Learn about the benefits and risks of local anesthesia in dentistry

Local anesthesia used by dentists allows several common dental procedures to be performed. Local anesthetic techniques in dentistry eliminate pain and sensitivity in the mouth to prevent discomfort during oral treatment .

Injections are required for local anesthesia, which is used for complex and uncomfortable procedures as well as for the treatment of various oral diseases, but it has the effect of eliminating the pain of oral treatment.

However , side effects may occur depending on several factors Dentists always try to take necessary precautions to avoid this.

Definition of Local Anesthesia in Dentistry

Local anesthesia used in dentistry is a procedure that suppresses nerve conduction in a specific area of ​​the mouth by injecting or applying a special substance to eliminate discomfort and sensitivity.

There are many ways to suppress the patient’s pain, but local anesthesia is most often used for general treatment, such as:

The patient is conscious and able to communicate under anesthesia and during dental procedures . It removes only the sensitivity of the area being treated.

The most common substances that can be applied for an anesthetic effect  are:

  • Prilocaine
  • articaine
  • bupivacaine
  • lidocaine
  • mepivacaine

It binds to vasoconstrictors such as epinephrine to prolong and localize their effects and reduce tissue bleeding.

It usually takes about 10 minutes for the anesthetic effect to appear. The paralysis lasts between 30 and 60 minutes depending on the medication used and the patient .

After application, the area feels numb and desensitized. You may also feel itchy or have a swollen mouth. The effect goes away after a few hours of anesthesia.

Local Anesthetic Sensitivity in Dentistry
Local anesthesia in dentistry helps avoid sensitivity and pain during various treatments.

Types of local anesthesia in dentistry

Dentistry uses different types of local anesthesia depending on where the drug is injected .

  • Infiltration anesthesia: A method of directly placing an anesthetic needle on the apical part of the tooth to be anesthetized, injecting it into the upper layer of the periosteum or inserting it into the thin upper jaw bone where anesthesia is well performed. It is often used on the roof of the mouth and parts of the lower canal, particularly in children.
  • Delivery anesthesia: With one anesthesia, the nerve is blocked not only to the anesthetized area but also to a large area dominated by the nerve. It is often used to anesthetize the entire lower canal, including the teeth, tongue, and lips, by desensitizing the lower dental nerves. It can also be used for the orbital nerve, large palatine nerve, nasal palatine nerve, Mentonian and buccal nerves.
  • Anesthesia in the periodontal ligament: The periodontal ligament is the space between the teeth and gums. It is usually performed in conjunction with the previous two anesthetic techniques.

Benefits of Local Anesthesia in Dentistry

The main advantage of using local anesthesia in dentistry is that the patient is treated without discomfort or pain. Also, both patients and dentists benefit.

  • The patient remains conscious and can cooperate during the intervention .
  • Patients are able to return home on their own without assistance from others.
  • Easy to place.
  • have minimal effect on the patient.
  • The failure rate is very low.
  • It is inexpensive and does not entail any additional costs.


As with all drugs applied to the body, dental local anesthetics cannot avoid side effects. However, these situations are sporadic and rare.

According to a COEM (Official College of Dentists and Stomatologists of the 1st Region) study on complications associated with oral anesthesia, the following can occur:

  • Injection pain: As with other injections, you may feel pain when punctured. If multiple injections are given to the same area, the injection is given too quickly, the medication is very cold, or the doctor is not careful, the pain can be severe.
  • Gastrointestinal Disorder: Inability to open the mouth normally due to spasm of the masticatory muscles. It may be associated with pain reflexes due to bleeding, contusion, or internal pterygoid muscle trauma during injection into the jaw.
  • Facial Nerve Paralysis: Paralysis may occur immediately or after the anesthetic is injected. It occurs when an anesthetic is accidentally placed in the deep lobe of the parotid gland through which the facial nerve passes.
  • Paresthesia : Perceived numbness, partial loss of sensation, burning sensation and tingling sensation in the affected area even after anesthesia has worn off.
  • Self-induced soft tissue damage: numbness in the cheek or tongue area, which can result in an unknowing bite or injury . You do not feel pain at the moment, but after the anesthetic effect wears off, the lesions in your mouth are painful.
  • Allergic reactions: Although rare , anesthetic medications can cause allergic reactions. It can cause urticaria, pruritus, edema, rhinitis and, in rare cases, an anaphylactic process.

Other complications associated with local anesthesia in dentistry

Some patients may experience other complications related to anesthesia . Locally, bruising at the injection site, ischemia of the facial skin, or infection of the anesthetized area may occur .

Nausea or vomiting may occur. Headaches or headaches, sweating, tremors, dizziness, fatigue and dry mouth may also occur. Very rarely, you may experience convulsions, heart problems, respiratory failure, and coma .

Local anesthesia pregnancy in dentistry
To reduce the risks when applying local anesthetics in dentistry, it is important to inform your dentist about possible pregnancy, underlying medical conditions, and any other special conditions.

Precautions before using local anesthetic

There are conditions and circumstances that require a special evaluation by a dentist prior to the application of an anesthetic in the mouth . Proper communication between dentist and patient is essential to avoid discomfort.

Meanwhile, the dentist has to explain the risks and safety measures to the patient. Patients should clarify all their health-related information to specialists before treatment.

Here are some situations that patients should inform their dentist about.

  • Pregnancy: Pregnant women should inform their dentist of their condition (even when in doubt). Local anesthesia is recommended for use in the second trimester of pregnancy.
  • Special circumstances: Some patients with special circumstances often have complications during treatment and need to adjust the anesthetic dose. It is also desirable to add a sedative to facilitate anesthesia.
  • Age: Children and the elderly also require special consideration when using local anesthesia.
  • Liver, kidney, lung or heart problems: You may need to adjust the anesthetic dose or use a vasoconstrictor-free product.
  • Oral infections or open sores in the mouth: Allow the lesion to heal before anesthesia.

Communication between dentist and patient

As we have seen, local anesthesia in dentistry provides many advantages for treatment and rarely causes side effects.

To avoid side effects, communication between the dentist and the patient is essential . This is because communication is key to clearing doubts and informing you about situations related to your health condition.

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