 |
|
|
|
|
Lingering numbness is a problem for boyDear Dr. Reitz: My 6-year-old son has needed multiple fillings the last few years. Each time the Novocain caused him to bite his lip, resulting in trauma and pain that lasts for at least a week. I was just told by his dentist that he needs another tooth filled. Can anything be done to limit the numbness so he doesn't accidently chew and self-inflict injury? - Marge Dear Marge: Local anesthetic (sometimes called Novocain) is the most frequently administered drug in dentistry and is the single most important discovery to aid the delivery of dental care since it was first used in 1905. Unfortunately, numbing the teeth causes the lip and cheek to also get numb, as well as the tongue in the case of the lower arch. In 1943 lidocaine, with a faster onset of action, longer duration and less potential for allergic reaction, replaced Novocain to become the most used local anesthetic in dentistry and medicine. Today, dentists have many other local anesthetics from which to choose. Dentits use various techniques to minimize the area that gets numb; however I have found the most effective injection method has the side effect of a numb lip. As soon as the local anesthetic is injected, the blood vessels begin the process of removing it from the area. To make the anesthetic work better and last long enough to do most dental procedures, manufacturers add a vasoconstrictor that narrows the blood vessels, reducing blood flow to the area. The vasoconstrictor is great until it's time to go home with a numb lip for the next few hours. For most people the numb lip is just an inconvenience, but in some cases such as children with a history of doing lip lacerations from biting after dental procedures, a reversal agent would be beneficial. A new product available to dentists called OraVerse works to remove the remaining local anesthetic by reversing the action of the vasoconstrictor and opening the narrow blood vessels. After finishing the dental procedure OraVerse is injected into the same site as the original anesthetic , and in clinical testing the lip sensation returned to normal in half the time. At this point you are likely thinking this is going to be the greatest thing since Novocain, and I would agree with you if it weren't for the price. Currently a syringe of OraVerse is 15 times more expensive than the same amount of lidocaine. When the cost becomes reasonable I will begin offering it to my patients. Until then, keep telling your son not to bite the numb lip. The column is written by John Reitz, DDS, and does not represent the opinion of the Pennsylvania State Dental Board. Dr Reitz answers questions from readers. E-mail them via his Web site at reitzdds.com or mail to John Reitz, DDS, 30 Commerce Drive, Wyomissing PA 19610 John
V. Reitz, D.D.S., F.A.G.D. Copyright
2010. All rights reserved. |
