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Dental Anesthesia

What Type of Anethestic Should be Used?

06/27/2011

Question:

I have a history of severe pain during dental procedures and would like to know what type of anethestic should be used in a root canal for someone with this history?

Answer:

From your description above, your history is not very clear and can mean many things. Also, I do not know your age, medical history, current medication, etc. that may influence this choice in addition to not knowing which tooth needs to be anesthetized.

That being said, besides conventional local anesthetic injection techniques, there are a number of "supplemental" techniques that may help. Unfortunately, not all dentists provide all the techniques. But, most root canal specialists do and they are called endodontists. You may want to discuss visiting an endodontist with your general dentist if he or she has had trouble with supplemental techniques in the past.

If the tooth is in the upper jaw, I might prefer 4% articaine with epinephrine, assuming no medical issues with this anesthetic. If in the lower jaw, nerve block with 2% lidocaine with epinephrine and infiltration with 4% articaine with epinephrine. Again, I do not know the exact situation and would discuss this with your dentist. If needed, IV sedation or general anesthesia can also usually be arranged. Good luck!

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Response by:

Steven I Ganzberg, SB, DMD, MS Steven I Ganzberg, SB, DMD, MS
Formerly, Clinical Professor of Dentistry
College of Dentistry
The Ohio State University