PAIN THRESHOLD

Everybody has a pain response to trauma to the body. However, the degree of pain experienced from patient to patient varies enormously. It has been estimated that about half of the population could have a simple filling (restoration) accomplished without feeling any pain. The other half cannot tolerate the slight pain associated with this restorative procedure. You probably know if you have a high tolerance to pain, or a so-called high pain threshold. If so, you are fortunate, not only because dental procedures are easier but also because many slight abuses to your body are not a problem. If you have low tolerance to pain, or a “low pain threshold,” one of the following types of anesthetic is probably necessary for you to tolerate some dental procedures. Your dentist will quickly determine the level of your pain threshold, and he or she will plan your anesthesia needs accordingly.

LOCAL ANESTHETICS

Local anesthetics are the most commonly used type of pain control in dentistry (FIG. 5.1). Although you may think dentists use the old product Novocaine (Procaine), the most pop ular type of local anesthetic in dentistry is lidocaine hydrochloride 2%. Usually, this anesthetic has a slight amount of epinephrine (1:100,000) in it to constrict the blood vessels in the anesthetic site and prolong the duration of the anesthetic influence. This popular type of anesthetic is usually effective a few minutes after anesthetic delivery, and its duration is up to 3 hours. With very few exceptions, when this anesthetic is delivered adequately, the patient does not feel anything during treatment. Properly delivered local anesthetic should not be painful. The very small-diameter needles (FIG. 5.2), used carefully, and with preinjection topical numbing, provide simple, easy, painless anesthesia that dissipates soon after therapy is completed.