local anesthesia

Comparison of Bupivacaine and Lidocaine for Wisdom Teeth Surgery

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An interesting article titled “Comparison of anaesthetic regime in patients undergoing third molar extraction” written by McCarthy et al. appears in Oral Surgery in 2018 (vol. 11, pp. 33-40). The article seeks to explore the use of lidocaine and bupivacaine which are two different anesthetic agents for wisdom teeth removal to see if there is any difference on patient pain, preference, and satisfaction. The authors state that using local anesthesia for removing wisdom teeth when also using general anesthesia is still controversial. They thus designed a double blind split-mouth randomized clinical trial where both an anesthetic and control were used on a patient at the same time. The authors conducted the study in two parts. In the first part 52 patients were given 2% lidocaine with 1: 80,000 epinepherine on one side and nothing given on the other side. In … Read more

Is there a Difference in Complications following Wisdom Teeth Removal when using Local Anesthesia versus General Anesthesia?

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An interesting article titled “Retrospective multivariable comparison for complications of third molar surgery performed under general versus local anaesthesia” written by Beteramia et al. appears in Oral Surgery in 2019 (vol. 12, pp. 96-103). The article seeks to explore if there is a difference in the amount of complications that occur during or after wisdom teeth surgery when using local anesthesia or when using general anesthesia. In the article the authors discuss complications that can happen during wisdom teeth removal including excessive bleeding, injury to the inferior alveolar and lingual nerves, damage to the adjacent second molar, alveolar bone fracture, and displacement of tooth fragments into fascial spaces and complications that can happen after wisdom teeth removal including alveolar osteitis (dry socket), a secondary infection, and hemorrhage. These complications are discussed more over at http://www.teethremoval.com/complications.html. The authors further discuss how … Read more

Long-acting Local Anesthetic After Wisdom Teeth Removal

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A new medication called Exparel produced by Pacira Pharmaceuticals provides an alternative to opioids for use as pain relief following wisdom teeth removal. Exparel is a long-acting local anesthetic that is delivered during the surgery that numbs the site of surgery for up to three days. Exparel is not an opioid and is not habit forming and therefore will not lead to any opioid addiction. Many patients are already familar with local pain analgesics such as lidocaine that are given as a dental injection to numb an area for several hours. Exparel is a long lasting analgesics which seems to share some similarities but lasts much longer. Recently the use of opioids after wisdom teeth removal has been more closely scrutinzed, see for example https://blog.teethremoval.com/opioid-prescriptions-from-dental-clinicians-for-young-adults-and-subsequent-opioid-use-and-abuse/ and https://blog.teethremoval.com/persistent-opioid-use-after-wisdom-teeth-removal. Many are concerned that patients having wisdom teeth surgery are exposed to opioids … Read more

Dental Anesthesia May Stop the Development of Wisdom Teeth

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An interesting study appears in the April 2013, JADA which looks at whether dentists giving inferior alveolar nerve blocks to young children may be stopping wisdom teeth from later developing. The article is titled “Inferior alveolar nerve block and third-molar agenesis: A retrospective clinical study,” and by Jerry Swee and et al., JADA, April 2013, vol. 144, issue 4, pp. 389-395. In the study the researchers looked at children who had received inferior alveolar nerve block (a local anesthesia) between the years of 2 and 6 at the Tufts dental clinic and also had a dental x-ray taken 3 years or after of being initially treated. The researchers arrived at 439 potential wisdom tooth sites from 220 patient records for their analysis. The control group consisted of 376 potential wisdom tooth sites where it was clear that the child never … Read more