Dental anesthetics. Anesthesia in dentistry: types and contraindications. Local anesthesia in dentistry

Fear of treatment or tooth extraction is largely due to the fact that previously there were no good quality anesthetic drugs. Today, clinics use new generation anesthetics. Painkillers in dentistry completely eliminate pain both during the main actions and at the time of their administration.

Indications for the use of painkillers in dentistry

Anesthesia is required when performing the following manipulations:

What painkillers are used in dental treatment?

The best means for local anesthesia are considered to be articaine anesthetics.. The main substance is much more effective than Novocaine and Lidocaine.

An important feature of Articaine is the possibility of its use in purulent inflammations, when the effect of other drugs is reduced. In addition to the main component, modern anesthetics contain vasoconstrictors.

Adrenaline or epinephrine constrict blood vessels, preventing the drug from being washed out from the injection site. Pain relief time increases.

The drug is an analogue of Ultracaine, their composition is the same. Produced in Germany in two forms depending on the epinephrine content.

Mepivastezin or Scandonest

Available in two forms, it contains adrenaline, as well as preservatives that can provoke an allergic reaction. The effect after administering the drug to the patient occurs within 1-3 minutes. Septanest is acceptable for use in children over 4 years of age.

Included in the group of second generation esters. It is used less and less, since its effectiveness in treating pain is 4-5 times worse than other drugs. Novocaine is most often administered for minor dental operations.

What is pain relief for wisdom tooth removal?

When removing a wisdom tooth, ester or amide anesthetics can be chosen. The action of the former is quick and short-term. These include Pyromecain and Novocain.

Amides include:

trimecaine– injection, anesthetizes for 90 minutes;
lidocaine– valid up to 5 hours;
bupivacaine– relieves pain 6 times better than novocaine, but it is 7 times more toxic, lasts up to 13 hours;
ultracaine D-S– the effect is 5 times higher than after the administration of Novocaine, lasts 75 minutes, can be used by pregnant women;

Names of modern anesthetics without adrenaline

Pain relievers without adrenaline include:

Articaine hydrochloride. Leader among other anesthetics. Available with or without epinephrine and with increased vasoconstrictor content;
Ubistezin. Patients with an allergic reaction, diabetes mellitus, hypertension, bronchial asthma, heart failure and thyroid disease are prescribed a drug labeled “D”, without adrenaline;
Prilocaine. It is used without vasoconstrictors or with a low content of them. The drug is not prescribed to pregnant women and patients with pathologies of the heart, lungs, or liver;
Trimekain. It has a calming effect and is not used very often in dentistry;
Bupivacaine. It is not used for heart pathologies and liver diseases;
Pyromecaine. It has an antiarrhythmic effect, so it is recommended to administer it to people with arrhythmias.

Pain relief during pregnancy and breastfeeding

The best option for pregnant and nursing mothers is a carpule of Ultracaine and Ubisiesin in a ratio of 1:200000. The vasoconstrictor substance does not affect the fetus because it cannot penetrate the placenta.

Both carpule anesthetics are safe for breastfed children, since the components of the drug do not pass into milk. Scandonest and Mepivastezin without epinephrine are also often used by doctors. They are 2 times more toxic than Novocain and are absorbed into the blood faster.

What drugs are used in pediatric dentistry?

In children, pain relief occurs in two stages. First of all, the dentist performs topical anesthesia, that is, using an aerosol or gel with Lidocaine and Benzocaine, reduces the sensitivity of the mucous membrane, then injects an anesthetic.

In pediatric dentistry, preparations with Articaine are more often used. It is less toxic and is quickly eliminated from the body.

According to the instructions, these drugs can be administered to children from the age of 4 years. When molars are removed, an injection of Mepivacaine may be given.

Contraindications and side effects of local anesthesia

Before starting treatment, the dentist must ask the patient about possible somatic diseases or an allergic reaction to any drugs.

Contraindications to anesthesia may include:

allergy to the administered drug;
hormonal disorders due to pathologies of the thyroid gland;
diabetes mellitus

How much does dental anesthesia cost in the clinic?

The cost of anesthesia in dentistry is determined based on individual clinic prices, the equipment used and the experience of doctors. The average price for an injection is 800-1200 rubles, an application costs from 100 to 1500, a conduction method costs from 250 to 4000.

List of the most powerful medications for toothache

There are 3 types of painkillers: opiates, analgesics and non-steroidal drugs. The latter are mainly used in dentistry. They cope well with pain, are not addictive, and can be bought without a doctor's prescription.

There are many medications to relieve toothache, but there are 5 most effective ones:

Ketonal. Based on ketoprofen, prescribed after tooth extraction, as anti-inflammatory therapy after implantation and other interventions;
Nurofen. Based on ibuprofen, it is also used in pediatric dentistry, has virtually no side effects;
Voltaren. Used as anti-inflammatory therapy for TMJ;
Nise. Based on nimesulide, relieves swelling and inflammation;
Nolodotak. Based on flupirtine, relieves acute and chronic pain.

Video on the topic

About the use of pain-relieving injections during dental treatment in the video:

Anesthesia in dentistry is a necessary procedure that relieves discomfort during dental treatment. The main thing is to choose the right drug and warn about possible diseases.

Types of modern methods of anesthesia in dentistry, drugs for pain relief

Fears associated with pain during treatment and tooth extraction are due to the fact that previously there were no high-quality anesthetic drugs. But today, almost all dental clinics use new generation local anesthetics. Modern drugs make it possible to completely eliminate pain not only during the main operation, but even at the time of their administration.

Anesthesiology in dentistry

Anesthesia is the absolute disappearance or partial decrease in sensitivity in the entire body or its individual parts. This effect is achieved by introducing special drugs into the patient’s body that block the transmission of pain impulses from the area of intervention to the brain.

Types of pain relief in dentistry

Based on the principle of impact on the psyche, there are two main types of anesthesia:

Local anesthesia, in which the patient is awake, and loss of sensitivity occurs exclusively in the area of future medical procedures.
General anesthesia (anesthesia). The patient is unconscious during the operation, the whole body is anesthetized and the skeletal muscles are relaxed.

Depending on the method of delivering the anesthetic to the body, dentistry distinguishes between injection and non-injection anesthesia. With the injection method, the anesthetic drug is administered through an injection. It can be injected intravenously, into the soft tissues of the oral cavity, into the bone or periosteum. In non-injection anesthesia, the anesthetic is administered by inhalation or applied to the surface of the mucosa.

General anesthesia in dentistry

General anesthesia is the complete loss of sensitivity of nerve fibers, accompanied by impaired consciousness. In dentistry, anesthesia for dental treatment is used less frequently than local anesthesia. This is due not only to the small area of the surgical field, but also to the large number of contraindications and possible complications.

General anesthesia can only be used in dental clinics that have an anesthesiologist and resuscitation equipment that may be required in case of emergency resuscitation.

General anesthesia in dentistry is only necessary for long-term complex maxillofacial operations - correction of cleft palate, multiple implantations, surgery after injury. Other indications for the use of general anesthesia:

allergic reactions to local anesthetics;
mental illnesses;
panic fear of manipulation in the oral cavity.

Contraindications:

diseases of the respiratory system;
pathologies of the cardiovascular system;
intolerance to anesthetic drugs.

The anesthetic can be delivered by injection or inhalation. The drug most commonly used by dentists for inhalational general anesthesia is nitrous oxide, known as laughing gas. Using an intravenous injection, the patient is immersed in a medicated sleep; for this purpose, drugs are used that have a sleeping pill, analgesic, muscle relaxant and sedative effect. The most common are:

Ketamine.
Propanidid.
Hexenal.
Sodium hydroxybutyrate.

Local anesthesia in dentistry

In dental treatment, local anesthesia is most in demand, aimed at blocking nerve impulses from the surgical field. Local anesthetics have an analgesic effect, due to which the patient does not experience pain, but retains sensitivity to touch and temperature.

The duration of anesthesia depends on how and with what exactly dentists numb the surgical field. The maximum effect lasts for two hours.

Local anesthesia is used for the following procedures:

turning for a bridge or crown;
pin tooth extension;
implantation;
channel cleaning;
surgical treatment of gums;
removal of carious tissues;
tooth extraction;
excision of the hood over the wisdom tooth.

Types and methods of local anesthesia in dentistry

Depending on what area and for how long the sensitivity needs to be deprived, the dentist selects the optimal technology, medicine and its concentration. The main methods of administering anesthetic are:

infiltration;
intraligamentary;
stem;
intraosseous;
applique.

Infiltration method

Used in dental practice and maxillofacial surgery. The advantage of the method is its rapid action, long-lasting analgesic effect, the possibility of repeated administration during a protracted operation, rapid removal of the anesthetic from the body, and deep analgesia of a large area of tissue. About eighty percent of dental interventions are performed under infiltration anesthesia.

The method is used for the following manipulations:

The anesthetic medicine is injected in layers, first under the mucous membrane at the apex of the tooth root, and then into the deeper layers. The patient feels discomfort only with the first injection; the rest are completely painless.

There are two types of infiltration dental anesthesia - direct and diffuse. In the first case, the immediate site of injection of the anesthetic is anesthetized, in the second, the analgesic effect extends to nearby tissue areas.

The following drugs are used for local infiltration anesthesia in dentistry:

Intraligamentous (intraligamentous) method

It is a modern type of infiltration anesthesia. The dose of the administered anesthetic is minimal (does not exceed 0.06 ml), which makes it possible to treat and remove teeth in pregnant and lactating women.

The anesthetic is injected into the periodontal space using a special syringe and under high pressure. The number of injections depends on the number of roots of the tooth. Sensitivity to pain disappears instantly without causing a feeling of numbness, so the patient can speak freely and does not experience discomfort after the operation.

Restrictions on the use of the method are:

The duration of the manipulation is more than 30 minutes.
Fang manipulations. Due to their anatomical features, it is not always possible to anesthetize them intraligamentously.
Inflammatory processes in the periodontium, periodontal pocket, gumboil.
Root cyst of the tooth.

The intraligamentous anesthesia method is the most painless and safe in dentistry, therefore it is often used in pediatric practice. Ease of implementation, painlessness, safety and high efficiency make the method popular among dentists. The cost of this procedure is higher than the infiltration procedure due to the high prices of injectors.

The following drugs are used for intraligamentous anesthesia during dental treatment:

Stem (conductor) method

Distinctive features of the stem method of pain relief are the power and long duration of the effect. It is used during long-term surgical operations and in situations where it is necessary to block sensitivity in the tissue area of the entire lower or upper jaw.

Indications for conduction anesthesia are:

high intensity pain syndrome;
neuralgia;
removal of cystic formations;
endodontic treatment;
severe injuries to the jaw and zygomatic bone;
curettage;
complex tooth extraction.

The injection is injected into the area of the base of the skull, thanks to which two jaw nerves can be blocked at once - both the upper and the lower. The injection is performed by an anesthesiologist and exclusively in a hospital.

Unlike all other methods of local anesthesia, stem anesthesia does not act on nerve endings, but completely on a nerve or group of nerves. The anesthetic effect time is one and a half to two hours. Novocaine and Lidocaine are considered the basic drugs; in modern anesthesiology, more effective agents are used.

Application method (surface, terminal)

It is used primarily in pediatric dental practice to desensitize the site where the anesthetic injection will be given, which ensures an absolute absence of pain. It is used as an independent method in cases where it is necessary:

For topical anesthesia in dentistry, painkillers are used in the form of spray, ointment, paste and gel. Most often, dentists use ten percent lidocaine in an aerosol as an analgesic. The drug penetrates 1–3 mm deep into the tissue and blocks nerve endings. The effect lasts from several minutes to half an hour.

Intraosseous (spongy) method

It is used for anesthesia of lower molars, during the extirpation of which infiltration and conduction anesthesia are ineffective. Instantly eliminates the sensitivity of one tooth and the adjacent gum area. The advantage of this method in dentistry is strong pain relief with small doses of the drug.

Classical intraosseous anesthesia has not received widespread use in anesthesiology due to the complexity of its implementation and the traumatic nature.

The essence of the method is to inject an anesthetic into the spongy layer of the jawbone between the roots of the teeth. Infiltration anesthesia is preliminarily performed. After numbness of the gums, the mucous membrane is dissected and the cortical plate of the bone is trepanned using a drill. The bur is buried 2 mm into the spongy tissue of the interdental septum, after which a needle with an anesthetic is inserted into the formed canal.

Contraindications to local anesthesia

Before prescribing local anesthesia to a patient, the dentist must find out whether there are any contraindications to its administration. The doctor must take special precautions when prescribing anesthesia for children and expectant mothers.

Contraindications to local anesthesia are:

history of allergic reactions to drugs;
diseases of the cardiovascular system;
suffered a stroke or heart attack less than six months ago;
diabetes mellitus;
hormonal disorders and pathologies of the endocrine system.

Modern anesthetics (painkillers) in dentistry

With the advent of local anesthetics and new generation technologies, the usual Novocaine is almost never used in dentistry, especially in Moscow and other large cities. Despite possible complications and a high percentage of allergic reactions, lidocaine remains the main local anesthetic in regional clinics.

When visiting the clinic, you need to provide the attending physician with a complete and reliable history so that he can eliminate all risks and choose the right drug. Most dental clinics use carpule technology to administer anesthetics, which consists in the fact that the active substance is contained in a special disposable carpule, which, without opening manually, is inserted into a syringe. The dose of the drug in the capsule is designed for one administration.

The basis of modern means for local anesthesia is the drugs Articaine and Mepivacaine. In the form of carpule capsules, Articaine is produced under the names Ultracaine, Septanest and Ubistezin. The effectiveness of drugs based on it exceeds the effectiveness of lidocaine by 2, and novocaine by 5–6 times.

In addition to Articaine itself, the carpul contains adrenaline (epinephrine) and an auxiliary substance that promotes vasoconstriction. Due to vasoconstriction, the period of action of the anesthetic is prolonged, and the rate of its spread into the general bloodstream is reduced.

Patients with endocrine disorders, bronchial asthma and a tendency to allergic reactions in dentistry are usually prescribed anesthetics without adrenaline. If powerful pain relief is required, it is permissible to use Ultracaine D with a minimum concentration of epinephrine.

Anesthesia without adrenaline in dentistry

Mepivacaine is used to treat patients with contraindications to adrenaline in dentistry. A drug with this active ingredient, marketed under the name Scandonest, is less effective than Articaine. But it does not contain epinephrine, so Scandonest is suitable for administration to children, pregnant women, people with heart disease, and individual intolerance to adrenaline.

For diseases of the endocrine system, Scandonest and drugs without adrenaline are more often used. It is unacceptable to use products with vasoconstrictor components for hypertension.

The type of anesthesia dentists use determines not only the degree of painlessness of the medical intervention, but also the list of consequences that will have to be encountered after the operation. Modern means minimize the risks associated with incorrect administration of the drug, incorrect dosage and the occurrence of allergic reactions to the anesthetic.

What drugs are used for anesthesia in dentistry?

At least once in their life, every person has experienced toothache. This symptom is a sign of inflammatory processes or pathologies of the jaw. Patients often put off visiting the dentist due to fear of discomfort during treatment. In our review, we will tell you in detail what anesthesia is like in dentistry.

Anesthesia in dentistry is an important element of complete treatment.

What is anesthesia

To prevent the patient from experiencing discomfort, many clinics and professional offices use pain relief. Thanks to anesthesia, sensitivity decreases or completely disappears in certain places or throughout the body. The drugs disrupt the transmission of pain impulses to the brain during operations. The person does not get nervous or twitch, which allows the dentist to quickly and efficiently carry out therapy.

The drug is administered when:

tooth extraction;
treatment of deep caries;
depulpation;
preparatory work for prosthetics;
orthodontic intervention;
low pain threshold.

If the patient has increased sensitivity and any touch causes pain, the dentist decides to administer anesthesia.

In this case, you can calmly perform all the necessary manipulations, and the person will not twitch and interfere with the treatment.

After the injection, the patient experiences numbness in the lips, cheeks or tongue, but after a while the effect disappears. The drug is broken down inside the body and gradually eliminated.

Types of anesthesia

There are several types of pain relief. Depending on the treatment or the patient’s pain threshold, the doctor chooses the best option to help avoid discomfort. Let's look at the most common tools used in modern dentistry.

Local anesthesia

Before almost all manipulations, the doctor uses this type of pain blocking. The drugs are quickly eliminated from the human body and do not have as many contraindications as with anesthesia. Depending on the direction of treatment, funds are divided into several types.

Application. Rapid superficial anesthesia, which is carried out by applying or spraying the medicine onto the oral mucosa. Most often used in the treatment of stomatitis and gingivitis to reduce the sensitivity of soft tissues before injection. It is also used when grinding a tooth before prosthetics and removing hard deposits in the cervical area.
Infiltration. Reduces sensitivity in a small area, which allows you to remove pulp without problems, as well as treat deep caries. The injection is given into the root tip, and the medicine blocks nerve impulses at the level of the branch.
Conductor. If the above method does not work on the patient or it is necessary to numb several closely spaced teeth, this anesthesia is used. The injection completely blocks the entire nerve chain, which is excellent for removing, opening and draining purulent foci, as well as for exacerbations of chronic periodontitis.

There are several types of injection anesthesia

Applying the drug before the injection - for those who are afraid

Local anesthesia helps relieve discomfort during treatment. Modern medications have virtually no complications, so they are used in all clinics and dental offices. Professional introduction will avoid negative consequences.

General anesthesia

This type of anesthesia leads to a complete loss of sensitivity, which is accompanied by varying degrees of loss of consciousness. Such anesthesia is rarely performed and only after indications permitting anesthesia. Serious operations of the maxillofacial region cannot be done without these procedures.

For children, “laughing gas” is most often used: nitrous oxide is given to the patient by inhalation.

for diseases of the cardiovascular system;
due to intolerance to anesthesia;
for diseases of the respiratory organs.

To identify these problems, specialists must take ECG readings for a real assessment of heart activity. And you also need a general blood and urine test (for hepatitis, HIV). If there are contraindications, then the operation is postponed until the course of the disease subsides.

General anesthesia through a mask

Why is such anesthesia prescribed, since there are many safe local methods? An allergy to drugs or panic fear before dental procedures forces the doctor to look for another, more accessible method. For some mental illnesses, general anesthesia is also chosen. Treatment of advanced forms of diseases or removal of teeth with deep roots is difficult without such anesthesia. A strong gag reflex will not allow the therapy to be carried out normally.

After the drug is administered, the patient goes through three stages.

Analgesia. Begins two minutes after injection. This stage is characterized by complete loss of sensation of pain. Speech becomes slurred and the patient soon passes out. Body reflexes are preserved, so it is allowed to perform light, non-traumatic operations (drilling with a drill).
Excitation. Breathing becomes irregular, pupils are dilated. Transitional stage into deep sleep. Now the dentist is taking no action.
Surgical stage. The patient breathes deeply and evenly, and the doctor can calmly remove the wisdom tooth or fill the canals. This condition of the patient allows the most complex operations to be performed.

General anesthesia is given to children only in the presence of an anesthesiologist.

Being unconscious, a person does not feel pain or worry, so his blood pressure does not rise. The amount of saliva that interferes with treatment is reduced. In one session, the dentist will carry out the entire scope of work, which is impossible under local anesthesia.

While under general anesthesia, the patient does not move, and this forces the specialist to independently adjust or look for a comfortable position. Due to the fact that a person lacks reactions, there is a possibility of medical errors.

For anesthesia, carpule syringes are now used, the needle of which is much thinner than the usual ones. Injection with such a device will become as painless as possible than it was five years ago.

Lidocaine, gel and spray - a popular anesthetic

Patients with an increased sensitive threshold are preliminarily treated with a spray containing Lidocaine. The substance is sprayed onto the gums, and only then anesthesia is carried out.

If a person regularly experiences stress before going to the dentist, then a few days before the session we recommend taking a course of sedatives (Afabazole, tincture or tablets of valerian, motherwort). Be sure to tell your doctor what medications you took.

For local anesthesia, Novocaine and Lidocaine were previously used, but recently doctors are moving away from these drugs and using modern means:

"Ubistezin";
"Artikain";
"Ultracaine";
"Septanest";
"Scandonest". To enhance the effect of drugs and speed up local anesthesia, adrenaline is often added to the solutions. The substance quickly activates the medicine and slows down absorption into the blood, which is used for therapy in pregnant women. Mepivacaine and Articaine are considered the safest for children.

Ultracaine is the most effective anesthetic

For heart disease, thyroid disease and diabetes mellitus, drugs with adrenaline are not recommended. Severe hypertension will negatively respond to the thoughtless use of medications. Before manipulation, be sure to warn your dentist about the presence of diseases. After all, local anesthesia does not provide for a complete examination of the body and the operation in the presence of an anesthesiologist.

Things to remember

Dental treatment under anesthesia is always stressful for the body. No matter what the modern drug is, complications may occur. The most common exacerbations during general anesthesia were cardiac arrest and respiratory depression. Such problems are associated with drug overdose or diseases of the cardiovascular system. To eliminate danger, the operation is performed in a specially equipped clinic room and in the presence of an anesthesiologist.

After recovery from anesthesia, patients often feel discomfort, which

The drug Desensil for topical anesthesia

hallucinations;
vomiting;
nausea;
decrease in pressure;
dizziness;
neuromuscular excitation.

You should not eat or drink for several hours before the procedure. Under the influence of anesthesia, a person does not control his body, so gastric juice will enter the lungs, which will cause a burn or inflammatory processes.

“General anesthesia for dental treatment is contraindicated in patients with pneumonia, catarrh of the upper respiratory tract, difficulty in nasal breathing, acute liver diseases, in all cases where the duration of medical intervention exceeds acceptable standards.”

The most common complications with local anesthesia are allergies and toxic reactions to the drug. Most often this is the result of an overdose of the drug or natural rejection of the components of the drug. Due to needle injury to the nerve, long-term sensory loss occurs. Burning and pain at the injection site is normal.

Due to doctor errors after the injection (damage to a vessel, breaking off the game), bruises and tumors are observed. If you do not follow the rules of antiseptics, then an infection gets into the injection site. A patient under anesthesia does not control his movements, so he often bites the soft tissues of his tongue, cheeks or lips. In this case, there is a temporary loss of sensitivity. The spasm of the masticatory muscles goes away after a few days.

“Infection from a needle is almost impossible, since all syringes are disposable. But this is quite possible if the injection is carried out into an infected area of the mucosa. In this case, under pressure, the anesthetic will push the infection into a healthy area of tissue.”

Local anesthesia causes complications in children, so doctors often warn parents.

Overdose. Given the small weight of the child, you need to carefully calculate the amount of the drug. When the norm is exceeded, a toxic reaction of the body occurs.
Allergy. Modern anesthetics are as safe as possible, but sometimes the body rejects the antioxidants included in the composition.
Mental complications. Children do not know how to independently control their emotions and feelings, so under the influence of fear, a short-term loss of consciousness occurs. Often the very sight of a syringe causes horror in a child. The doctor’s task will be to distract the patient as much as possible before the injection to another object.

Alcoholic drinks reduce the effect of the drug, so a few days before your visit to a specialist, you need to abstain from alcohol. We also do not recommend visiting the clinic during a cold season.

Women should not have dental treatment before or during menstruation. These days, all sensations become aggravated and the nervous system is unstable, which will negatively affect susceptibility to anesthesia. Additionally, under the influence of the drug, bleeding may increase.

The use of anesthesia drugs in dentistry is a necessary procedure that will relieve the patient of discomfort during dental treatment. A properly selected drug will relieve pain and will not cause concern to the person. Tell your specialist about any illnesses.

Many people are afraid to visit the dentist. The doctor's actions are associated with pain and discomfort. Suffering from toothache, patients put off visiting the dentist until the critical moment and often, without time to spare, ask the doctor to perform several extensive procedures at once.

Today in dentistry, several methods of anesthesia are used to remove and treat teeth. An experienced specialist knows which drug will relieve pain best. The patient will not feel pain, and the dentist will have the opportunity to provide dental treatment at the proper level.

Anesthesia methods used in dentistry

Anesthesia during tooth extraction and other dental procedures involves a decrease or complete loss of sensitivity in certain areas of the oral cavity. It is possible to anesthetize the surgical site through the use of pharmaceuticals that interrupt the transmission of pain impulses coming from the sources of pain to the brain.

Thus, it is almost impossible to carry out high-quality treatment of wisdom teeth without anesthesia - therapeutic and surgical actions performed by a doctor will be accompanied by severe pain. That is why all modern dental clinics treat teeth using various types of anesthesia.

General anesthesia

Under general anesthesia, the patient falls into a deep sleep, his consciousness turns off. With this method of pain relief, narcotic drugs are administered intravenously or inhaled. During dental treatment, the patient’s condition is monitored by an anesthesiologist-resuscitator.

When a person is under general anesthesia, on the one hand, it is easier for the dentist to treat teeth, in particular wisdom teeth. But on the other hand, the doctor constantly needs to adapt to the patient, since he is immobilized and cannot fix his head in the correct position and open his mouth wider. As a rule, with this type of anesthesia, after waking up, a person does not remember what happened to him during the operation.

This type of pain relief is advisable to use in the following cases:

complex surgical operation;
pathological fear of dental procedures;
allergies to local anesthetics.

In many cases, general anesthesia is contraindicated for dental procedures. Before the patient is put under anesthesia, he needs to have his blood tested and undergo an ECG to rule out heart pathologies.

Shortly before dental surgery, the patient must give up smoking and alcohol. A few hours before going under anesthesia, the patient should not eat.

Local anesthesia

Local anesthesia is the safest. The person is conscious, the drug used affects only the peripheral nervous system.

With the introduction of carpule (strictly dosed) anesthesia, the patient begins to feel numbness in the gums, tongue and lips. There are often cases when, with an incorrectly calculated dose of the drug, patients complained that the anesthesia did not work. With the advent of carpules (ampoules with anesthetic), this problem disappeared. After the analgesic is broken down, its effect stops and sensitivity is restored.

The method of local anesthesia is widely used in dentistry. It is used for therapeutic and surgical procedures.

Preparations for general anesthesia

Is anesthesia harmful when removing wisdom teeth? Under the influence of drugs, a person does not feel pain, but at the same time his body is subjected to serious stress. First of all, the brain is affected; anesthesia affects the conduction system of the heart; the components of the anesthetic can cause allergic reactions. That is why during the operation an anesthesiologist is present next to the patient, who has all the necessary resuscitation equipment at his disposal.

In dentistry, only intravenous general anesthesia is performed using drugs called Ketamine, Propofol, Sodium Thiopental, etc., which have a hypnotic, sedative and muscle relaxant effect. A person can be put into a state of deep sleep using nitrous oxide inhaled through a mask.

Types of anesthetics for local anesthesia

Artikain

Today, the strongest anesthetics of the articaine series are considered the best anesthesia used in dentistry for local anesthesia. The main component of the painkiller is several times more effective than Lidocaine and Novocaine.

A distinctive feature of Articaine is the possibility of use for purulent inflammations, when the activity of other drugs is reduced. Many patients in such cases do not understand why the anesthetic does not work. In addition to the main component Articaine, modern drugs contain vasoconstrictors. Due to adrenaline or epinophrine, the blood vessels narrow, preventing the drug from being washed out from the injection site. The strength of anesthesia and the duration of action of the intraseptal anesthetic increase.

Ubistezin

Ubistezin is an analogue of Ultracain; the composition of the two drugs is identical. The manufacturing company is registered in Germany. The anesthetic is available in two forms depending on the concentration of epinephrine: Ubistezin or Ubistezin forte.

This drug can be administered to children and pregnant women, as it has a very modest list of contraindications. Ubistezin is used in dentistry to treat patients with cardiovascular diseases.

Mepivastezin or Scandonest

It is not recommended for hypertensive patients to use anesthetics with vasoconstrictor components; for high blood pressure, it is worth selecting drugs without adrenaline and epinephrine in the composition. Mepivastezin (manufactured in Germany) and its full analog Scandonest (France) are prescribed to patients at risk.

These pharmaceuticals do not contain vasoconstrictors, so they are used to relieve pain in children, pregnant women and patients with bronchial asthma. Mepivastezin and Scandonest are also prescribed to patients with adrenaline intolerance.

Septanest

Dentists have been successfully using Septanest anesthesia for several years. The anesthetic is presented in two forms, each of which differs in the content of adrenaline in the composition. Unlike Ultracaine and its analogues, Septanest contains preservatives, which, according to the instructions for use, can provoke allergic reactions.

After the drug is administered to the patient, the anesthetic effect occurs within 1-3 minutes. Anesthesia lasts for 45 minutes. Septanest can be used as a local anesthetic for children from 4 years of age.

Novocaine

Novocaine belongs to the group of second generation esters. A drug with moderate anesthetic activity is inferior in effectiveness to anesthetics of the articaine and mepivacaine series. It is used less and less, since modern painkillers are 4-5 times better at treating pain during tooth extraction. Novocaine is used for minor dental operations and in the treatment of pain syndromes.

Other types of anesthetics

When going to see a surgeon to have a tooth removed, many people wonder what types of anesthesia are used? Based on their chemical properties, anesthetics are divided into two groups: substituted amides and esters. There are short-, medium- and long-acting drugs. Anesthesia in dentistry also has its own classification:

superficial;
conductor;
infiltration

In modern dentistry, preference is given to carpule pharmaceuticals of the amide group: Lidocaine, Articaine, Ubistezin forte, Mepivacaine, etc.

Lidocaine has a deep analgesic effect, but it copes with toothache worse than other intraseptal anesthetics (we recommend reading:). If we compare it with Novocaine, which is widely used in government medical institutions, then the choice of dentists is more likely to focus on Lidocaine.

What medications are allowed during pregnancy?

The best option for pregnant women and nursing mothers is a carpule of Ultracaine or Ubistezin with epinephrine at a concentration of 1:200,000. The vasoconstrictor substance has no effect on the fetus, since it fails to penetrate the placenta. Studies have proven the safety of these carpule anesthetics for breastfed children - their components do not pass into breast milk.

During pregnancy, there is no need to refuse injections with vasoconstrictors. However, in their practice, doctors use Scandonest and Mepivastezin without epinephrine in the composition for anesthesia for women during pregnancy. These drugs are twice as toxic as Novocaine and are absorbed into the blood faster.

Use of anesthesia in children

What anesthesia is used in pediatric dentistry? Dentists anaesthetize children in two stages. First, topical anesthesia is performed, when the doctor, using an aerosol or a special gel with Lidocaine or Benzocaine, desensitizes the area of the mucous membrane where the anesthetic injection will subsequently be made. This type of anesthesia is also used for intraosseous anesthesia.

Children are administered drugs with Articaine as the main component. It is less toxic and is quickly eliminated from the body. According to the instructions for use, such drugs can be used for anesthesia in children over 4 years of age. Also, when molars are removed, an injection of Mepivacaine is often given. In pediatric dental practice, a table with weight and the maximum permissible dose of anesthetic administered is often used.

Artikain

An important feature of Articaine is the possibility of its use when the effect of other drugs is reduced. In addition to the main component, modern anesthetics contain vasoconstrictors.

Adrenaline or epinephrine constrict blood vessels, preventing the drug from being washed out from the injection site. Pain relief time increases.

Ubistezin

The drug is an analogue, their composition is the same. Produced in Germany in two forms depending on the epinephrine content.

The drug can also be administered to children, since the list of contraindications is very small. Used in dentistry to treat patients with heart disease.

Mepivastezin or Scandonest

Septanest

Novocaine

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Ester or amide anesthetics can be chosen. The action of the former is quick and short-term. These include Pyromecain and Novocain.

Amides include:

trimecaine– injection, anesthetizes for 90 minutes;
– valid up to 5 hours;
bupivacaine– relieves pain 6 times better than novocaine, but it is 7 times more toxic, lasts up to 13 hours;
ultracaine D-S– the effect is 5 times higher than after the administration of Novocaine, lasts 75 minutes;

Names of modern anesthetics without adrenaline

Pain relievers without adrenaline include:

Articaine hydrochloride. Leader among other anesthetics. Available with or without epinephrine and with increased vasoconstrictor content;
Ubistezin. Patients with an allergic reaction, diabetes mellitus, hypertension, bronchial asthma, heart failure and thyroid disease are prescribed a drug labeled “D”, without adrenaline;
Prilocaine. It is used without vasoconstrictors or with a low content of them. The drug is not prescribed to pregnant women and patients with pathologies of the heart, lungs, or liver;
Trimekain. It has a calming effect and is not used very often in dentistry;
Bupivacaine. It is not used for heart pathologies and liver diseases;
Pyromecaine. It has an antiarrhythmic effect, so it is recommended to administer it to people with arrhythmias.

Pain relief during pregnancy and breastfeeding

Ultracaine D-S

What drugs are used in pediatric dentistry?

In children, pain relief occurs in two stages. First of all, the dentist performs topical anesthesia, that is, using an aerosol or Benzocaine to reduce the sensitivity of the mucous membrane, then injects an anesthetic.

In pediatric dentistry, preparations with Articaine are more often used. It is less toxic and is quickly eliminated from the body.

According to the instructions, these drugs can be administered to children from the age of 4 years. When molars are removed, an injection of Mepivacaine may be given.

In practice, dentists often use a table indicating weight and the allowable dose of the drug.

Contraindications and side effects of local anesthesia

Before starting treatment, the dentist must ask the patient about possible somatic diseases or an allergic reaction to any drugs.

Contraindications to anesthesia may include:

allergy to the administered drug;
diseases of the cardiovascular system;
hormonal disorders due to pathologies of the thyroid gland;
diabetes mellitus

How much does dental anesthesia cost in the clinic?

To clarify the price, you must contact the clinic for a price list.

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Video on the topic

About the use of pain-relieving injections during dental treatment in the video:

Anesthesia in dentistry is a necessary procedure that relieves discomfort during dental treatment. The main thing is to choose the right drug and warn about possible diseases.

“A patient well secured in a chair does not require anesthesia” - this well-known joke among dentists lost its relevance when dental practice began to use anesthesia for dental treatment. Today, going to the dentist no longer causes trembling knees, hysterics and tears. To remove a tooth, a nerve, to fill canals, to place crowns, to perform pulp surgery - any dental procedure can now be performed without pain and fear.

Types of pain relief in dental practice

Anesthesia is used when it is necessary to reduce or completely block the sensitivity of the body. Depending on the clinical situation and individual characteristics of the body, anesthesia can be performed in 3 options:

Local – specific areas of the oral cavity are subject to pain relief.
General (anesthesia) – complete blocking of the body’s sensitivity to pain.
Combined.

Dental procedures under local anesthesia: types, features, contraindications

Local anesthesia is divided into several categories:

№	Types of local anesthesia in dental practice	Category description
1		The gel (or spray) is applied to the surface of the oral mucosa. This method is used before the next injection (for painless needle insertion): when opening an abscess, removing tartar. The effect of this type of pain relief is short-term
2		An anesthetic injection is given into the area requiring treatment. The effect of the anesthetic is 1 hour. A method is used to remove the nerve, clean the canals
3		A more extensive method of anesthesia than the previous one. The injection is made into the nerve trunk, the anesthetic acts not only on 1 area, but also on the entire jaw; The tongue and cheeks may become numb. This method is used if several teeth need to be treated at one time.
4		The injection is made into the periodontal space of the jaw. The injection does not cause numbness, as in the previous case; this method is more often used in dental treatment in young patients
5		It is rarely used and only if a person is being treated in a hospital. Anesthesia is injected near the base of the skull. The method is used when performing serious operations on the jaw, for injuries, neuralgia

Attention! In order for treatment of diseased teeth using a local anesthetic to take place without side effects, the patient must inform the specialist about increased sensitivity to painkillers, what sensations he experienced during the last visit to the dentist, and whether local anesthesia was used then. Based on these criteria, as well as the person’s health characteristics and the severity of the problem, the specialist will determine the most harmless method of local anesthesia.

Video - Why use anesthesia during dental treatment?

Contraindications to local anesthesia

Increased sensitivity (allergy) to painkillers. If a person doubts a possible allergic reaction, then before undergoing anesthesia, the person must undergo an allergy test in a specialized center.
Recent heart disease (heart attack, stroke).
Diseases of the endocrine system.

The use of general anesthesia in dentistry

The feasibility of this type of anesthesia is justified if:

The patient has a pronounced fear – dentophobia. A person experiences real horror and panic while sitting in a dental chair.
A person needs to undergo an extensive form of dental treatment.
The patient is allergic to local anesthetics.
The patient has neurological disorders, for example, cerebral palsy, autism, schizophrenia.

With this type of anesthesia, a person’s consciousness turns off. General anesthesia is not as safe as local anesthesia; it can disrupt the functioning of the body and lead to side effects such as:

nausea, vomiting;
arrhythmia;
bronchospasm;
temporary increase or decrease in pressure;
convulsions;
stopping breathing.

Due to the possible occurrence of side effects, resorting to anesthesia is prohibited:

During pregnancy.
For sore throat, bronchitis and other diseases of the respiratory system.
For heart disease.
In old age.
When under the influence of alcohol or drugs.
With exacerbation of chronic diseases, diseases in the acute period.

Attention! General anesthesia complicates the specialist's work, because during it the doctor inserts a special tube that allows the patient to breathe normally, but makes the doctor's work more difficult.

Combined anesthesia as an alternative to general anesthesia

If a patient is contraindicated for general anesthesia, and local anesthesia is not an option for a person suffering from panic disorder, then a combined type of anesthesia may be offered.

Its essence: a specialist gives the patient a sedative. The patient’s consciousness is preserved, however, the person quickly calms down. Then the doctor administers local anesthesia using the chosen method and only then begins dental procedures.

Attention! The advantage of combined anesthesia over general anesthesia is its safety and the absence of side effects.

Anesthesia in dentistry for pregnant women

It is imperative for pregnant women to treat bad teeth. You cannot endure pain and discomfort throughout pregnancy; expectant mothers should be attentive to their health and, if necessary, undergo dental treatment, and not put it off until later. Otherwise, a diseased tooth can cause infection in the woman’s body and fetus, leading to serious complications, including miscarriage.

Treatment of diseased teeth in pregnant women is carried out only with the use of anesthesia. A woman in this position is prohibited from enduring pain, as this can lead to severe stress and the release of adrenaline, which can provoke an increase in the tone of the uterus.

Attention! To relieve pain during dental procedures in pregnant women, only local anesthesia (injections) is used.

Most often, for local anesthesia of teeth in pregnant women, injections with a solution are used “ Lidocaine" Although this drug penetrates the placenta, it is eliminated very quickly and does not harm the fetus.

Also, for dental pain relief in pregnant women, the drug “ Novocaine", only in a smaller dosage than usual. Such drugs as “ Mepivastezin», « Ultracaine" They do not cause side effects, do not penetrate the placenta, and have an excellent anesthetic effect.

Carrying out pediatric anesthesia in dentistry

When treating sick teeth in children, specialists resort to the following anesthesia methods:

Dental treatment using anesthesia is an important process that allows the doctor to effectively perform the procedure and the patient not to experience pain, fear and anxiety. Depending on the type of anesthesia and the characteristics of the patient’s body, the doctor chooses the desired method of pain relief. The patient’s task is to tune into a positive mood, notify the doctor about the characteristics of the body, the presence of allergies and diseases, and answer the specialist’s questions reliably and completely. Only then will the treatment outcome be positive, without side effects.

Anesthesia or local anesthesia in dentistry allows you to treat teeth without pain, which provides comfort for the patient and ease of work for the dentist. Please note that in this article we will talk specifically about anesthesia, not anesthesia. Anesthesia (sometimes also called general anesthesia, which is not entirely correct) is a complete shutdown of a person’s consciousness; in dentistry this is now commonly called “dental treatment in a dream.” This can only be carried out by anesthesiologists.

In this article I want to talk specifically about anesthesia (sometimes it is also called local anesthesia). This type of anesthesia acts only on a limited area and is usually carried out by the dentist himself.

Currently, dental treatment without anesthesia is nonsense. Modern medical standards require not only high-quality, but also the most comfortable and painless treatment for the patient. The dentist, if necessary, together with the anesthesiologist, individually decides how and what type of anesthesia will be carried out, taking into account the amount of work, area, depth and individual characteristics of the patient.

Many of us often delay visiting the dentist because... They have been afraid of them since childhood, but “advanced” caries can cause serious complications that may even require surgical intervention. The smaller the destruction and the earlier the patient consulted a doctor, the better, faster and less painful the treatment can be.

pulpitis and periodontitis;

diseases of the cardiovascular system and joints, because caries is a source of infection;

chronic allergic reactions;

if the tooth is completely destroyed, this will affect the quality of chewing food and, as a result, may lead to gastrointestinal diseases

Yes, I’ll say right away: there are medicinal and non-medicinal methods of pain relief in dentistry. The latter include:

hypnosis (psychotherapy);
electrical neurostimulation;
audio analgesia.

To be honest, I, like most of my colleagues, are very skeptical about all of the above, and therefore I will tell you about drug methods of pain relief.

Local anesthesia in dentistry

In dentistry, the following types of local anesthesia are distinguished; below we will briefly consider each of them, and if you want to find out more, follow the links:

Intraosseous
Intraligamentary (intraligamentous)
Stem
Combined.
Computer

All modern methods of pain relief in dentistry have their own characteristics, indications and contraindications.

In pediatric dentistry, the same types of local anesthesia are used, but for very young patients (2-3 years old), who simply will not allow the dentist to work, we give short-term anesthesia, for example, propofol. This is a very modern and safe drug.

Application anesthesia

Allows you to anesthetize superficial soft tissues: skin and mucous membranes to a depth of approximately 1 - 3 mm. The drug quickly penetrates the tissue and temporarily disables the nerve endings located there. During the procedure, a high concentration of local anesthetic is used in the form of a gel, aerosol or emulsion. Apply the drug to the dried mucous membrane or spray the solution onto it using a spray bottle.

Local topical anesthesia in dentistry (in other words, anesthesia without an injection) is used:

to numb the needle insertion point before administering injection anesthesia;
for removing baby teeth;
when removing small soft tissue tumors.

Pain relief for stomatitis in children using special pastes and gels is also an application.

Infiltration of tissues with anesthetic solution

Conductive anesthesia in dentistry

Conduction dental anesthesia is used much less frequently than infiltration anesthesia. An anesthetic solution is injected near the peripheral nerve trunk, which numbs the entire area for which it is responsible. The desired effect occurs 10-15 minutes after the injection and lasts for 1-2 hours.

It is used when you need to numb a large area at once or if infiltration anesthesia does not work. Unlike infiltration anesthesia, a smaller amount of anesthetic is used here, but in a higher concentration.

Torusal and mandibular anesthesia are performed on the lower jaw.

Injection site for mandibular anesthesia

In this case, the lower alveolar and lingual nerves are switched off, so during the action of the anesthetic the patient feels numbness in the entire half of the lower jaw, lip, chin and tongue. Tuberal anesthesia in dentistry is often accompanied by the formation of a hematoma. It was this inconvenience, combined with the complexity of the technique and the high likelihood of complications, that forced dentists to abandon this type of anesthesia.

Intraosseous anesthesia

To administer an anesthetic solution intraosseously during injection, the doctor perforates the dense outer cortical plate of the jaw bone and injects the solution into the spongy substance itself, where the terminal branches of the dental plexus are located. The effect appears within 1-2 minutes, the teeth and alveolar process are numbed. This manipulation is performed using a special syringe with a short, large-diameter needle and is a type of carpule anesthesia in dentistry.

Intraligamentary anesthesia

Intraligamentary anesthesia involves the dentist injecting a solution into the periodontal ligament, which connects the tooth root to the bone alveolus. In this way, you can anesthetize only one tooth and do it with a record small amount of anesthetic, which is why this type of anesthesia remains very popular. It should be noted that the injection into the periodontium is quite painful and minor discomfort remains in the tooth for 24 hours after it is performed.

Trunk anesthesia in dentistry

This type of anesthesia is rarely performed in dentistry. This technique is also called (according to the author) “according to Bershe-Dubov.” This technique is used for severe pain in the patient, for the treatment of serious injuries and operations on the jaw and zygomatic bone, as well as for neuralgia, and only in a hospital setting.

An anesthetic injection is given at the base of the skull (brain stem), and the pain relief spreads through both trigeminal nerves and their branches. This allows you to immediately disconnect the mandibular and maxillary nerves. The effect of stem anesthesia lasts quite a long time.

Combined anesthesia

Combined or sedative anesthesia in dentistry is used more and more often. In order for the treatment to be not only painless, but also completely comfortable, it is not enough to simply eliminate pain, it is necessary to cope with fear and emotional stress. It is this effect that potentiated analgesia can achieve. It is a combination of superficial sedation and local anesthesia, carried out with the participation of an anesthesiologist. This is one of the best types of anesthesia for children in dentistry at the moment.

Superficial sedation is a state of stunning, slight depression of consciousness. In this case, the patient does not experience fear or anxiety before the upcoming intervention, but remains conscious. Of course, the advantage of this pain relief is not only its comfort. Anxiety and fear, among other things, cause a significant decrease in the pain threshold. That is, eliminating negative emotions allows you to achieve a good level of pain relief with smaller doses of anesthetic.

What is computer anesthesia?

Computer-controlled anesthesia is carried out by a special electronic system, which consists of a system unit and a handpiece. The needle has a special design that allows you to pierce soft tissue and perforate the cortical plate of the bone absolutely painlessly. Another advantage is the dosed administration of an anesthetic drug: the amount and speed of this process is controlled by a computer.

Carpule anesthesia

To perform carpule anesthesia in dentistry, special instruments are used - carpule syringes. They are a reusable metal device that has a body, a plunger and a needle that is much thinner than a regular injection needle. The drugs are supplied in special carpules and placed in the syringe body.

Preparations for local anesthesia in dentistry

Local dentistry is divided into:

Novocaine;
Anestezin;
Dicaine.

Lidocaine;
Pyromecaine;
Trimecaine;
Prilocaine;
Mepivacaine;
Articaine;
Etidocaine;
Bupivakakin.

In addition to the main analgesic component, most anesthetics contain vasoconstrictors, such as, for example, adrenaline or epinephrine. Due to the effect of vasoconstriction at the injection site, the washout of the anesthetic occurs more slowly. This allows you to increase the strength and duration of pain relief.

For pediatric dentistry, drugs must be selected with the lowest level of toxicity, but at the same time effective. The choice in this case falls on drugs of the amide group: ultracaine and scandonest in children's dosages. The first of these is, in principle, considered the best anesthetic in dentistry. The analgesic effect of ultracaine occurs quickly and lasts a long time.

You shouldn’t endure the pain and give up. Local anesthetics are excreted in small quantities in milk, which means they can enter the child’s body. In this case, I recommend expressing several portions of milk before visiting the dentist and not breastfeeding for 24 hours after dental treatment.

If a woman decides not to treat or remove a diseased tooth, then sooner or later complications will arise that will require emergency treatment, which can have an even greater impact on the baby.

If you are planning a pregnancy, be sure to visit the dentist in advance, because... Doctors categorically do not recommend using anesthesia, especially in the first trimester. Because It is in the first trimester that the main organs of the child are formed, and the use of anesthetics or anesthesia drugs can negatively affect the further development of the baby.

Anesthesia without adrenaline in dentistry

As I already said, to enhance the effect, vasoconstrictor drugs are added to the anesthetic solution - this increases the duration of action and reduces the level of absorption of the drug into the blood. But accidental entry of the vasoconstrictor itself into the bloodstream is associated with serious side effects. This is why anesthetics without adrenaline are used for pain relief in dentistry for pregnant women, in pediatric practice and in the treatment of patients with diseases of the cardiovascular system.

Contraindications to anesthesia in dentistry

Contraindications for this are:

Allergic reactions to substances included in anesthetics;
History of cardiovascular diseases;
Diabetes mellitus;
Pathology of the endocrine system organs;
Some types of severe injuries of the maxillofacial area.

Side effects of anesthesia in dentistry

If the doctor is a professional in his field, complications during local anesthesia in dentistry are very unlikely. There are some points that worry patients after dental treatment and, in principle, are a variant of the norm: or, or even for several hours.

However, all these symptoms should go away within 1-3 days after treatment. If you see that the situation is not improving or even worsening, contact the dentist who performed the procedure.

Rarely, more serious complications may occur, including:

Allergic and toxic reactions. The body's increased sensitivity to medications is due to an allergic predisposition. May manifest as urticaria, Quincke's edema, anaphylactic shock, etc.;
Trauma to blood vessels from an injection needle, which may result in hematomas and bruises;
Pain and burning at the injection site (quite common and considered normal);
Lockjaw. Spasm of the masticatory muscles. Occurs when muscle fibers or nerves are damaged;
Loss of sensation. Occurs when a nerve is damaged during injection;
Damage to soft tissues. If sensitivity is lost, the patient may bite his tongue, lip, or cheek;
Infection. If antiseptic rules are not followed.

Pain during anesthetic injection and treatment will depend on several factors:

from your sensitivity;
professionalism of the dentist and equipment of the clinic;
on the degree of tooth destruction and the depth of caries.

If you are planning a visit to the doctor, I advise you to observe a number of points:

do not drink alcohol the day before, this may worsen the effect of the anesthetic;
if you have a cold, cough, or runny nose, it is better to postpone your visit until you have fully recovered;
Women and girls are not recommended to visit the dentist during menstruation, because... during this period, blood clotting worsens (by the way, do not be surprised if the anesthesiologist asks you this question before surgery; operations are not performed during menstruation.
If you are very worried, try to calm down and get a good sleep. There are, of course, sedatives, such as Afobazole or the well-known “valerian,” but I would not recommend taking any medications again; most of us know how to cope with our emotions without them.
choose your clinic carefully! Now their choice is very large, but very few comply with important requirements and all antiseptic requirements!

If you choose a clinic, pay attention to:

Legal name and registration documents, the same name must be in the contract for the provision of services.
Keep all receipts and receipts for payment, pay only through the cashier (also keep track of the legal name of the clinic on them).
Go to the clinic’s website (certificates, licenses and certificates of specialists should be presented there), read reviews on the Internet, talk with friends.
Visit the clinic itself and make an initial appointment.
If you plan to treat your teeth “in your sleep”, i.e. under anesthesia, be sure to check the availability of an anesthesiologist on the clinic staff!
Please note that the doctor must wear new gloves and print out all the disposable instruments with which he will carry out treatment and examination!!! In addition, the clinic must have air sterilizers.
Be wary of dental offices located on the ground floor of residential buildings; it is better to give preference to large clinics with good equipment, but remember that expensive does not mean quality.

For information on how to choose dentistry and what to pay attention to, see Channel 1’s investigation, Dentists: a conspiracy theory.