Pain associated with dental problems and a fear of dental treatments has been around since the beginning of time. But imagine what it was really like back before the use of modern anesthesia. While many people believe that it began with medical treatments, the truth is dentists were the first to develop anesthesia, and it has been a long road. Here, we look at how dental anesthesia first began and how it has improved over the years. At Soundview Family Dental, we use the newest technology and advances in dental anesthesia to make your dental visit as pain-free and comfortable as possible.
- Dental anesthesia controls pain and anxiety during dental procedures.
- Nitrous oxide, or “laughing gas,” first used in dentistry in 1844.
- Safer alternatives to cocaine, like Novocain and Lidocaine, developed in the late 1800s.
- Oral sedation with Valium and Xanax helps patients relax during dental treatment.
- IV sedation with benzodiazepines popular in the 1900s for better results and lower risks.
What is dental anesthesia?
Dental anesthesia is the use of different drugs to help create a more comfortable dental experience. The administration of these drugs can help to control pain, reduce anxiety and create a relaxed state, or put you into a deep sleep-like state during a dental procedure. Dentists administer these drugs topically, orally, through injection or IV, or inhalation.
A brief history of anesthesia
The use of pain management for dental care dates back to 2250 BC when evidence reveals a cement created by mixing henbane seed and gum mastic was used to reduce the pain associated with dental cavities. In 1540, Valerius Cordus of Germany introduced synthesized sweet vitriol, which is commonly known as ether. However, it wasn’t until the 1800s when some modern-day treatments were first discovered.
Joseph Priestly first discovered nitrous oxide in 1772, though it wouldn’t be used in dental treatments for more than 20 years. In fact, inhaled nitrous oxide was first used for entertainment because of the silly way it made people act, thus earning it the nickname of “laughing gas.” In 1778, Humphry Daly first inhaled the gas when he suffered from pain due to a partially erupted wisdom tooth. However, he did not share the benefits he received until 1779. Despite these benefits, nitrous oxide did not move forward until 1844.
In 1844, traveling entertainer Gardner Colton shared nitrous oxide with Dr. Horace Wells. He, along with Dr. Riggs, used nitrous oxide during a wisdom tooth extraction on Wells. While Wells experienced a positive result, his demonstration on another patient in 1846 was unsuccessful, with the patient still experiencing pain. They determined the dose was too small, but this, unfortunately, put nitrous oxide on the back burner for another 20 years. Today, however, nitrous oxide is widely used, and the administration of doses is well regulated, allowing dentists to achieve great results.
The use of local anesthesia began in the late 1800s with cocaine when Carl Koller highlighted its anesthetic properties. Unfortunately, this proved fatal for many patients. Doses were not regulated, causing many patients to overdose.
In 1898, German chemist Alfred Einhorn began looking for alternatives to cocaine. After years of trials and experiments, he introduced Procaine in 1904. Now known as Novocain, this new drug was weaker than cocaine but offered a much safer alternative. In 1943, Lidocaine was synthesized and quickly became popular. While Novocain is still used today, Lidocaine is more prominent.
Oral sedation is still relatively new and is the desired sedation method for dental anxiety. Oral sedation is not designed to address pain. Instead, it puts the patient in a relaxed state in order to comfortably undergo dental treatment. This is often given to patients before they come in for their dental appointment. Drugs often used for oral sedation include Valium, Xanax, and Vistaril.
The use of IV sedation did not begin until the 1900s. After realizing that it had fewer risks than general anesthesia and offered better results than nitrous oxide at the time, it grew even more in popularity. By the 1930s, dentists in the United Kingdom were using barbiturate hexobarbitone regularly. Over the years, drug development changed, and various drugs, including diazepam (Valium), midazolam, and propofol, were used. Today, most dentists in the United States use benzodiazepines, such as midazolam or diazepam.
Technological advancement in local dental anesthesia
Technological advances over the years have made the administration of local anesthesia less painful and easier on the patient. While Lidocaine works well for procedures, it still requires injections into the area to be numbed. The new technology takes advantage of the gate control theory of pain management, suggesting that pain reduction occurs when nerve fibers are actively stimulated by vibration.
Vibrotactile devices, such as Accupal, uses both vibration and pressure on the oral mucosa to effectively close the pain sensors, enabling the dentist to administer local anesthesia without pain.
In the mid-1990s, a new concept was created for anesthetic delivery that used computer technology to control flow rate. Known as CCLAD, or computer-controlled local anesthetic delivery, this system allows dentists to control the flow rate of medications.
Comfort dentistry makes all the difference
At Soundview Family Dentistry, we understand how pain and anxiety can keep many people from getting the dental treatments they need to maintain a beautiful and healthy smile. We follow all the new technological developments in the world of dental anesthesia and work to incorporate new technology into our practice to make our dental procedures as pain-free and comfortable as possible. To learn more about dental anesthesia and the options available, contact us online or call the office at (425) 563-6360 today and let us help you achieve a healthy, beautiful smile.