Had my first major dental procedure in a few decades performed yesterday, and was pleasantly surprised to experience no pain in either the administration of the novocaine or the actual procedure. Have there been major changes while i wasn’t looking?
I think you are onto something. Over the past 5 years or so, I’ve had a bridge (with two root canals) and two implants done, and all of these procedures were largely painless.
I wouldn’t exactly call them fun - there was pressure and ratcheting and sore jaw muscles from a long-opened mouth - but pain? Not really.
mmm
If this is true, though, how has it happened? Smaller gauge needles? More efficient placement? Better anesthetics? I noticed my dentist doing something unusual, jabbing my gums with his finger rhythmically as he was injecting, which distracted me from the momentary pain. By the time I figured out what he was doing, it was over.
I’ve noticed needles have been getting more (relatively) painless and not just in dentistry.
Retired dentist here. If it has been decades as you say the biggest change is the needle. When I was a kid, 1960-70s, needles were sterilized and reused. They had to be thicker metal to withstand repeated use and got dull so didn’t insert as easily. Now with single use they are smaller and sharper. You may have had novocaine if you are older than average. Lidocaine replaced novocaine in the early 50s. It works better and is longer lasting than novocaine. When I started dental school in 1986 they weren’t making novocaine for dental use. I do not know when they stopped. I started using articaine in the early 2000s when it came on the U S market. It is better than lidocaine in that it is more lipidophillic. It bonds to the fatty covering of the nerve better. To me though the most important improvement is good technique by the dentist. Good injection technique is much more emphasized than it used to be.
Recently before injecting they applied a topical anesthetic – not sure if they did that in the past.
Brian
My dentists have explained that there are basically two types of injectable anesthetic- one is short acting with a duration around an hour or so, and the other is considerably longer- on the order of four hours. This was as part of a crown- he was just commenting that if he could get it done fast enough, a couple doses of the short-acting stuff would be ideal for me, but if it took longer, he’d have been better off just using the longer-acting stuff due to dosage limits and what-not.
This helps.
Also, the guy doing my wisdom tooth removal made some comment about a technique where the injection happens more quickly. I remember as a teen novocaine injections lasted a long time (like 20 seconds) and now the dentist would count 1, 2, 3 and done.
The one thing that had the most effect, though, was a shot into the roof (hard palate) of my mouth. Wowzer did that hurt! But it only lasted a few seconds and then I couldn’t feel my face at all and there was no pain during the procedure.
74 year old here. Needles don’t bother me much, so Novocaine/Lidocaine injections might sting a little but no big deal.
- As a child I survived 1950’s dentistry which was a medieval nightmare. Many fillings.
- In 1969 I had four crowns. The processes were awful with moments of extreme pain.
- 30 years of regular checkups, not so much as a cavity.
- 2001, three of the crowned teeth needed root canals. I was terrified, the Oral Surgeon insisted I would feel no pain, I had no choice but to trust him. Throughout all three RC’s I felt literally no pain whatever. Not a single twinge.
I have two questions about things in dental anesthetics that I noticed lately, about the time my long-time dentist retired and a young one took over his practice. Until then, my old dentist always waited for about 15 minutes between giving the needle and starting his dental work to let the anesthetic kick in, now it’s only about two or three minutes. The second thing is that my old dentist always warned me about not driving until the anesthetics stopped working, but my new dentist never gave me that warning. Is this all due to new drugs?
I think that’s made a big difference. Tapping on the gum for distraction - not so much.
I had a root canal awhile back that I was dreading, due to others’ reports of horrible pain. But it wasn’t bad at all, just that the procedure went on for a looong time.
EinsteinsHund Four minutes is enough wait time. For uppers that should always be good. Dentists generally always get them numb. On lowers it is fairly easy to miss the nerve. If half the lip feels numb after four minutes, good to go. If the lip isn’t numb the placement was off and need to retry. No restrictions on driving after local anesthetic. Not a function of the drugs, I’ve never heard of no driving in four years of school and 34 years of practice.
I’m in for 3 hours of “something” at JCU Dental School which is free for seniors here in Australia.
My second appointment with the fourth year …they sawed a bridge in two and removed a tooth last time.
A very long 3 hours 
That bridge was bullet proof but 30 years old and cracked. They burned out a lot grinders getting it through it.
I hadn’t recalled getting a needle in pallete…get did some pressure thing but it still hurt.
After that there was no pain just lots of pressure including the tooth removal which a senior supervisor did.
Now on to stage 2 today - not sure what they are doing but sure to be stressful 
and I have to take a bus !!! been a long time since I’ve been on a transit bus anywhere…too rainy to ride mcycle and appointment conflict with partner who usually drives me.
Getting old sucks but those bridges served me for 30 years
Thanks for the explanation. I never heeded my dentist’s advice not to drive after anesthetics anyway because I never felt impaired in any way.
I’m a retired pharmacist, and when I was given articaine, I had never heard of it. (Late 00s) I thought that stuff was NEVER going to wear off. I had my procedure early in the day, and I looked like I had Bell’s palsy until well into the afternoon, and that was the worst part of it.
“Novocaine” is actually a brand of procaine, and has entered the language, like Kleenex has. The only place I ever personally saw procaine was as an additive to long-acting penicillin syringes.
I was just talking to my brother about this and he complained that it took a long time too. My experience is it was pretty fast. What we guessed at was my brother’s dentist did his and I went to a guy who does nothing but root canals (that’s his whole practice).
My root canal was like an assembly line. There were several rooms (4-5…I forget). I get plopped in the chair. The dental assistants prep everything. Dentist comes in room, asks a few questions, hits me with all the Novocaine and leaves to let it take effect. Presumably he was dealing with other patients. He comes back 10(ish) minutes later and gets to work. Maybe in 15 minutes he was done. I got up, paid and walked out.
I doubt the whole thing from walking in to walking out took even one hour. (and no pain beyond that hard palate shot)
My brother’s dentist was no where near as efficient. The end result was the same but it took much longer.
As well as everything else here, the placement has got better in my experience.
When I was young, on at least two occasions I can remember, much of my jaw was numb but not the actual tooth they were doing the procedure on. In fact on the second occasion they were borderline accusing me of faking, because they kept emphasizing they’d given me a lot of anesthetic.
But that was a long time ago, and every time since then, this hasn’t been an issue. Sure, I might still feel the occasional twinge but the anesthetic is in the right place.
I might have been unlucky…just adding my anecdote to the pile.
To me, as someone who has been going to the dentist since the 1960’s, another important improvement is more attention to pain management, and not just with the dentists who advertise “painless dentistry”.
Over time it seems the profession has moved to being a lot more attentive to whether or not a particular person is sufficiently numbed up, anxiety relieved, and post-procedure pain management. My recollection from childhood is “I gave you a shot, that should be enough” and out comes the drill, ready or not. Now it’s actually probing a bit to make sure the relevant bits are numb. Also, actual discussions about options, comfort levels, sedation levels (zero to significant) use of not just pharmaceuticals but distractions like music on headphones, comforting images on a screen, and so forth.
I don’t think it was so much one or two particular things as incremental change combined with a different attitude being promoted among dentists to focus more on patient comfort and not just technique.
Can’t help but think having relaxed, calm, pain-free patients make the work environment much easier and more pleasant for everyone involved.
My one “dental anesthetic” story I retell in the dentist’s chair is from when I was in the Navy in boot camp and had to have my wisdom teeth removed. Their policy was that anyone who was potentially going to be on a submarine had to have their wisdom teeth removed, as they didn’t want inconvenient dental issues coming up while a submarine was in some forbidden waters. As a nuclear power candidate, I fell into that category.
It was half way through boot camp. At the time of my appointment I went over to the medical facility and entered the fastest moving line of my Navy career. That line moved way too fast for comfort.
Eventually I was at the head of the line and trembled at the voice calling “Next!”
The dentist was friendly, and he joked around as he gave me injections here and there.
Then, he lay down the syringe, and without pause, in the same motion of his arm, he picked up the forceps and brought them up before my face.
I looked on in absolute horror, knowing full well that I should have been sitting there for ten or fifteen minutes reading a comic book for the anesthetic to take effect…but when he went to work I felt nothing.
Whatever he used was potent stuff.
I asked my dentist about this a few months back and he rattled off some name that he thought it could have been, and he mentioned that it has health risks, and said it wouldn’t have been a concern for healthy 18-year-olds.
Any idea what the Navy dentists were using?
Oh yeah, I remember my time in the boot camp dental chair. It wasn’t pleasant, had to have 4 removed–including one that was hiding out sideways and had to be drilled out/busted up.
But like you–I don’t remember any pain. I do remember they put a little cloth over my eyes and I could just barely peek out of the bottom and see the dentist’s friggin 24-inch Hulk Hogan pythons. When he started pulling bloody bits out my mouth I understood the reason for the cloth.
Again though–no pain. I just remember the tugging, and oh dear god the sound. That rending and tearing sound that just resonates through your entire skull was the worst haha.