What is topical anesthesia? Anesthesia in dentistry: topical anesthesia.

For painful manipulations, application anesthesia is often used in dentistry, since not every patient tolerates anesthesia well. Anesthetic agents are always available to a large extent influence the condition of the human body. If he has a tendency to allergic reactions, then you need to be extremely careful with anesthesia.

However, there are certain types of dental operations that cannot be performed without pain relief, and difficulties often arise here. In such situations, the doctor must use anesthesia as carefully as possible. If the patient has previously had negative reactions on similar drugs, then only local anesthesia is always used. One of the varieties of this method of pain relief is the application system. This is the superficial application of drugs that are classified as anesthetics.

Advantages of superficial anesthesia

This method is very popular in medical practice generally. But it is in dentistry that application anesthesia is used most often. This is the best option for cases where the gums need to be pierced multiple times or small incisions made. In order not to burden the body with full anesthesia, application is used.

With a low-traumatic intervention, this type of pain relief will be the best option. But when in oral cavity a full-fledged operation is being carried out, the application method may not be suitable enough. Used for local anesthesia special drugs, which are applied to the mucous membrane and are quickly absorbed.

Often, when working with young patients, it is the method of application anesthesia that is used. Children are often very afraid of dentists, and this method makes it possible to get rid of phobias.

Anesthetics that are used for local topical anesthesia have a fairly powerful effect on nerve receptors. Thanks to this, unpleasant sensations completely disappear in the treated area.

Active components do not penetrate too deeply into the body, so they do not affect internal organs. A huge advantage of this technology is that it is always noted high efficiency with maximum safety for the patient. Therefore, topical anesthesia can be used even when treating children.

In pediatric dentistry similar method very common. The anesthetic is produced in the form of a gel, which often has a very pleasant taste. For adults, not only gel forms can be used, but also aerosols, solutions and ointments. In any case, this method of pain relief is very effective and is well suited for all patients.

In dentistry, this method is often used. When we're talking about Regarding the treatment of children's teeth, special gels can be used in every oral therapy. But there are also special indications, when the application system will be especially useful.

Local anesthesia is convenient to use when removing teeth, including difficult cases. Application anesthetic will be appropriate when treating caries, removing tartar, opening abscesses, removing pulp, and even fixing dentures, which is not always painless.

There are several types of drugs that can be used in dentistry as topical anesthesia. For each case, one or the other option is more suitable.

Anesthetics can be cauterizing, dehydrating, have a physiological effect, or work as local anesthesia. Often, specialists use dehydration or physiological drugs. The former have a dehydrating effect on tissues. As a result, the nerve endings become less sensitive, which relieves pain. In the second case, we are talking about the use of pastes with fluorine or strontium.

Application anesthesia is the best option if minor or moderate surgical intervention is necessary.

When deleting large quantity In teeth or large-scale operations, general anesthesia is still used, since local anesthesia will not be enough. Indications for complete immersion in artificial sleep maybe strong gag reflex.

When choosing drugs for topical anesthesia, only those drugs are used that are suitable for a particular patient, taking into account the sensitivity of his teeth and other indications. Therefore, the choice of anesthetic is an individual process for each patient.

Before using this or that drug, the doctor is obliged to check the patient for contraindications. This is very important condition, which concerns every patient, and especially a child. Allergic reactions to local anesthetics are not as severe as when using general anesthesia, but they can be quite noticeable and even life-threatening. Therefore, the specialist is obliged to eliminate all risks before starting treatment.

If the freezing method is chosen, the dentist will most likely use chloroethyl. It is released in a stream onto the place where the incision or puncture will be made. The effect of chlorethyl is quite powerful, so the mucous membrane immediately becomes insensitive. The main thing is that this method allows you to treat only the area of tissue that is to be treated. Everything else will not be in any way related to the action of the anesthetic.

The cauterization and freezing method is considered very common, but it has some significant disadvantages. The thing is that a side effect of such anesthesia is often tissue necrosis. This is very dangerous, so many specialists are trying to move away from such anesthesia and opt for other means. Freezing works well for gum abscesses and when superficial roots need to be removed.

Application anesthesia can be applied not only as a jet, as when using chloroethyl. In addition, gel and ointment can be used. After a short period of time, a strong analgesic effect appears that lasts quite a long time. for a long time. If you need to enhance the effect of anesthesia, then the specialist can add Dimexide or Lidase to the agent used. When choosing drugs of this type, the condition of the tooth and tissues around it is always taken into account. Each area may experience different sensitivity. Therefore, the amount of anesthetic may vary significantly.

One of the frequently used means of topical anesthesia is Emla gel. It can be called the most popular product of its kind. Feature this drug is its absolute safety for the human body. Emla's active components act for about 20 minutes, but after their effect ends, simply apply a new portion of the product. This way you can ensure good pain relief for 1 hour. More long-term use there will be no funds the best solution, as this may cause an overdose.

Application anesthesia can also be used in powder form. Sometimes they simply sprinkle it on a certain area of tissue, but in some cases, when you need to numb the gums a little, the dry ingredients are diluted and a solution is prepared.

Some time ago, Tetracaine, which was used as a powder, enjoyed considerable popularity. Nowadays it is rarely used, since it has very high level toxicity.

From folk remedies The best anesthetic is an alcohol solution of propolis. But it must be borne in mind that such a remedy should in no case be used by those patients who have allergic reactions to bee products. Before using any anesthetic, you must make sure that the patient has no contraindications to its use.

Application anesthesia is widely used primarily due to the low number of side effects, as well as due to its relative safety for patients different categories. However, this method of pain relief has some disadvantages and can cause complications. It all depends on the type of drug used as a local anesthetic.

Problems with use superficial anesthesia can be systemic or local. In the first case, pathologies occur on the skin or mucous membranes, namely where the product was applied. The main systemic complication that is possible when using topical anesthesia is allergies. In this case it is not excluded severe itching and tissue swelling. The severity of unpleasant symptoms depends on the amount of the substance used.

If the specialist used freezing or cauterization, this can cause permanent tissue damage. Sometimes even necrosis occurs, which requires special attention from the doctor.

It is necessary to select drugs for topical anesthesia as carefully as possible. Some products can be quite toxic. This primarily applies to water-soluble products. They are used very carefully to avoid overdose, which can lead to bad consequences.

Contraindications for use

The main indicator that a patient should not use a particular pain reliever is allergic reaction, which has already taken place before. These drugs will be prohibited for him forever.

Otherwise special contraindications There is no requirement to use most substances used for topical anesthesia. The main thing is to monitor the body’s reaction and avoid overdose. Each drug has age restrictions. This must be taken into account when treating a child’s oral cavity.

Scientists have learned to turn off pain different levels human body, which made it possible to carry out surgical treatment of any complexity and duration. In outpatient medicine, local anesthesia is widely used, one type of which is topical anesthesia, which allows you to anesthetize the superficial layers of the skin and mucous membranes.

Topical anesthesia is widely used in dentistry.

Many therapeutic and diagnostic procedures are painful or unpleasant; often such sensations lead to the development of involuntary protective reflexes, in which case it is difficult to carry out a full procedure. It is also important that during manipulations, as a rule, sharp instruments are used, and if, under the influence of pain, the patient does involuntary movement, this can lead to damage to healthy tissue, so anesthesia is important not only for the patient’s comfort, but also for the quality of the operation.

Application anesthesia is a non-invasive method (without compromising the integrity of tissues). Medicines used for application are applied to the surface of the skin or mucous membranes, after which they penetrate to a depth of three millimeters, which allows blocking nerve impulses superficial nerve fibers. Products used for superficial pain relief are produced in the form of solutions, sprays and gels. Sometimes, to enhance penetrating ability, the doctor mechanically rubs anesthetics into the tissue (like a cream), this allows the development of the analgesic effect to accelerate and enhance the effect of medications.

Where is the superficial anesthesia technique used?

Currently, superficial anesthesia is very widespread; it is used for minor medical procedures on the skin and mucous membranes, in diagnostic studies, widely used in cosmetology and dentistry. Also, the principle of topical anesthesia underlies some types of drug therapy.

Topical anesthesia does not require an injection, so it is not scary for children

Technologies used to perform application anesthesia do not involve an injection, which is important factor for children, therefore the method is widely used in pediatrics. Superficial anesthesia can be an independent species pain relief or be part of a more complex analgesia, allowing you to anesthetize the site of the future injection.

How to self-relieve pain

For carrying out many manipulations within skin and mucous membranes, it is enough to turn off pain sensitivity only at the level of superficial nerve endings:

In dentistry: you can whiten teeth, remove tartar and plaque, perform manipulations on the mucous membrane, fix dentures and crowns. Anesthetics, used in the form of a solution, spray or gel, are applied to the surface of the gum mucosa and rubbed in.
In surgery: for removing small benign formations on the skin and mucous membranes, coagulation of superficial vessels, dressing and treatment of wounds.
In cosmetology superficial anesthesia is often necessary for peeling, hair removal, mesotherapy, and other therapeutic and preventive procedures on the skin.
In otolaryngology: examination of ENT organs is always accompanied by unpleasant and painful sensations, a gag reflex often occurs, making examination difficult. Therefore, so that the doctor can fully examine the throat, ligaments, nasal passages and the patient does not experience pain, superficial anesthesia in the form of a spray is often used.
In ophthalmology: for inspection of external surfaces visual analyzer(sclera, cornea, eyelids), as well as to neutralize pupillary reflex During a fundus examination, anesthetics are instilled into the eye.
For diagnostic studies : many people find it difficult to stand endoscopic methods diagnostics (FGDS, bronchoscopy), the application of anesthetics makes it easier to transfer the examination.

As part of more complex pain relief

For some local operations and procedures, it is not enough to anesthetize only the upper layers of the skin, since the intervention involves deeper penetration into the tissue. In such cases, infiltration, conduction and epidural anesthesia are used. These types of anesthesia involve injecting an anesthetic into the tissue. Often the anesthesia procedure itself is the most frightening moment of the operation; everyone knows that the injection hurts. Injections in dentistry are especially frightening for patients.

The injection site is often numbed with topical anesthesia.

Meanwhile, for the success of the operation, it is very important for the doctor to inject anesthetics correctly, and for this the patient should not be in pain. Therefore, often before performing infiltration and other types of anesthesia, the site of the future injection is anesthetized superficially and only after that the injection is performed.

Superficial anesthesia is widely used in dentistry, surgery and gynecology before an injection for infiltration and conduction anesthesia. Performing an epidural and spinal anesthesia requires special care due to possible complications In addition, the procedure takes longer than the infiltration technique, so it is important for the doctor that the patient is not in pain and remains motionless.

As a method of drug therapy

Inflammatory diseases of the oral cavity are often accompanied by unpleasant sensations: with a sore throat it hurts to swallow, stomatitis is accompanied by severe pain With any movement of the tongue and jaw, babies teething hurts. In such cases, medications that contain anesthetics (lozenges, sprays, gels) are used.

Medicines with anesthetic are used for various dental diseases

The application technique also helps with superficial skin damage (after burns and injuries), as well as with skin diseases accompanied by itching. This method allows you to reduce unpleasant symptoms without using system tools, which significantly reduces the risk of side effects.

What medications are used for superficial pain relief?

Anesthetics: Novocaine, Lidocaine, Bumecaine, Benzocaine. Used for superficial anesthesia during invasive procedures in dentistry, cosmetology, surgery and diagnostic procedures.
Dehydration agents (alcohol solutions), which have an analgesic effect indirectly, as they dehydrate tissues and then pain sensitivity decreases.
Combined products containing extracts in addition to the anesthetic medicinal herbs(Lidoxor, Kalgel), used in dentistry for superficial anesthesia during manipulations, as well as during teething, for stomatitis, after operations in the oral cavity. Ease of use medicine Lidoxor for children is based on a pleasant taste and the absence of a tingling sensation in the mucous membrane after use.

Contraindications to superficial anesthesia

Medicines used for local superficial anesthesia have virtually no effect system effect on the body, therefore the only absolute contraindications for use are allergic reactions to the anesthetic substance. When using combined drugs, such as Lidoxor and Kalgel, it is also necessary to take into account an allergic history not only with respect to anesthetics, but also with other components of the drug, which is also a contraindication for use.

Treatment dental diseases rarely goes away without injection into the affected area. Most patients fear the injection no less than the treatment procedure itself.

To make the process of administering the anesthetic more comfortable, topical anesthesia is used before the injection.

What is it?

Application-type anesthesia is not injection method anesthesia of oral tissues, which is achieved by applying concentrated anesthetic drug to a limited area of expected impact.

As an anesthetic application, not only medications are used, but also methods of physical and chemical influence, in which the tissues of the oral cavity are cooled or cauterized, due to which their sensitivity is reduced.

For dental intervention, most often they use medicinal topical anesthesia in the form of ointment, spray, gel. Many of these products have additional flavoring, which makes the process of use more comfortable.

Mechanisms of action

Topical anesthesia is different quick action, which is achieved due to the instant penetration of the drug into periodontal tissues. The mechanism of development of sensitivity blocking will depend on the type of application.

When an anesthetic is applied to the mucosa, it is absorbed into the mucosa and quickly distributed throughout its cells. In a few seconds, the product reaches and blocks the nerve endings, which leads to pain relief.

If fluoride or strontium paste was used as topical anesthesia, then the blockade pain carried out by clogging periodontal micropores, thereby eliminating the impact on nerve fibers.

When using silver nitrate or dehydration agents, pain relief occurs due to the narrowing of blood vessels and pores of the mucous membrane.

Regardless of the mechanism of action of superficial anesthesia, the analgesic effect appears within a few seconds or minutes, and can last up to half an hour.

Species

Based on the mechanisms of development of the anesthetic effect, several types of application anesthesia have been identified.

Cauterization

One of the first types of superficial anesthesia, which used potent aggressive drugs: nitric and carbolic acid, zinc chloride, silver nitrate. These products were used not only for freezing periodontal disease, but also dental tissues.

At the moment of application of the product, there was blockage and narrowing of pores that closed the nerve endings from any impact. Cauterization produced results in a short period of time, but never became widespread due to the aggressiveness of the substances used.

They are highly toxic and, when applied directly, damage tooth tissue, pulp and surrounding periodontium.

Dehydration

This type is relief of tooth sensitivity through the use of substances with dehydration properties. Basically, bicarbonate or carbonate is used: sodium, magnesium, potassium, as well as other microelements with similar properties.

The products can slightly reduce sensitivity due to dehydration of enamel and dentin. This method often used for professional cleaning teeth or during minor manipulations on them.

Physiological agents

As a means physiological action secrete sulfidine, aspirin, glycerophosphate, strontium pastes. They are different specific impact to dentinal receptors blocking the transmission of impulses to nerve endings .

In addition to the analgesic effect, these substances have a pronounced therapeutic effect, and therefore are often used in the treatment of teeth with pathological enamel or dentin. Regular use restores the structure of damaged dental tissue and strengthens healthy areas of the teeth.

Local painkillers

The most common type of superficial anesthesia. They allow quickly relieve sensitivity and accurately calculate the time of exposure to the drug.

For the procedure, concentrated anesthetics are used: benzocaine, lidocaine, tetracaine, which can quickly eliminate the conductivity of peripheral nerve fibers.

Indications and contraindications

The main indication for the use of topical anesthesia is increased anxiety patient before administering an injection with an anesthetic drug. Even in the absence of excessive stress, pre-treatment with an anesthetic reduces the psychological discomfort of the patient, which has a positive effect on the work of the dentist.

Especially often, this type of anesthesia is used in children's dental practice. According to the observations of doctors, the worst or unpleasant moment, children do not consider treatment or tooth extraction, but rather an injection into the gums.

In addition to the listed factors, indications for the use of superficial anesthesia include:

professional cleaning;
removal of the neurovascular bundle of the pulp;
any effect on the periodontium;
opening of purulent capsules of gum tissue;
extraction of temporary or permanent mobile teeth;
fixation of orthodontic devices, crowns, prostheses;
treatment of stomatitis, gingivitis;
pronounced gag reflex when taking impressions.

A contraindication for superficial anesthesia is sensitivity or an allergic reaction to the components of the product used. For drugs that contain lidocaine, age under 10 years is a contraindication.

Advantages and Disadvantages

The advantages of this type of sensitivity reduction include, first of all, speed of action of drugs. In addition, there are a number of positive aspects applications:

safety. Since the substances are applied only to the surface of the periodontium, their overall negative impact is eliminated;
duration of exposure which, depending on the concentration of the active substance, lasts from 10 to 30 minutes;
minimum side effects, due to which anesthetics can be used in young children.

Despite the serious advantages, the superficial application of anesthetics has certain disadvantages. The main ones include:

inability to accurately dose the product. As a result of application high concentration painkiller, it penetrates into the bloodstream, where it has toxic effect. Aerosols are especially inconvenient in this regard;
lack of deep analgesic effect, due to which the scope of application of the application method is reduced;
pronounced vasodilator effect which can lead to bleeding gums.

The listed disadvantages are easily eliminated by replacing one remedy with another, and strictly following the methodology for carrying out the procedure of superficial anesthesia.

What drugs are used?

To relieve the sensitivity of dental and periodontal tissue, products are used that contain the following substances as an anesthetic:

lidocaine;
dicaine (tetracaine);
bumecaine (pyromecaine);
benzocaine (anesthetic).

The preparations are presented for use for dental purposes in a wide range in different forms: gels, ointments, aerosols, films, oil- or water-based emulsions.

Often, in addition to the main active ingredient, the composition may include flavorings, antiseptics, and anti-inflammatory components.

To the most popular means include:

Diplen LH

It is a film containing painkillers and antibacterial properties, intended for gluing to the area of influence. The film consists of a hydrophobic and hydrophilic layer with sorption capacity.

They are impregnated with chlorhexidine and lidocaine. After gluing the film, the effect appears within 1 minute. The injection is made directly through the film.

It can be left after the intervention, as the layers dissolve after 12 hours.

Topex – gel based on benzocaine

Apply to the problem area for at least 1-2 minutes. The consistency of the gel allows you to accurately treat the mucous membrane without affecting the healthy area.

Disilane

This drug is in the form of a spray, the main active substance which is also benzocaine. The drug relieves sensitivity for no more than 15 minutes.

A small concentration of the main substance makes it possible to use the product in children over 5 years old.

Desensetin

Refers to the most fast-acting drugs. It contains lidocaine, which has an effect within 10 minutes after application.

Methodology

The high effect of the anesthetic application will be ensured only if it is correct implementation, in compliance with a certain technology. Before applying the anesthetic, the mucous membrane and surface of the tooth are treated with an anesthetic and dried.

Then the drug is rubbed into the mucous membrane or the desired area is irrigated with it. If the dosage is observed, the depth of pain relief will reach up to 3 mm. The duration of action of the product will depend on the main substance and its concentration.

The acceptable range of pain relief is 10–30 minutes. For longer-term relief of sensitivity, the substance is applied repeatedly.

Side effects

As side effect there is a long-term restoration of full sensitivity of the mucous membrane. In children, this can lead to injury due to biting.

For adults this state associated with psychological discomfort, which in the future may be the cause of development.

In conclusion, we suggest watching a video about another type of anesthesia used in modern dentistry:

If you find an error, please highlight a piece of text and click Ctrl+Enter.

Development pharmaceutical industry has made it possible today to minimize any discomfort in the patient during a dental appointment.

Use by a physician various methods pain relief guarantees high-quality and complete implementation of all manipulations necessary for the sanitation (health improvement) of the oral cavity.

In the majority clinical cases local anesthesia is administered, which involves influencing peripheral parts nervous system.

During treatment, only the area of medical intervention in the oral cavity is anesthetized and the patient remains conscious. One of the methods local anesthesia is an application, by applying medications on the mucous membranes of the oral cavity.

General ideas about the methodology

The oral cavity area is reached in two ways:

Injection.
By superficial impact on the mucous membrane without damaging its integrity. Methods for carrying out this manipulation can be:

physical;
physico-chemical;
chemical.

The scientific name of application anesthesia is non-injection terminal anesthesia. It refers to chemical methods temporary reversible decrease in sensitivity only in the superficial layers of the oral mucosa.

The essence of this technique is to apply, lubricate or rub an anesthetic drug into the tissues to be anaesthetized.

The advantages of topical anesthesia are ease of implementation, non-traumatic, high efficiency and safety. A wide range of modern painkillers allows this technique to be used not only in adults, but also in children.

Mechanism of action

Application anesthesia is the most in a simple way local anesthesia.

Its peculiarity is that the tissues are impregnated with an anesthetic agent with surface layers mucous membranes to which the pharmaceutical drug is applied.

Modern painkillers are available in the form of:

liquid solutions for applications;
ointments;
gels;
paste;
aerosols;
wafers (tablet forms).

The high efficiency and speed of action of topical anesthesia is achieved due to the significant concentration of anesthetic substances contained in local anesthetics. Active components pharmaceutical product quickly penetrate periodontal tissues and block the activity of receptors and peripheral nerve fibers.

The mechanism of development of local anesthesia depends on the type of drug used for application.

The anesthetic effect can develop due to:

blockage of microscopic pores of the periodontium, as a result of which the effect on nerve fibers is stopped;
narrowing of the lumen of blood vessels and pores of the mucous membrane.

Local anesthetics also include fluoride varnishes to numb hard dental tissues.

Indications and contraindications

Application anesthesia is carried out in the following clinical cases:

preliminary anesthesia before injection anesthesia;
removal of primary and permanent mobile teeth (III degree);
orthopedic treatment – during fitting (adjustment) of crowns and bridges;
removal of hypertrophied areas of gums ();
opening of submucosal abscesses;
as part of complex therapy and stomatitis;
stopping a pronounced gag reflex.

Some types of local anesthetics are applied directly to hard tissues tooth. This anesthesia is used to treat caries.

Application anesthesia is prohibited:

if the patient has hypersensitivity to the action of any component local anesthetic;
children under 10 years of age - when using certain painkillers.

Possible side effect topical anesthesia – development of allergic hypersensitivity to varying degrees burdens. However, preliminary collection of general somatic and allergy history, allows you to avoid complications during the dental process.

Technique of application anesthesia

The high efficiency of local anesthesia is ensured by strict adherence to the algorithm for its implementation:

Preliminary disinfection of the oral cavity - mouth rinsing antiseptic, for example, a solution of furatsilin.
Isolation and drying of saliva from the area of the mucous membrane that needs to be anesthetized (covering with gauze napkins).
Application of a pharmaceutical agent to the mucous membrane. Liquid anesthetics are applied using a cotton ball or gauze ball soaked in medicinal solution. Gel-like preparations are distributed on the surface surgical field thin layer using a spatula. Aerosols are sprayed within a few seconds.
The local anesthetic is left on the surface of the surgical field for 1-3 minutes, after which its remains are removed with a gauze pad and the sensitivity of the treated area is checked with a needle or probe. If the quality of anesthesia is unsatisfactory, it is repeated.

Despite the widespread and convenient use of painkillers in the form of aerosols, their use is undesirable. Disadvantages of such anesthetics: - poor control of the spray area and dosage of the drug, the risk of the drug getting into the upper respiratory tract patient, professional allergization of the dentist. In any case, it is better to apply painkillers using a cotton swab.

Regardless of the type of local anesthetic, the analgesic effect appears 1-3 minutes after its application and lasts 15-20 minutes.

Preparations used for topical anesthesia

The main local anesthetics used in dental practice:

– used in the form of 5-15% aerosol solutions, 2-5% ointments and gels;
Silver nitrate, carbolic and trichloroacetic acids are available in solid form (lapis) or as a solution. They have a cauterizing property, so their use in children is limited;
Septodent (Anextopulpa) is a fibrous paste that has an anesthetic and disinfecting effect. Applied to hard tooth tissues for pain relief during caries;
Dicaine (Tetracaine) - available in the form of 0.5-4% solutions and ointments. Due to high toxicity, it is not used in children under 10 years of age;
Pyromecaine (Bumecaine) – available in the form of a 5% ointment and a 2% solution. The intensity and duration of the analgesic effect is not inferior to Dikain, but is less toxic;
Anestezin – used in the form of 5-20% oil solutions, ointments, pastes, powders;
Kalgel is a dental gel used for painful teething, as part of complex therapy for gingivitis and stomatitis;
Sensigel is a gel containing fluorinol and potassium. Used to reduce tooth sensitivity and protect them from external irritants;
Fluoridine, Bifluoride 12 – fluoride-containing varnishes used for therapy high sensitivity(hyperesthesia), caries prevention, pain relief during dental plaque removal;
Urea, soda slurry, hypertonic solution– means used for hyperesthesia of hard dental tissues. A decrease in tooth sensitivity is due to dehydration of their tissues after application of the drug;
Drill - lozenges for resorption, which have an analgesic and antiseptic effect.

You cannot purchase and use painkillers on your own. The choice of anesthetic is made by the dentist, based on the collected medical history and taking into account the complexity of the required medical intervention.

Many dental procedures are painful, unpleasant and causing discomfort. During their implementation, involuntary defensive reflexes, arising as a reaction to pain, which, in turn, is fraught with damage to healthy tissue, because such manipulations are usually carried out using sharp instruments.

To minimize pain during the removal of dental defects, the use of local anesthesia is common. It provides comfort when carrying out dental procedures and their high-quality, full implementation. One option is topical anesthesia, which is used to numb the superficial skin and mucous membranes.

What is topical anesthesia and how it is performed?

Application anesthesia is a type of superficial anesthesia, which is carried out by applying special concentrated agents to the required limited area of the skin and mucous membranes, without the use of injections. The applied drugs instantly spread their effect to a depth of 3 millimeters, blocking the impulses of nerve fibers located on the surface from the first seconds or minutes after application.

The drugs that are used are available in the form of gels, ointments, solutions and sprays. It is possible that the dentist rubs the product in manually in order to speed up and enhance the effect of the drug. When spraying an aerosol, the drug also reaches other parts of the oral cavity, which is not always desirable.

Medicines are not the only way implementation of anesthetic application. Pain relief can be carried out by physical or chemical influence, for example, cooling or cauterization.

The doctor must select the type of anesthesia and the means for it, taking into account the direction of the future manipulation and the characteristics of the patient’s body.

Ensuring the effectiveness of the application is possible as a result of its correct implementation:

Before starting the pain relief procedure using an anesthetic application, you should check whether the chosen remedy does not cause allergies.
The mucous membrane and tooth surface are first dried.
The anesthetic is applied with a cotton swab or rubbed into the oral mucosa.
If there is no effect or to prolong the analgesic effect, the procedure is repeated. Depending on the tooth being treated, the dosage changes, since each tooth has its own sensitivity threshold.

Types of topical anesthesia

This article talks about typical ways to solve your issues, but each case is unique! If you want to find out from me how to solve your particular problem, ask your question. It's fast and free!

This method of superficial anesthesia, such as topical anesthesia, has a certain classification, which is based on the methods of exposure. In total, there are four types of it - cauterization, dehydration, physiological and local effects:

Cauterization. With this method, due to the narrowing and clogging of the pores, the nerve endings are closed from any impact. Cauterization is carried out using aggressive substances, including nitric and carbolic acids, zinc chloride, and silver nitrate solution. Since they are toxic and their use is often accompanied by damage to dental and pulp tissue, the method is not widely used.
Dehydration. A decrease in tissue sensitivity to pain is due to the use of agents that reduce the amount of fluid in enamel and dentin. These include bicarbonate or carbonate of sodium, magnesium, potassium and other elements with similar qualities.
Physiological effects. When applied special paste, for example, aspirin, strontium, glycerophosphate or sulfidine, the transmission of pain impulses to the nerve endings is blocked. In addition to pain relief, it is used in therapeutic purposes, as it helps restore damaged tissue and strengthen teeth.
Effect of local anesthesia. As a result, the conduction of nerve fibers in the periphery is blocked. It is carried out using anesthetics.

Medicines used for topical anesthesia

All drugs that are used for superficial pain relief in dentistry are divided into three large groups:

anesthetics;
dehydration agents, which are alcohol solutions;
combined means.

Among the most commonly used anesthetics for anesthesia are:

When using alcohol solutions a decrease in sensitivity occurs due to tissue dehydration. The most popular is propolis solution, which effectively eliminates pain.

Regarding combined agents, then in addition to anesthetics they contain extracts of medicinal herbs. Examples of such drugs are Lidoxor and Kalgel. Pleasant taste and the absence of tingling of the mucous membrane after application makes these drugs convenient and popular in pediatric dentistry.

When is topical anesthesia used?

The use of topical anesthesia as a pretreatment before an anesthetic injection is widespread. The procedure reduces anxiety and psychological discomfort. This is especially true for children who are afraid of injections.

There are a number of situations in which this type of pain relief cannot be avoided. Application anesthesia is used when they want:

Contraindications and side effects

The main contraindication to the use of topical anesthesia is individual sensitivity to the components of the drug, which is used as an anesthetic. If the drug contains lidocoine, then the use is age restrictions, and is only allowed from 10 years old. Other contraindications include: