Are local anesthetics safe?
The local anesthetics that our patients have had determined as most compatible will be the ones we select from for their use. Local anesthesia is achieved without the use of products containing epinephrine or other additives that act as vasoconstrictors – that diminish blood flow to the area of anesthesia to prolong its effect. Traditionally, this has been thought of as an overall helpful tool. Recent research suggests that the diminished blood flow to the teeth and surrounding bone may be detrimental, perhaps to the point of promoting tooth and/or bone death. In the interest of “erring on the side of caution”, we use vasoconstrictors as the extreme exception. No compromise is made regarding the very popular concept of our patients being totally numb for their operative or surgical procedures. Bravery and toughness are not qualities that we require or request of our clients.
A. Most clinical problems have been traced to preservative agents. But, how could a nerve poison really be safe? Some of the breakdown products of common local anesthetics become aniline dyes during detoxification. Aniline dyes are carcinogenic. What we are worried about here is risk/reward ratio. The degree of dose versus strong or weak detoxification pathways. Sometimes there is nothing better than that wooden numbness. Most dental procedures really do not require local anesthetic. Valerian and passiflora herbals are incredibly relaxing. If necessary, new devices allow the placement of much less amount of local anesthetic to achieve satisfactory pain control. Less local anesthetic is used if you use general anesthetic. That is trading one poison for another. Some poison is excreted in the urine unchanged. Support detoxification pathways with water, garlic, milk thistle, dandelion, burdock root, St. John’s Wort, greens and richly pigmented fruits and berries.
Since 1993 we have endeavored to use only the highest quality materials and medicines which are regarded as the safest as well. Local anesthetics are no exception. We have limited our selection of local anesthetics to two: Carbocaine and Septocaine. Carbocaine does not contain epinephrine, which acts as a vaso constrictor to diminish blood supply to the area of injection for a period of time. Traditionally, this was thought to be a desirable effect since diminished blood flow will prolong the duration of anesthesia. However, when anesthetizing teeth in the lower jaw this is cause for concern since blood supply there has only one way in and one way out. If that supply is shut down, even temporarily, then the teeth and surrounding bone may die. As a matter of protocol, we now never use anything but carbocaine for lower jaw injections.
