Local anesthesia is a common method used during wisdom teeth extraction. This medication temporarily numbs a specific area of the mouth, allowing the procedure to be completed without pain. It creates a localized absence of sensation, ensuring a more comfortable experience during the removal of these molars.
How Local Anesthesia Works
Local anesthesia functions by temporarily blocking nerve signals in the targeted area. Neurons normally transmit pain signals to the brain through electrical impulses. These impulses are generated when sodium ions flow into the nerve cell through specialized channels called voltage-gated sodium channels.
The anesthetic agents bind to these sodium channels on the nerve membrane. This prevents the channels from opening, stopping the influx of sodium ions. As a result, the nerve cell cannot generate electrical signals, effectively blocking pain messages from reaching the brain. This temporary interruption of nerve transmission results in numbness in the treated region.
Types of Local Anesthesia Used
Several local anesthetic agents are commonly employed for wisdom teeth procedures. Lidocaine is frequently used due to its rapid onset (2-3 minutes) and duration of action (1.5 to 2 hours). Articaine is another agent known for its deep penetration and fast onset, lasting between 1 to 2.5 hours. Bupivacaine offers a longer duration of action, lasting 4 to 9 hours when combined with a vasoconstrictor. This can be beneficial for longer procedures or those with expected postoperative pain.
Many anesthetics are combined with a vasoconstrictor, such as epinephrine. Epinephrine constricts blood vessels in the area, prolonging the numbing effect by slowing the anesthetic’s removal from the site. This addition also minimizes bleeding during the procedure, contributing to a clearer surgical field. Mepivacaine has less vasodilating activity and can be used without a vasoconstrictor, making it suitable for patients with certain heart conditions or sensitivities to epinephrine.
The Administration Process
Before the injection of local anesthesia, the dental professional prepares the area by drying it with cotton or air. A topical numbing gel, often containing benzocaine, may then be applied to the gum tissue. This gel helps to desensitize the surface and reduce discomfort from the needle insertion, taking approximately 1 to 5 minutes to take effect.
Following the topical application, the local anesthetic is injected into the gum or inner cheek, carefully targeting the nerves for the wisdom tooth area. Patients may experience a sensation of pressure or a slight sting as the medication enters the tissues. Numbness onset is usually rapid, allowing for a swift transition to the extraction procedure.
What to Expect During and After
During wisdom teeth extraction with local anesthesia, patients remain conscious and aware. While the area is numb to pain, patients will still perceive pressure and movement as the dentist works. Patients should communicate with their dental professional if any discomfort is felt, as additional anesthetic can be administered to ensure comfort.
After the procedure, numbness from the local anesthetic typically lasts for several hours, ranging from 2 to 6 hours, or longer depending on the anesthetic type and amount used. Sensation will gradually return as the anesthetic wears off. During numbness, avoid biting the cheek or tongue, as this can cause accidental injury due to the lack of sensation. Patients may also experience temporary difficulty speaking clearly or eating due to altered sensation.
Potential Side Effects and Risks
While local anesthesia is generally safe for wisdom teeth removal, some common and less common side effects can occur. Temporary swelling and bruising at the injection site are frequently observed after the procedure. Patients may also experience temporary muscle soreness in the jaw from keeping the mouth open during extraction.
Less common side effects include temporary nerve paresthesia, which is a tingling or numbness sensation in areas like the lower lip, chin, or tongue. This condition is usually temporary and resolves on its own, though it can persist for several days to months. Allergic reactions to local anesthetics are possible but rare. In very infrequent cases, temporary facial nerve paralysis (which might cause a drooping lip) or systemic effects like heart palpitations or lightheadedness can occur if the anesthetic is absorbed too quickly. These systemic effects are generally mild and transient.