How is Lidocaine Injected for Teeth? An Expert's Guide

Learn about lidocaine injections for teeth from an expert's perspective: what it is, how it works, techniques used by dentists and more.

How is Lidocaine Injected for Teeth? An Expert's Guide

When it comes to dental procedures, local anesthetics are often used to numb the area and reduce pain. Nowadays, the most common anesthetic used by dentists is lidocaine, also known as lignocaine. This medication is injected into the inside of the cheek or gum, near the tip of the tooth root, into the seam where the gum line connects to the beginning of the lip. Intraseptal injection may be a useful technique for achieving bone and soft tissue anesthesia and hemostasis for scaling and root planing and surgical flap procedures.

A short 27-gauge needle is inserted into the center of the interdental papilla (approximately 2 mm apical to the gingival margin) adjacent to the tooth to be treated. The bevel must be oriented towards the apex of the tooth. The needle should be at an angle of 45 degrees to the long axis of the tooth and at an angle of 90 degrees to the gum. The dentist should slowly inject a few drops of anesthetic as the needle enters the soft tissue and then advance the needle until it contacts the bone.

While gentle pressure is applied to the syringe, the needle is inserted slightly deeper (1 to 2 mm) into the interdental septum and 0.2 to 0.4 ml of anesthetic is deposited for a minimum of 20 seconds. The duration of anesthesia varies, but it can last up to several hours. To make sure that patients feel as little discomfort as possible during injection, many dentists clean the area with a gel to numb the skin before injecting local anesthetic. In some cases, a numbing gel is placed on the gum at the injection site before injecting lidocaine. This makes it completely painless for most patients, which is ideal for those with dental phobia or fear of needles.To allow higher doses for numbing, lidocaine may be mixed with small amounts of epinephrine.

It can also help reduce bleeding and make the numbing effect last longer. Additionally, if the pH of the local anesthetic solution in the dental cartridge could be increased to 7.4 before injection, it would increase both rate of onset of anesthesia and patient comfort during injection. Several techniques have been tried to reduce discomfort during intraoral injection, such as altering pH of injected solutions, temperature, slow deposition of anesthetic solution and use of topical anesthetic aerosol prior to needle insertion. There is conflicting evidence in medical literature that warming local anesthetics to body temperature (37°C) decreases injection pain. When you have dental procedures in your dentist's office, you may receive gum injections with lidocaine to numb the area. We have discussed issues of importance to safe and effective administration of local anesthetics, including needle gauge; traditional, advanced and alternative injection techniques; and techniques, devices and agents to make local anesthetic injection more comfortable for patients. The process takes less than 15 seconds, after which buffered cartridge is placed in syringe and dental injection is administered.

The anesthetic solution is delivered to cancellous bone through ultrashort 27 gauge injection needle placed in hole made by perforator. A further difference of this system is that it is a high-volume, low-pressure technique that leads to greater patient comfort.