Recovery time after anesthesia in dentistry

What is anesthesia?

The procedure for injecting special drugs aimed at eliminating local sensitivity is called anesthesia. The active substance of the anesthetic blocks the conduction of impulses from nerve endings to the brain, preventing the occurrence of pain in response to manipulations. After the anesthetic wears off, sensitivity is completely restored.

Today in dentistry there are several types of local anesthesia. The most commonly used anesthesia is an injection into the area of ​​one tooth. Other methods are aimed at “switching off” the nerves of several teeth at once.

The anesthesia procedure allows you to avoid discomfort during dental procedures, which is why anesthesia is used everywhere during the treatment and extraction of teeth.

Types

There are three main types of anesthesia . General anesthesia is just one of them.

Local anesthesia is another option. It is done before minor surgeries such as toenail removal. This reduces pain in small, focused areas of the body, but the person receiving treatment remains conscious.

Regional anesthesia is another type. It numbs the entire part of the body - the lower half, for example, during childbirth. There are two main forms of regional anesthesia: spinal anesthesia and epidural anesthesia.

Spinal anesthesia is used for operations on the lower extremities and abdomen. The anesthetic is injected through a special very thin needle into the intervertebral space of the lumbar region . Epidural anesthesia is used for long-term pain relief. Can be used for operations on the chest, abdomen, and lower extremities. During an epidural, a thin plastic catheter is inserted through which a local anesthetic is injected. Pain relief can last as long as needed.

Reasons for the lack of effect of anesthesia

• Individual features of anatomy. The effect of the local anesthetic is ensured by its injection into a specific location near the nerves. However, there are people who have a non-standard structure and arrangement of nerves. In such situations, additional injections of anesthetic solution are required in other areas.
• Local inflammatory process. In the presence of infectious inflammation in the tissues, the pH level decreases, which indicates an increase in the acidity of the environment. Under such conditions, the chemical structure of anesthetics is destroyed and their effect is neutralized. There are several solutions to this problem: preliminary therapy with antibacterial drugs or the use of alternative methods of pain relief that do not affect the area of ​​inflammation (Gow-Gates anesthesia, intraosseous anesthesia, etc.).
• Ehlers-Danlos syndrome. This is a genetic disease that affects the condition of the skin, bone tissue and muscles. With this pathology, conventional anesthesia is not effective, and it is necessary to resort to the use of stronger drugs. In some cases, for high-quality pain relief, several injections are required at once.
• Psychological state of the patient. With dental phobia (panic fear of dental treatment), the production of anxiety hormones that interfere with the action of anesthetics increases. People with this condition are advised to take sedatives before visiting the dentist.
• Red hair color. It is known that red hair is a consequence of a mutation in the melanocortin-1 gene, a change in which also reduces the effectiveness of local anesthesia.
• Poor quality anesthetic. If the storage rules for the drug are not followed and its expiration date expires, you may not expect any effect from the administration of the anesthetic. Therefore, you should be responsible when choosing a doctor and a clinic where treatment will be carried out.
• Insufficient amount of administered drug. If the dosage is incorrectly selected, the anesthetic will not be able to work effectively.
• Wrong choice of drug for pain relief. The anesthetic should be selected by the dentist depending on the method of anesthesia and the desired result.
• Violation of the integrity of the mucous membrane at the site of injection of the anesthetic. The solution will simply flow out of the tissue without having the desired effect. This can happen if you select an injection needle incorrectly, which will injure the mucous membrane, forming a wide channel behind it.

If pain relief is repeatedly unsuccessful during treatment or tooth extraction, the dentist will be able to determine the cause of the problem and select an alternative method of anesthesia.

How to cope with pain after dental treatment?

To feel comfortable after dental treatment, you must first take proper care of your oral cavity. The dentist must tell the patient in detail exactly how to carry out daily hygienic care of teeth and gums. After installing a filling or cleaning the canals, it is important not to put heavy stress on the treated tooth for some time. The following methods are also effective:

• Cold compress . Exposure to cold is good for eliminating swelling and dulling pain after invasive dental procedures. On the first day after treatment, you can apply cold compresses to the cheek in the area of ​​pain. In order not to overcool the tissues, it is important to take a short break every 10-15 minutes.
• Baths with antiseptics or medicinal herbs . In some cases, it is recommended to take baths with antiseptic solutions several times a day to prevent infection and relieve pain.
• Taking medications . To improve your well-being in the first few days after dental treatment, you can take non-steroidal anti-inflammatory drugs that quickly and effectively relieve pain, swelling and other unpleasant symptoms. A safe remedy must be recommended by a doctor. Antibiotics after dental treatment are also prescribed exclusively by the attending physician.

If you follow all the doctor’s recommendations, the pain after tooth treatment will gradually decrease and completely disappear after a few days.

Recommendations before visiting the dentist:

• The night before your appointment, drink lemon balm or chamomile tea before bed. These natural remedies have excellent calming effects.
• If you have constant strong feelings, before each dentist appointment, it is recommended to take a course of light sedatives a week before visiting the doctor. For example, “Afobazol” and “Tenoten”, they calm the nervous system, improving well-being and relieving anxiety before dental surgery. Drugs such as valerian and motherwort are best taken in tablets: tinctures are alcohol-based, which impairs the quality of pain relief.
• For the same reason, you should not drink alcoholic beverages at least 24 hours before your dentist appointment. Alcohol is eliminated from the body within 72 hours, but the products of its metabolism remain in the body for another week. To speed up the cleansing of the body from toxic substances, it is recommended to take sorbent preparations.
• Get a good night's sleep and eat before your appointment. This way you will save yourself from additional stress, and, consequently, from unnecessary problems during dental procedures.
• Be sure to tell your dentist about any medical conditions you have and the medications you are taking! This will help the doctor choose the right method of pain relief and anesthetic. In addition, taking certain medications can greatly reduce the quality of pain relief.

The main recommendation would be a careful approach to choosing a dental clinic and doctor. After all, a competent dentist, even if difficulties arise with administering anesthesia, will be able to find the right way out of the current situation.

Unintentional intraoperative awakening

This refers to rare cases where patients report remaining conscious during surgery, long after the anesthetic should have taken effect . Some patients are aware of the procedure itself, and some may even feel pain.

Unintentional intraoperative awakening is incredibly rare, affecting approximately 1 in every 19,000 patients under general anesthesia.

Because of the muscle relaxants used at the same time as anesthesia, patients are unable to let their surgeon or anesthesiologist know that they still know what is happening.

Unintentional intraoperative awakening is more likely during emergency surgery.

Patients who experience unintentional intraoperative awakening may suffer from long-term psychological problems. Most often, awareness is short-lived and only sounds, and occurs before or at the very end of the procedure.

According to a recent large-scale study of this phenomenon, patients experienced involuntary twitching , stabbing pain, pain, paralysis and suffocation, among other sensations.

Because unintentional intraoperative awakening is rare, it is unclear exactly why it occurs.

Indications for treatment under anesthesia

• Dentophobia/stomatophobia (panic fear of dentistry in both children and adults);
• Very low pain threshold;
• Strongly expressed gag reflex;
• Individual intolerance to drugs included in local anesthesia, allergic reactions;
• Mental abnormalities that exclude the possibility of contact between the doctor and the patient, when the patient is unable to adequately respond to the doctor’s actions;
• A large amount of work, or a very long treatment time;

Possible complications during general anesthesia

There are many side effects of general anesthesia. Sometimes, even in the absence of contraindications, the body's reaction to an anesthetic can be unpredictable, so anesthesia is always a risk. The following complications may occur:

1. Decreased cognitive function of the brain;
2. Difficult recovery from anesthesia, prolonged confusion;
3. Dizziness;
4. Nausea and urge to vomit;
5. Strong headache;
6. Muscle pain;
7. Injury to the oral cavity (tongue, teeth, lips);
8. Respiratory tract infection;
9. Severe brain damage, death (the percentage of cases is minimal).

Medicines you shouldn't take

Many people use homemade medications for pain relief. But they have low efficiency and can provoke undesirable results:

1. Aspirin. The medicine is intended to perform an antipyretic function. The analgesic effect is minimal. Aspirin is a good blood thinner. This may lead to delayed bleeding. Although this medicine is included in many painkillers.
2. Paracetamol. The drug can only cope with mild headaches. It has no anti-inflammatory effect and has a negative effect on the liver. Included in painkillers as an adjuvant.
3. No-shpa. Many people think that this medicine is a pain reliever. But that's not true. No-spa is an antispasmodic drug that only eliminates pain associated with spasms. The pain after tooth extraction is completely different and no-spa will not be able to cope with it.

Basic painkillers

Not any anesthesia can be used when extracting a tooth. In dentistry, only the most common and effective medications are used. And almost every hospital has Novocaine.

But in modern treatment, novocaine is used much less frequently. If previously not a single operation could be done without it, now this drug causes an allergic reaction in most people. It has a number of side effects:

1. dizziness;
2. lethargy;
3. lowering blood pressure.

Today there are more intense anesthetics, and therefore novocaine is used only in combination. It is injected into the body with a small dose of adrenaline. In combination, these drugs have the best analgesic functions. But such a mixture should not be prescribed to people whose blood pressure is off the charts.

For infiltration anesthesia, a 0.5% lidocaine solution is used. This drug can be used for the conduction method; only a 1–2% solution is required. For an adult, the norm is 300–400 mg. Side effects of this medicine include:

1. headache;
2. fatigue;
3. loss of sensation in the lips and tongue;
4. heart rhythm is disturbed;
5. blood pressure decreases;
6. there may be hives.

The most modern anesthesia is a medicine based on the substance articaine. Such drugs can provide long-term and reliable pain relief. It is used by a large number of dental surgeons. The substance reaches its maximum effect after 10 minutes and maintains its result for 1–3.5 hours. But no matter how good the drug is, it always has side effects:

1. muscle twitching;
2. headache;
3. tremor;
4. nausea;
5. vomiting reflex;
6. diarrhea.

These are the most common side effects. But sometimes others happen:

1. blood pressure decreases;
2. cardiac arrhythmia is disturbed;
3. rashes appear on the skin;
4. angioedema may occur.

These painkillers cannot be used for meningitis, tumors, osteochondrosis, spondylitis, tuberculosis, metastatic lesions of the spine, heart failure, tumors in the abdominal area, severe arterial hypotension, and hemostasis disorders.

Use with caution during pregnancy. The drug may cause a decrease in the fetal heart rate.

A very good drug based on articaine is Ubistezin. It also contains adrenaline. It reduces blood vessels in the area where anesthesia was administered. This makes it difficult to absorb the substance. As a result, the analgesic effect begins to act within 3 minutes. In addition to the above listed side effects that drugs based on articaine have, Ubistezin also adds the likelihood of an ischemic zone in the area where anesthesia was administered. This occurs if a blood vessel has been hit or a nerve has been damaged.

Expert opinion

Emir Romanovich Omerelli

Maxillofacial surgeon, implantologist

Experience: more than 13 years

To exclude the development of complications, before starting treatment it is necessary to conduct a thorough examination: ECG, X-ray of the lungs, consultations, if necessary, with a therapist, cardiologist and other doctors, collection of blood tests. All this is important to fully assess the patient’s condition and select the optimal type and drug of anesthesia.

They are as follows:

1. Mask (inhalation), which is carried out by the patient inhaling a mixture of oxygen and anesthetic gases through a mask. This type of anesthesia is often given to children;
2. Intravenous. By introducing anesthetic drugs into the blood.

Dental procedures that can be performed under general anesthesia:

1. Removal of a tooth cyst;
2. Removal of several wisdom teeth;
3. Multiple dental implants.

What to prepare for after removal: what is considered normal, and when to urgently see a doctor

In order to prevent the development of dangerous situations after tooth extraction, you need to notice alarming signs, and even if they are mild, consult a doctor in time - this way you will avoid serious complications. This may be alveolitis, fistula, nerve damage and other pathologies. They cannot be stopped or cured at home.

In the table, we have listed the symptoms and explained in which cases they should alert you, and when the situation remains within the normal range.
What to prepare for after removal