to the brain.
• Sedatives – Sedatives are powerful relaxants that block pain.  There are two main types of sedatives.  One type of sedation is using nitrous oxide which is commonly known as laughing gas.  During this type of sedation, the patient is awake and alert.  On the other hand, the second type of anesthesia places the patient in a state of unconsciousness.  The patient is monitored during this time

Types of sedatives include:

• Inhalation is a type of sedation where a mask is placed over the face (such as nitrous oxide)
• Intravenous (IV) sedation is a type of sedation where a small needle gives the patient a tranquilizer. The patient is awake during this type of sedation.[2]

Managing Pain
Here is a quick list for alleviation oral pain

• Do not sleep on your back
• Use ice pack on the site of pain
• Do not eat candy and avoid ice

Here is a quick list of tools for pain management:

• Analgesics such as ibuprofen and aspirin
• Anesthetics such as Lidocaine and Novocain
• Sedation which can mean “conscious sedation” or deep sedation (also known as general sedation)

Medications
I may prescribe medications to prevent infection or to alleviate discomfort and pain after an operation.  I may do this for more invasive procedures such as oral surgery or teeth extractions.

It is important to share your child’s medical history because some of the medications that I prescribe could conflict with medications that your child may be taking.

Lastly, make sure to carefully follow all the instructions for the medications that I prescribe.  Even if your child is feeling better, finish all of the instructed medication.[3]