Instructions for use in dentistry Ultracain

• reviews on Ultracain, release forms,
• pros and cons of the drug,
• How much does Ultracaine anesthesia cost?

The article was written by a dental surgeon with more than 19 years of experience.

The anesthetic Ultracaine is a drug in the form of an injection solution that has a very high analgesic effect when administered locally into tissues. The main active component of ultracaine is the substance “articaine hydrochloride” (Articaine), which makes it possible to classify this drug as an anesthetic of the articaine series. Ultracaine is most often used in dentistry, which is explained by its high efficiency.

There are several forms of release of this drug, which differ from each other in the concentration of the vasoconstrictor component (epinephrine) included in ultracaine. It is added to articaine to locally reduce blood supply in the anesthesia zone and reduce the leaching of the anesthetic from the tissues. Those. Epinephrine increases the duration and depth (strength) of anesthesia.

Anesthetic Ultracaine and carpule syringe –

For dentistry, the anesthetic is available both in the form of regular injection ampoules and special cartridges called carpules (these are most often used). The anesthetic carpule is inserted inside a special carpule syringe, which has a piston in the form of a handle, and a special double-edged needle is inserted into it from the side of the syringe nose. When pressing on the syringe piston, the latter presses on the movable rubber liner inside the carpule, which leads to an increase in pressure inside the carpule and the release of the anesthetic solution through the needle.

Ultracaine release forms –

• ultracaine DS-forte (epinephrine concentration 1:100,000),
• ultracaine DS (epinephrine concentration 1:200,000),
• ultracaine D (without epinephrine).

The presence of three forms of drugs is explained by the possible side effects of epinephrine, which can increase the patient's blood pressure. For completely healthy people who do not have cardiovascular or other diseases, Ultracain DS Forte is used. For moderately high blood pressure, Ultracaine DS with a reduced concentration of epinephrine can be used. However, the instructions for use for Ultracain indicate that any of the listed forms can be used from the age of 4 years. We will tell you more about the indications for use of each form below.

How anesthesia is performed in dentistry: video

Information about the drug

Ultracaine is a combined local anesthetic drug that contains epinephrine and articaine. The first is a vasoconstrictor, the second is an amide anesthetic. When injecting the drug, loss of sensitivity occurs after the conduction of sensory impulses at the nerve endings ceases to function. The level of effectiveness is much higher than lidocaine and novocaine.

The main component of the anesthetic is articaine hydrochloride. The composition also includes sodium chloride and bisulfite, adrenaline and water.

There are 3 types of Ultracaine:

1. D - does not contain epinephrine. Can be taken by allergy sufferers and those suffering from bronchial asthma.
2. DS - epinephrine composition 1:200000 - is prohibited for use by asthmatics, but is acceptable for cardiovascular diseases.
3. DS Forte - epinephrine 1:100000 - is not recommended for use in asthma, thyroid disease and hypertension.

The solution begins to act within one to two minutes after the injection and lasts up to an hour. Available in ampoules of 2 ml and cartridges of 1.7 ml.

Ultracaine during pregnancy and breastfeeding

The optimal form of this anesthetic during pregnancy is Ultracaine DS with an epinephrine concentration of 1:200,000. The use of anesthetics without epinephrine (or adrenaline) in pregnant and lactating women is generally not recommended. This is due to the fact that adrenaline, by constricting blood vessels at the injection site, slows down the absorption of the main component (articaine) into the blood, and accordingly this will reduce the peak concentrations of articaine in the blood, and therefore its possible side effects on the fetus.

Ultracaine during breastfeeding - after anesthesia with Ultracaine, the content of articaine in breast milk is possible, but the concentration is so low that it cannot cause any harm. Therefore, there is no need to give up breastfeeding. The epinephrine content in Ultracaine DS is also very small and cannot adversely affect either the mother or the child.

Sources:

1. Dental education of the author of the article, 2. Based on personal experience as a dentist, 3. National Library of Medicine (USA), 4. “Local anesthesia in dentistry” (Baart J.), 5. https://dental.sanofi. de/.

Main indications and dosage

An effective pain reliever Ultracaine is used for dental procedures that are accompanied by severe pain. It is administered for single and multiple tooth extractions, installation of crowns, fillings and other dental procedures.

It is used during conduction anesthesia for the following dental interventions:

• uncomplicated tooth extraction;
• preparation and grinding of teeth before prosthetics;
• performing treatment of carious cavities.

The medication is used to perform certain manipulations in the oral cavity. It is forbidden to perform an injection if there is tissue inflammation.

The dosage depends on the type of procedures performed, the characteristics of the body and the age of the patient. The pressure of the solution must fully correspond to the sensitivity of the tissue. When performing resection of teeth in the upper row, the calculation for each tooth is 1.7 ml. If it is necessary to increase the analgesic effect, the dose may be increased. To remove the lower premolars, 1 injection will be enough. If the effect does not appear in the first minutes, you can give a second injection at a dose of 1-1.7 ml.

When preparing a tooth for a crown, infiltration anesthesia is 0.5-1.7 Ultracaine. The maximum dosage can reach 7 microns/kg.

Ultracain: reviews from dentists

As a practicing physician, I try to use this particular anesthetic primarily, although its cost is 1.5-2 times more expensive than similar anesthetics based on articaine.
Thanks to the optimal composition, a minimum of preservatives in the composition (and the complete absence of preservatives in the form of Ultracaine D), this anesthetic can be used in all patients at risk (for cardiovascular, endocrine disorders, allergies, pregnancy and lactation). Ultracaine reviews from dentists are also as favorable as possible because this anesthetic will be a good choice if you have an allergic reaction to amide group anesthetics, for example Novocaine, Lidocaine and others. But in addition to the high safety profile, this anesthetic is also much stronger than its predecessors (see below). In addition, this anesthetic acts in inflamed tissues, but Novocain practically does not anesthetize in the presence of purulent inflammation.

The duration of action and depth of anesthesia will depend on the concentration of epinephrine in the composition of the product, for example, Ultracaine DS forte 1: 100,000 is the most powerful drug in the line. When conducting conduction anesthesia on the lower jaw, the duration of action averages from 2 to 3 hours. With infiltration anesthesia on the lower and upper jaws - a little more than an hour (24stoma.ru).

Ultracaine or lidocaine: which is better?

• Ultracaine is stronger than Novocaine - 5-6 times,
• more effective than lidocaine - 1.5-2 times.

Overdose and contraindications

In case of an overdose of Ultracaine, symptoms such as dizziness, stupor, respiratory failure, bradycardia, twitching of muscle tissue, and circulatory disorders may occur.

If such consequences occur, it is necessary to stop its administration and immediately place the patient in a horizontal position with raised lower limbs. In case of complicated symptoms, artificial respiration and endotracheal intubation should be performed.

Ultracaine DS and DS Forte contain adrenaline, which is contraindicated in cases of hypertension, glaucoma, asthma, tachyarrhythmia, anemia, tachycardia. The drug should not be used by children under 4 years of age.

How long does dental anesthesia wear off?

How long the anesthesia wears off on a tooth during treatment depends on the type of drug used:

1. Applied to the surface of the mucous membrane, they act within a few minutes. They are used as a preparatory anesthetic, for example, to reduce pain when an anesthetic is injected into the gum. Comes off quickly;
2. When anesthetizing the upper part of the dentition, the drug can act for up to 2.5 hours. How long the anesthesia wears off also depends on the individual characteristics of the patient;
3. When intervening in the lower jaw area, stronger anesthesia is required, which takes longer. Therefore, the drug is injected deeper. As a result, the analgesic effect lasts up to four hours. The area of ​​the jaw that needs to be anesthetized also plays a big role.

Only a dentist will tell you exactly how much anesthesia acts on a tooth during treatment; only he knows the dosage and effect of the specific drug that will be used.

The use of painkillers during most dental procedures has long become the norm. General anesthesia, the use of which puts a person into a state of artificial sleep, is rarely used; other methods are usually used. This requires special indications or major surgery.

General anesthesia is indicated in the following cases:

1. mental disorders of the patient;
2. risk of epileptic seizure;
3. pathological fear of dental procedures;
4. complexity of the dental procedure.

The scope of application of local anesthesia is much wider. This method is based on the fact that the drugs used block the conduction of nerve endings, thereby relieving the sensation of pain.

Anesthesia has practically replaced the previously used method of providing anesthetic care, based on the use of arsenic to eliminate nerve endings in the dental canal.

What does this depend on?

How long the dental anesthesia takes to wear off depends on the following factors:

1. Inflammatory lesions at the injection site. The active elements of painkillers have an alkaline environment, and the localized inflammatory process forms an acidic environment. As a result of their interaction, the alkaline composition of the anesthetic is neutralized, and the anesthesia of the tooth wears off very quickly or does not occur. Therefore, the doctor must carefully calculate the amount of anesthesia, since numbness in such patients goes away much faster.
2. The presence in the anesthesia formulation of elements that lead to vasoconstriction. It enhances the effect of the pain reliever. The anesthetic effect occurs later, but at the same time its duration increases, the freezing goes away more slowly.
3. Patient's age. The older the patient, the more difficult it is to provide pain relief. At the same time, the process of weakening the anesthetic effect also lasts longer.
4. Diseases of the digestive system (diseases of the gastrointestinal tract). Anesthesia is eliminated from the body by the liver and kidneys. Their level of health significantly affects how long tooth frost lasts and how it goes away.
5. The duration of the effect of the anesthetic drug depends on the qualifications of the specialist who performed the procedure. If the technique is violated, either prolonged anesthesia or its complete absence occurs; it is very difficult to predict how the anesthesia will wear off.

Side effects

Most often, the body reacts to the injection under the influence of epinephrine. From the central nervous system, symptoms may appear in the form of loss of consciousness, hypoesthesia, muscle tremors, twitching and severe headache.

If we consider the cardiovascular system, Ultracaine can lead to tachycardia, heart rhythm disturbances, and heart failure.

An allergic reaction manifests itself in the form of rhinitis, difficulty breathing, urticaria, itching, and angioedema. Double vision and blurred vision may also occur.

Can pregnant women have their teeth treated with anesthesia?

A visit to the dentist is a must when planning a pregnancy. But even if all serious dental problems are eliminated at this stage, the woman is not immune from the development of dental diseases at any stage of pregnancy. The fact is that at this time significant hormonal changes and changes in the functioning of all systems and organs occur in the body. In addition, the pH of saliva changes and a lack of calcium may be felt. Therefore, during pregnancy, problems with teeth and gums often worsen, which can lead to dangerous diseases such as pulpitis and periodontitis. These diseases require mandatory treatment, since their complications can harm the health of the mother and baby.

It is possible to treat teeth with anesthesia during pregnancy. The main thing is to use anesthesia only when it is really necessary, and also to choose the right method and means of pain relief. Remember that a pregnant woman should not endure acute pain. Lack of anesthesia during painful dental procedures can lead to painful shock in a pregnant woman, which is severe stress for the body of the mother and baby.

Interaction with other drugs

Ultracaine D-S is not recommended for use with cardio-nonselective adrenergic blockers. It is also prohibited to consume alcohol while administering the solution.

Ultracaine is a local anesthetic solution that is mainly used in dentistry.
When performing various interventions, low toxicity and high efficiency allow the anesthetic to be administered to patients without much harm to their body. This article is for informational purposes only, please consult your doctor for details! Ask your doctor about contraindications and side effects.

Ultracaine: price of anesthesia

The cost of 1 carpule of Ultracaine is from 90 rubles (this is the price at which dental clinics purchase it). But in a dental clinic using Ultracain, the price for anesthesia will be approximately 400 to 500 rubles. Unfortunately, you won’t be able to buy a carpule of anesthetic at a pharmacy and bring it with you. This is strictly prohibited by law, because... In this case, the dentist cannot guarantee that the anesthetic is not counterfeit or that it was stored correctly. As a result, the dentist will in any case be to blame for the complications and will be held responsible for it.

Why does anesthesia not go away after dental treatment?

Sometimes the effect of the painkiller lasts longer than expected. The patient can try to reduce the effect of the anesthetic at home. To do this, apply a non-hot compress or massage to the site of anesthesia during the day. This will lead to expansion of the capillaries, which will speed up the removal of active substances from the anesthetized area, and the anesthesia will wear off faster.

In this case, you need to contact your doctor for advice. In addition, these measures are permissible if a filling is placed, but in no case after tooth extraction.

To ensure that the drug does not last longer than necessary, the patient’s liver should not be overloaded, since it is the liver that is responsible for removing the drug from the body. You should also not drink alcoholic beverages immediately after visiting the dentist.

Sometimes anesthesia may not go away due to complications. The main reason for the long-term effects of anesthesia is damage to the nerves of those organs where the zone of anesthesia was located. This may require the help of not only a dentist, but also a neurologist. This occurs both when the pain medication is administered incorrectly, and as a result of the treatment itself.

The prolonged effect of anesthesia should not create panic. The normal duration of anesthesia after injection of an anesthetic into the upper jaw is 2-3 hours, for the lower jaw - 4-5 hours.

If, during these standard dental procedures in the oral cavity, the tooth was anesthetized for a longer period of time, headaches, chills, or general malaise appeared, it is necessary to seek qualified help in a timely manner. The specialist will determine the cause and take measures to ensure that the anesthesia wears off in accordance with the norms.

Sometimes physical therapy may be necessary to eliminate negative symptoms. But cases where anesthesia takes too long to wear off are rare. Also, prolonged exposure to anesthesia is a result of the patient's hypersensitive reaction to the drug.

Types of anesthetics and their features

Exactly how long anesthesia lasts after dental treatment depends on what type of anesthesia is used.

The following types of anesthesia are used in modern dentistry:

• Applique. The main feature is a short period of action. It is a gel or spray for surface use. Use is limited to a small number of procedures that do not require significant anesthesia for a long period. These drugs can be used as auxiliary drugs.
• Infiltration. Such anesthesia must be injected with a syringe into the area of ​​bone tissue or periosteum. It is used for many procedures, including cleaning dental canals. Valid for an hour.
• Conductor. The product acts directly on the trigeminal nerve area. The injection may cause severe pain, which can be relieved with another anesthesia. Used to treat molars.
• Intraligamentary. It is aimed at a specific tooth for various procedures - chipping occurs around the diseased incisor. Used for tooth extraction or complex operations.

Articaine series

Articaine is a common painkiller used throughout the world. It is available in various forms and dosages, which allows you to choose the optimal anesthetic for the patient. It can be combined with medications of the adrenaline group, which allows you to narrow blood vessels and prevent possible blood loss.

This anesthetic is stronger in effect than traditional painkillers: five to six times than lidocaine and two to three times than novocaine. Anesthesia can be performed in such a way that it will not harm either patients with contraindications or pregnant and lactating women.

The duration of tooth freezing can be selected so that the anesthesia after tooth treatment begins to wear off immediately after the end of the intervention and does not cause discomfort.

Mepivacaines

This is a special group of anesthetics that does not require combination with adrenaline. Due to this, it is less effective. But thanks to its formula, it can be prescribed for the treatment of pregnant women, patients with cardiovascular diseases and is used to treat children.

It is used in dentistry not only during treatment and procedures, but also to reduce pain after their completion, for example, as painkillers after wisdom tooth removal. The use of the drug allows you to painlessly treat severe cases of dental diseases.

It has contraindications, so before use a sensitivity test is required, which will determine how long the effect will take and how the patient will tolerate anesthesia.