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Dental Anesthesia: Understanding Types, Side Effects, Risks, and Precautions

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Medically Reviewed By Colgate Global Scientific Communications

To ensure overall health and well-being, including oral health, medical treatments are sometimes necessary. These treatments may involve the use of anesthesia to assist in complex procedures. Anesthesia plays a crucial role in various medical procedures, including knee surgery and the treatment of advanced dental cavities. 

In dentistry, anesthesia is used for pain control during dental procedures and surgeries. It numbs areas of the mouth to prevent pain and to acquire a state of analgesia. When administered correctly, anesthesia for teeth typically does not pose significant concerns. However, certain people may have specific side effects from dental anesthesia.

In this article, we will explore the different types of anesthesia, the potential dental anesthesia side effects, and the risks associated with dental anesthesia.

Types of Dental Anesthesia

Dental anesthesia plays an important role in ensuring a comfortable and pain-free experience during various dental procedures. 

Most often, medications are used alone or combined together to get better results. The medication is also individualized for a safe and successful procedure. Additionally, the choice of anesthetics is influenced by various factors, such as the individual's age, health status, duration of the procedure, and any history of adverse reactions to anesthesia.

There are three primary types of dental anesthesia, each serving a specific purpose.

  • Local anesthesia

  • General anesthesia

  • Sedation

Local Anesthesia

Local anesthesia in dentistry is a method used to numb a specific area of the body using medications known as local anesthetics. It prevents pain during medical procedures or surgeries and can provide pain relief after an operation. Unlike general anesthesia, which induces unconsciousness, local anesthesia allows you to remain awake and aware during the procedure. 

The American Academy of Pediatric Dentistry (AAPD) defines local anesthesia as “the temporary loss of sensation including pain in one part of the body produced by a topically-applied (topical anesthesia) or injected agent without depressing the level of consciousness.” 

Local anesthetics which comes under dental anesthetics work by blocking the transmission of nerve signals from a specific region to the brain. As a result, you won't experience any pain in the area where the local anesthesia for tooth extraction is administered, although you may still experience sensations such as pressure or movement. 

Local anesthetics typically take effect quickly, usually within 10 minutes, and provide relief for 30 to 60 minutes. For local anesthesia in dentistry, teeth in the lower jaw (mandibular) section of the mouth are harder to anesthetize than the upper jaw (maxillary) teeth.

Dental professionals commonly administer local anesthesia in dentistry for minor dental works, such as:

  • Cavity fillings

  • Tooth extractions

  • Dental cleanings

  • Root canal treatment

  • Gum treatments

  • Crown placements

  • Repair of minor oral injuries

Various types of local anesthetics are utilised in dentistry, including lidocaine, articaine, prilocaine, mepivacaine, and bupivacaine. These anesthetics may be available in different forms, including gels, creams, liquids, ointments, sprays, patches, or injectable solutions. Some local anesthetics can also be obtained with a prescription or over-the-counter.

General Anesthesia

General anesthesia is a type of anesthesia that causes a temporary loss of consciousness, which makes the individual unresponsive and unaware during the procedure. It is typically employed for longer and more complex dental treatments when a patient cannot tolerate the pain of dental procedures. General anesthesia is administered by a trained professional, such as an oral-maxillofacial surgeon or medical anesthesiologist.

During general anesthesia, you will not feel pain or discomfort, as you will be completely unconscious. General anesthesia can be given through inhalation or by injecting it into a vein to make sure the right level of sedation is achieved.

In dentistry, general anesthesia is commonly utilized in a hospital setting for patients undergoing invasive oral surgeries, including:

  • Extensive bone grafts

  • Corrective jaw surgery

  • Multiple tooth extractions

  • Oral cancer surgery

  • Sleep apnea surgery

  • Cosmetic dental procedures

  • Cleft lip/Palate surgery

By utilizing general anesthesia, dental professionals experienced in anesthesiology can perform intricate and lengthy procedures while ensuring patient comfort and safety. Throughout the procedure, an anesthesiologist or a specially trained dental anesthetist closely monitors the patient's vital signs, including heart rate, blood pressure, oxygen levels, and depth of anesthesia, to ensure their well-being.


Sedation dentistry helps to relieve the nervousness and anxiety experienced during dental procedures. It serves to reduce pain and discomfort and also helps patient cooperation by minimizing movement or involuntary reactions. 

Sedation can be administered in varying degrees of strength, depending on the patient's needs and the complexity of the procedure:

  • Mild sedation: This level of sedation allows patients to remain conscious and responsive to commands.

  • Moderate sedation: It induces a semi-conscious state in which patients may still respond to verbal cues but have a reduced awareness of their surroundings.

  • Deep sedation: This level of sedation induces a state of unconsciousness, where the patients are unaware of their surroundings and unable to respond to commands.

One popular form of conscious sedation is nitrous oxide, commonly referred to as laughing gas. Nitrous oxide is an inhalable gas administered through a nasal hood placed over the nose. Other sedative options include medications such as diazepam (Valium), midazolam (Versed), and propofol (Diprivan). The medication can be given orally (oral sedation), inhaled, intramuscularly (IM), or intravenously (IV). 

IV sedation is considered more risky compared to other forms of sedation due to the direct administration of sedative medications into the bloodstream. Individuals who experience severe dental anxiety or dental phobia often require sedation prior to receiving anesthesia.

Procedures Requiring Dental Anesthesia

Dental anesthesia is a crucial part of various dental procedures, ensuring patients undergo treatments comfortably and painlessly. The choice of anesthesia depends on factors such as the nature of the procedure, the patient's health condition, and the expected duration. 

Here are some common dental procedures that often involve the use of dental anesthesia:

  • Tooth Extractions: Local anesthesia is often used for pain-free experiences, whether it's routine tooth extraction, complex wisdom tooth removal, or decayed tooth removal.

  • Root Canal Treatment: Root canal procedures involve the removal of infected pulp from the tooth. Local anesthesia is administered to relieve pain and discomfort during the treatment.

  • Dental Implant Placement: Dental implant surgeries involve the placement of artificial tooth roots and often require local anesthesia to manage pain and discomfort.

  • Gum Surgeries: Various gum surgeries, such as gum grafts or periodontal procedures, may involve the use of local anesthesia to numb the gums and surrounding tissues.

  • Complex Dental Restorations: Procedures like dental crowns, bridges, and inlays/onlays may require local anesthesia to ensure a painless and stress-free experience for the patient.

  • Orthodontic Procedures: Certain orthodontic treatments, especially those involving surgical interventions, may require the administration of dental anesthesia.

  • Surgical Tooth Exposure: In cases where a tooth fails to erupt properly, surgical tooth exposure procedures may be performed under local anesthesia.

Understanding the types of dental anesthesia and the procedures they are associated with allows both healthcare professionals and dental patients to make informed decisions regarding pain management and overall dental care. If you have specific concerns about anesthesia for a dental procedure, discuss them with your dental professional or oral surgeon. This is crucial for a personalized and comfortable experience. 

Side Effects of Dental Anesthesia

Dental anesthesia is usually safe and well-tolerated. But, some people may experience temporary side effects. It's important to be aware of these potential side effects, which typically resolve on their own shortly after the procedure. Common dental anesthesia side effects include:

  • Numbness: Temporary numbness in the treated area is a common side effect. It may take some time for the anesthesia to wear off completely.

  • Tingling or Itching: Some individuals may experience sensations of tingling or itching as the anesthesia wears off. This is usually temporary and should subside soon.

  • Swelling and Bruising: In certain cases, there may be mild swelling or bruising at the injection site. This is generally minimal and resolves within a short period of time.

  • Nausea: A mild sensation of nausea may occur in some individuals, but it is usually brief and diminishes quickly.

  • Dizziness or Lightheadedness: Feeling dizzy or lightheaded can be a temporary side effect. It is advisable to move slowly and avoid sudden changes in position.

  • Allergic Reactions: Although rare, some individuals may be allergic to components of the anesthesia. It's important to inform your dental professional about any known allergies before the procedure.

  • Injection Site Discomfort: Mild discomfort or soreness at the injection site may occur, but it typically resolves without the need for specific treatment.

  • Unable to Blink: Temporary inability to blink one eye is a rare side effect. Dental professionals can address this by taping the eye shut until normal function returns.

  • Hematoma: Hematoma, a blood-filled swelling, may occur if the injection needle inadvertently hits a blood vessel. This is an infrequent complication.

  • Racing Heartbeat: The vasoconstrictor drug in anesthesia can transiently increase heart rate. It's important to inform your doctor if you experience this, although it typically resolves quickly.

  • Nerve Damage: Direct contact of the needle with a nerve can lead to numbness and pain lasting for weeks or months. However, nerve damage is considered very rare in regional injections, as per the American Society of Regional Anesthesia and Pain Medicine (ASRA).

Precautions to Take When Undergoing Dental Anesthesia

Before opting for dental anesthesia, it is important to consult with your dental team about your health conditions and situations. It is better to ask questions to gather relevant information. Ask about the risks and safety steps for dental anesthesia. 

Here are some conditions that require special care when undergoing dental anesthesia:

  • Pregnancy: If you are pregnant, it is important to inform your dental professional. They will evaluate the potential risks and benefits associated with anesthesia for both you and your baby. 

  • Special needs: Individuals with special needs, such as cognitive or developmental disabilities, may require additional considerations when it comes to dental anesthesia. 

  • Older adults: Older adults may have specific health concerns or take medications that can interact with anesthesia. It is important to disclose this information to your dental professional so that they can make informed decisions.

  • Pre-existing medical conditions: If you have pre-existing medical history of illness, such as liver, kidney, lung, or heart problems, it is crucial to inform your dental professional. 

  • Neurologic conditions: Certain neurologic conditions, like epilepsy or Parkinson's disease, may affect the choice and use of anesthesia.  

  • Other medical conditions: Even if you have other medical conditions not mentioned above, it is essential to discuss them with your dental professional. They will be able to identify any potential risks or necessary precautions associated with anesthesia based on your specific conditions.

What are the Risks of Dental Anesthesia?

Most individuals do not typically experience adverse reactions to local anesthesia. However, it is important to note that sedation and general anesthesia carry higher risks. This is especially true for older adults and people with health problems. Also, people with a history of bleeding disorders or those taking medications that increase the risk of bleeding, such as aspirin, may have a higher risk during dental anesthesia.

If you are taking pain medications, like opioids or gabapentin, or anxiety medications, like benzodiazepines, you must inform your dental professional or surgeon. This information will let them make any needed adjustments to your anesthetic plan. 

To reduce dental anesthesia side effects, minimize the risk factors that may require desensitization.. Maintaining a healthy oral hygiene routine is key. It includes effective dental practices like regular brushing, flossing, and a nutritious diet. These practices are essential for oral well-being. Additionally, do not forget to schedule routine dental checkups to ensure ongoing dental health.