Dental Anaesthesia: Important Considerations in Patent Care

One aspect of dentistry that is of utmost importance is patient comfort and safety. This extends from the patient dental chair selected for the clinic to infection control practices and the safe, minimally invasive administration of local anaesthesia for dental procedures.

This also informs the selection of dental needles.

Every dental clinic must administer dental anaesthesia for certain procedures, including but not limited to fillings, extractions, endodontics, implants, and more. Using oral local anaesthetic eliminates the sensitivity of certain areas of the mouth, particularly of the relevant teeth and adjacent gums, by numbing the area and enabling painless dental treatment. This benefits both the patient and the dentist in numerous ways.

Selecting the right type of anaesthetic drug and dental needles for this purpose based on each patient’s unique needs is crucial.

Dental Anaesthetics

Most in-clinic dental procedures use only a local anaesthetic.

General anaesthetic in dentistry is, for the most part, reserved for in-hospital surgeries, though some of these are carried out in-chair in the clinic by some dentists (e.g. wisdom teeth removal).

There are two basic types of local dental anaesthesia: with and without vasoconstrictors. Vasoconstrictors are drugs that are added to the local anaesthetic, and which help to minimise or control blood loss, deepen the level of anaesthesia and prolong its action, and help prevent unwanted, potentially harmful reactions to the anaesthetic drugs. Anaesthetic drugs without vasoconstrictors are better suited for very short treatments and for some people who have medical issues like diabetes, hypertension, and coronary artery disease which compromise the suitability of using vasoconstrictors.

Aside from topical numbing agents like sprays and gels, most forms of local anaesthesia used for dentistry are injectable, and the way they are injected will determine the type of dental needle used. Anaesthetic may be applied to the area between the gum mucosa and the bone, to the tooth nerve itself, into the dental pulp, into a dental ligament, or other areas.

Dental Needles and Syringes

There are several considerations when choosing the appropriate syringes and needles – from the specific location of injection to the anaesthetic volume, injection speed, waiting time, and more.

Most dental needles used today are single-use, disposable items that come sterile and maximise infection control. Strong, flexible, and very thin, most are manufactured from heat- and corrosion-resistant base metal alloys like nickel, chromium, or cobalt.

Needles comprise several parts:

  • Shaft – the length of the needle
  • Syringe adapter and connector – attach the needle to the syringe
  • Gauge – external diameter of the needle
  • Bore – internal diameter of the needle
  • Bevel – the angled tip

Needle gauge is important in selection. For example, a large 20G needle has a larger external and bore diameter. It is stronger, has less flex, and is more precise. The smaller the needle gauge, e.g. for a 30G needle, the finer it is and the more it will flex, but it will also take longer to inject or aspirate.

Does the size of the needle influence injection pain for the patient? While many dentists prefer using a smaller gauge needle to minimize pain, studies have demonstrated that, as long as patients are unaware of the size of needles used, the gauge of the needle used for local anaesthetic in dentistry makes little if any difference.

The needle used will depend on an array of factors – from the injection zone to the depth required, and factors unique to each patient. As such, dental clinics must have a range of these supplies on hand at all times to achieve the very best outcomes for their clients.

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