If you have a sick heart or diabetes, then before performing dental procedures with anesthesia, you should consult a doctor. Procedures performed under local anesthesia are much less burdensome for the patient than treatment without anesthesia. But, at the same time, general anesthesia can be too much burden on the body. It is used only in extreme cases.
Local, regional or general?
Local anesthesia is performed by a dentist right at the site of the operation. The purpose of this type of anesthesia is to interrupt pain stimuli in the central nervous system with the help of local anesthetics. This inflow is interrupted in a place that hurts. The brain simply blocks pain in the area of nerve bundles. At the same time you feel a touch, you feel and realize everything that happens to you.
Regional anesthesia is usually performed by an anesthesiologist. Local anesthetic is injected into the neighborhood, further away from the surgical site. Instead of nerves or nerve trunks the drug acts directly on the spinal cord. This type of anesthesia is, for example, a spinal blockade in a caesarean section. Then the entire lower part of the body completely loses sensitivity, while the person remains in full consciousness. In dentistry, this kind of anesthesia is rarely used, mainly with severe maxillofacial injuries.
General anesthesia is a complete unconscious condition. The active substance has an effect on the brain, completely disabling sensory and motor activity. Such anesthesia can only be given by a qualified anesthesiologist and only in a specialized clinic. General anesthesia is rarely used, only when there is no other way out.
Pain blocker
Dental local anesthesia is performed at the request of the patient. General anesthesia is absolutely necessary in cases with dental surgery. The dentist determines the method of anesthesia, depending on the type of operation and the patient's health. Most often, dentists use local anesthetics, which interrupt nerve conduction in the operated area. So an anesthetic of one tooth or group of several teeth, sometimes a larger area - for example, 1/4 of all teeth, is performed. The most famous drug is novocaine. It is administered in the form of injections and blocks painful impulses in the operated site. There is no danger of overdose due to the small amount necessary to achieve anesthesia. True, the effectiveness of the drug leaves much to be desired. In addition, the effect of the drug is very individual. On someone, it has the best effect, but for someone completely useless. Local anesthetics amides or esters are more effective, but they have a rather complex structure and it is difficult to calculate the desired dose of the drug.
The injection starts to act quickly, a few minutes after application. When planning treatment, the dentist determines the point at which anesthesia is performed. Anesthesia has a positive side in that you do not feel pain during the operation and for a while after the operation. This is important, for example, when removing the nerve from the tooth, which usually causes severe pain when placed in the center of the tooth.
Like in a dream
General anesthesia is not performed at the request of the patient. However, there are people who only under this condition will allow the dentist to perform any procedures. The reason, of course, is in their fear of the dentist. This type of anesthesia is always performed during operations in the field of maxillofacial surgery. This is an invasive procedure, for example, when it is necessary to perform a large incision or other cavity intervention.
With general anesthesia, many drugs with different activity profiles are used. This allows the patient to fall asleep without feeling pain, as there is a complete muscle relaxation. Chemically a simple drug with a powerful analgesic effect is nitrous oxide (N2O). Other drugs are more complex chemically. Used in general anesthesia and barbiturates (they cause sleep), as well as drugs and muscle relaxants (eliminate pain).
Surgery conducted under general anesthesia requires several workers: an anesthesiologist and nurses. Anesthesia equipment (control devices, several drugs, as well as other additional funds in case of unforeseen complications) is also needed. Not always these procedures are conducted in the operating room, sometimes simply in the dental chair in the dentist's office. However, if it is a major operation in the field of dental surgery, surgery is simply necessary.
During the operation, under general anesthesia, as well as after surgery, there is continuous monitoring of the patient's vital functions (for example, ECG, blood pressure, oxygen saturation of the patient, exhalation of carbon dioxide, depth of anesthesia, possible blood loss), volume of necessary drugs and fluids. The most common complications in general anesthesia are nausea and vomiting after surgery, of course, temporary. Also, there can be changes in consciousness, in a sense of balance, the reaction time can be extended. We must not forget that anesthesia is a medical procedure, and there is always the risk of various complications.
Different reactions to anesthesia
Not all patients want to receive dental anesthesia, for example, when filling teeth. They have such a high threshold of tolerance of pain that they simply do not need it. There are also cases where people complain that anesthetics do not work on them. They think that drugs are used substandard, however, this is not so. In rare cases, this may be due, unfortunately - to an inadequate tolerability of the patient's anesthesia. Most often this is due to inflammation. In the place where the focus of inflammation is generated, the local anesthetic does not work, which is the result of a lower pH in the inflamed area. A dentist can bypass the inflamed area around the teeth, providing an anesthetic of the entire surrounding area.
It should be emphasized that all the reactions to anesthesia depend on the individual susceptibility of the organism. Each of us reacts differently to different types of drugs. The key in any anesthesia is the fact of the absence of pain. Sometimes the anesthetic effect disappears rather quickly after the operation, and the pain is felt with renewed vigor. If this happens a few hours after the visit to the dentist, during which the patient underwent surgery with anesthesia, you should take painkillers to prevent pain from escalating. According to experts, the feeling of discomfort after dental surgery is often psychological. People just hate pain, especially dental. It seems truly unbearable.
"Special" patients - pregnant women and children
Pregnant women should carefully analyze whether dental treatment is necessary. It is necessary to consult with leading gynecologists. If the pregnant woman has abscesses in her mouth, then it is necessary to perform an operation to remove them. After all, their presence can cause a systemic infection, extremely dangerous for the fetus. It is worth noting that every pregnant woman should have well-groomed and treated teeth, and not only because abscesses are dangerous. Local anesthetics are administered to pregnant women in small amounts so as not to harm the child. But their efficiency is rather small. A pregnant woman often has to suffer pain in the treatment of teeth. But it is safer for a baby than high doses of anesthetics.
Children also belong to a group of "special" patients, because they are usually afraid of even one type of dentist. Local and general anesthesia is often used. This also applies to problems with dairy and permanent teeth. If the children are not anesthetized, then, in most cases, the dentist can not perform any operations. It is better to resort to anesthesia than to expose the child to stress and fix in him the fear of a visit to the dentist for life. In case of need of general anesthesia, in dentistry for anesthesia children often use sleeping pills, injected rectally or by inhalation. Only in rare cases, anesthesia is injected into a vein (with this usually begins the activity of an anesthesiologist in adults).
Precautionary measures
Always, before performing a procedure under general or regional anesthesia, you need to do laboratory tests. If you have any illness before going to the dentist, you should consult your doctor. An important role here is played by the state of your health in general. Sometimes, additional tests are necessary before anesthesia surgery. For example, people who have heart problems should necessarily pass an electrocardiogram. Often, dentists need to perform testing for the blood coagulation system, because some people have a fairly large bleeding after tooth extraction. It does not pose a health hazard, but it can complicate the process of recovery after surgery. It is also important that the patient does not have allergies to local anesthetics, although they are very rare. It is worth noting that some people sometimes have symptoms that can be interpreted as allergies. Also, these symptoms sometimes turn into disturbances, such as taste, vision or even loss of consciousness.
As in medicine in general, as you know, things can happen, and in dentists - anesthetists should be ready for anything. Each dental office should be equipped with everything necessary in case of a freelance situation. However, if enough quality drugs are used in dentistry, anesthesia will be carried out without consequences and will have the proper effect. After all, its main advantage is the absence of pain.