What is Topical Anesthetic, or Superficial Freezing?

Anesthetic, commonly known as freezing  is “medication that produces the temporary loss of feeling or sensation”. It is used during many dental procedures for pain control. There are two main types used on a regular basis in any dental practice. The first is topical anesthetic. The purpose of topical anesthetic is to numb the oral mucosa in a specific area where the injection is going to take place. This creates a temporary numbing of the nerve endings, making the injection less painful. For this type of gel to have maximum effectiveness it should remain on the site for 3-5 minutes.

What is Local Anesthetic, or Full Freezing?

Local anesthetic is what actually numbs your teeth, cheek, lip or tongue. It is achieved by injecting a solution near a nerve, which temporarily blocks nerves from generating an impulse. A vasoconstrictor is used in anesthetic to slow down the intake of the agent and increase the duration, which is the “time from induction to complete reversal of anesthesia”. This agent prolongs the duration by decreasing blood flow and bleeding. The typical vasoconstrictor used with anesthetic is epinephrine. Since the solution is absorbed into the body, it can cause strain on your heart. Therefore, patients with heart conditions should receive freezing without a vasoconstrictor. This is why it is important to inform your dentist of any medical conditions and medications being taken.

Do Some Places Take Longer to Freeze Than Others?

When receiving local anesthetic on the mandible, it lasts longer and takes a little longer to start working because the bone is dense. Therefore, the dentist will perform a block injection. This freezes the entire area, which is approximately half of your mouth. Sometimes you will feel a shock to the lip or tongue. That just means the injection is in the appropriate spot. The second option is to utilize the maxillary arch, which uses infiltration. This area is more porous and reaches the apices and bone of your teeth more easily.

 How Long Does Freezing Last?

According to the Canadian Dental Association, the approximate duration of anesthetic is as shown:

Type of Anesthetic

Maxillary

Mandibular

Articaine 4% with epinephrine

3 hours 10 min

3 hours 50 minutes

Bupivacaine 0.5% with epinephrine

5 hours 40 min

7 hours 30 minutes

*Lidocaine 2% with epinephrine

2 hours

3 hours 10 minutes

Mepivacaine 2% with levonordefrin

2 hour 10 min

3 hours 5 minutes

Mepivacaine 3% plain

1 hour 30 min

2 hours 45 minutes

Prilocaine 4% with epinephrine

2 hours 20 min

3 hours 40 minutes

*Prilocaine 4% plain

1 hour 45 min

3 hours 10 minutes

* Used in our dental practice.

Are There Any Possible Complications?

As with everything in life, it is important to be aware of possible complications. While rare, complications such as the injection of air into a blood vessel are possible. To ensure this does not happen, your experienced dentist will alway aspirate the needle before injecting the solution. Another possible complication is paresthesia, which is freezing that lasts longer then it should. This can be temporary or permanent, but most cases are resolved within 8 weeks. Paresthesia can be caused by contaminated solution, bleeding in or around the nerve sheath or by trauma during injections.

However, the most common complications aren't nearly so severe, and are even more easily avoided. Since local anesthetic creates temporary numbing you have to make sure you do not bite your lip, cheek or tongue. If you do, you may feel swollen or have a ‘fat lip’, but this is completely normal and should pass in a few days.