Comfortably Numb

Today drilling and tooth extraction's are routine and often painless dental procedures. This is due almost entirely to the discovery of local anesthetics and the ability to apply them deep into the tissue of the mouth.

Cocaine was the first local anesthetic to be used routinely in dental work starting in 1884. While effective at numbing the surface of the skin, it did little to deaden nerve endings deep within the tissue. It wasn't until 1920 when the syringe was combined with a cartridge designed to hold a local anesthetic, that anesthetics were applied deeper into surrounding tissue. Since then the cartridge syringe has continued to be the primary tool used by dentists to apply local anesthesia to oral tissue. While effective, the syringe has shortcomings. Most notably, the very sight of a syringe causes some people anxiety.

In the past decade strides have been made in dental instrumentation to improve how local anesthetics are applied. In the early 1990's a noninvasive dental anesthesia application was developed called Targeted Electronic Anesthesia (TEA). TEA uses electronic signals operating at a low frequency that penetrate tissue to block the pain signals being sent to the brain. The electronic signal is transmitted through very low electrical current pads placed on the back of the patient's hands. The signals travel through the body to a receptor placed in the tissue to be treated, effectively blocking the pain receptors.

TEA has many advantages over the traditional syringe. Since no chemicals are injected, the chance of an allergic reaction is practically eliminated. Also, the discomfort associated with initial needle penetration in the mouth is eliminated reducing the anxiety associated with dental procedures. However, TEA cannot be used with patients who are pregnant, have pacemakers, suffer from seizures, or used in tandem with other electrosurgical instruments.

While TEA changes the type of local anesthetic itself, from chemical to electrical, other improvements have been made in how traditional local anesthetics are applied. Usually the discomfort experienced with a syringe is due to the plunger system within the syringe that regulates the flow of anesthetic. The plunger system makes it difficult to regulate the flow of anesthesia causing changes in pressure that may result in discomfort.

A recent technological advancement takes the novel approach of pairing the syringe with a computer to create a "smart needle". A monitor is attached to the tube that carries the anesthesia enabling the dentist to precisely gauge the rate of flow. Flow of the anesthesia can be corrected instantly through a foot pedal that regulates the flow rate and volume of anesthetic passing through the needle. This ability to maintain an almost perfect flow rate is central to creating a practically pain free injection.

These are only a couple of the advances being made in dentistry. Dentistry as a whole is a state-of-the-art medical practice that is constantly changing and making technological advances to better aid the patient. Curious about other advances in dental instruments? Just ask your dentist to point out the latest instrumentation in the office during your next visit. You'll be amazed at the cutting edge technology surrounding you that helps you keep that winning smile.