Local Anesthesia in Dentistry

Pain and dentistry are often synonymous in the minds of patients, especially those with poor dentition due to multiple extractions, periodontal disease requiring surgery, or symptomatic teeth requiring endodontic therapy. Members of the public perceive a good dentist as a practitioner who causes little or no discomfort. In turn, dental practitioners identify a good anesthetic as one that allows them to focus solely on operative procedures without distractions from pain-induced patient movements. The everyday practice of dentistry is therefore based upon achieving adequate local anesthesia. Research has shown that the fear of pain associated with dentistry is closely associated with the most common method for blocking pain during dental procedures—intraoral administration of local anesthetics. This is considered aversive due to the pain associated with the injection and the perceived threat of needle puncture prior to the injection. Another survey finding was that those individuals who reported themselves as highly fearful of dentistry were worried about receiving oral injections and demonstrated an association between high dental anxieties and missed or delayed appointments. Pain is a result of stimulation of nociceptors that are receptors preferentially sensitive to a noxious stimulus or a stimulus that will become noxious if prolonged. When nociception reaches the cerebral cortex, it may be perceived as pain. Pain may be abolished by interrupting the pathways that carry the information of the stimulus from the periphery of the body to the central nervous system, by blocking the central nervous system, or by removing the stimulus. Local anesthetics block sensory neuronal conduction of noxious stimuli from reaching the central nervous system. omnicef 300mg