Paglakov Pavel PhotoSince childhood, dental treatment has been associated with pain. And at a more mature age in the background, the thought will certainly overwhelm: what if it hurts? Or will anesthesia not work?

Dentist of the Dudko & Sons dental implantation center Pavel Pazhlakov answered questions about the possibilities of pain relief in modern dentistry:

— Pavel Anatolyevich, could you outline, in general terms, which pain management options exist in modern dentistry?

All methods are divided into local, general anesthesia and their combinations. Local means that it acts only on the area that actually needs to be anesthetized, that is, in our case, on the nerves that directly transmit the pain signal from the tooth. With general anesthesia (or anesthesia), a person falls asleep and does not feel anything. In dentistry, this option is overwhelming in most cases. We always try to adhere to the golden rule: anesthesia should be adequate and reasonable – that is, correspond to a specific clinical situation. In each case, you need to choose the most effective and, at the same time, safe way of pain relief.

— How can I “disconnect” a nerve transmitting a pain signal from a tooth?

For this, local anesthetics are used, what is popularly called “freezing”. These substances block the nerve signal. How to deliver anesthetic to the nerve? The two most popular options are the so-called infiltration and conduction anesthesia. In the first case, we simply inject anesthetic into the tissue with a syringe – naturally, it reaches the peripheral nerve endings and blocks them. In the second – we introduce the drug in the immediate vicinity of the nerve in the place where all the fibers that conduct the signal from the desired area have already gathered in a single bundle. In any case, all the ways in which the message of pain can reach the brain are blocked – and the person does not feel anything.

— But the injection itself is also not very pleasant. Some are afraid of the injections themselves.

In this case, there is application anesthesia. Its essence is that an anesthetic, gel or spray is applied to the area that needs to be anesthetized before anesthesia is done with a syringe. Application anesthesia is not very effective in that it only anesthetizes the superficial layers. But on the other hand, it allows you to “disconnect” a section of the skin, so that the patient does not feel an injection.

— Does local anesthesia have side effects?

Some people have intolerance to local anesthetics. Perhaps, remember that when you go to the dentist, he always asks: “Have you done pain relief before?” This is done in order to find out if the person had a reaction to local anesthesia.

— If there was such a reaction, what should I do? To treat teeth under general anesthesia?

No, why is it so radical right away. Just apply another anesthetic, there are a lot of them that are being released now. Sometimes, however, there are patients who do not tolerate any local anesthetics at all – then anesthesia or sedation.

– So, can any patient have adequate pain relief? And is there a difference in pain relief for the upper and lower jaws?

Yes. Of course, difficult cases happen, but the arsenal of methods is so wide that there is always something suitable. And if we consider the analgesic effect, then the lower jaw is not always observed 100% anesthetic effect because bone tissue is denser. Because of this, the anesthetic is less permeable to the solution. In such cases, we increase the waiting time for the onset of anesthetic pain relief or increase the dose of the drug.

– Thank you, Pavel Anatolyevich, having talked with you, it’s almost not scary to go to treat your teeth. But still I really do not want to be drilled …

And it is not necessary! My advice to patients is to go to the dentists before something starts to hurt. You need to try at least twice a year to go for a routine examination in order to prevent those complications that can cause a lot of problems. Do not be afraid to go to the dentist, he is not an inquisitor: if you are healthy, no one will climb to make extra “holes” in the teeth. And if the teeth need to be treated, today it can be done absolutely painlessly.

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