One of my assistants suggested I explain the technique I use when I give injections. She had some dental work done and was surprised that there was no pain. It's a technique I learned around 15 years ago and I don't think much about it now, but my assistant thought it was important.

One of the nicest complements I receive is when someone says “That was so easy”. Fortunately that happens frequently. It hurts me when, in order to complete a procedure, a patient feels pain. Of course injections can't always be given painlessly. It is most difficult when someone comes in with a lot of pain or swelling and some people just have very sensitive gums. I would guess that 90% of my shots are painless, 9% are equivalent to a mosquito bite and the other 1% hurt a bit.

Here is the boring part. The procedure is as follows. Topical anesthetic for 1 to 2 minutes. I then very slowly inject one half cc of Citanest local anesthetic. The purpose of the Citanest is only to “numb” the gum. Citanest is a short acting anesthetic that has a higher PH than most other anesthetics. On most people Citanest, by itself would not anesthetize your tooth. But it does inject almost painlessly. Injecting slowly is also important in reducing pain. I then follow with Articaine. Articaine is the anesthetic that removes sensation from your teeth.

A few other notes while I'm on the subject. Novacaine is rarely used anymore because other anesthetics work better. Articaine, which I use now, is the latest. For whatever reason it works better than past anesthetics. I now very rarely do a block on the lower jaw. Because of this, it's much more comfortable to do fillings on both sides of the jaw. You can still talk when we are done because your tongue isn't anesthetized.

Before Articaine, at least once per month, I would have a patient where I would be unable to get them numb. It was usually someone in a lot of pain. Now it might be once per year.