Is it going to hurt?

July 23, 2013
Sarah Robinson, RDH, talks about two products — Oraqix and Cetacaine — that eliminate the “needle” while allowing her patients to be more comfortable and relaxed. Her patients give both products a big thumbs-up!

“Is it going to hurt?” How many times have we heard that question from our patients? As clinicians, one of our goals is to make sure that the patient is comfortable. With the new advancements in technology, comfort in dentistry is becoming easier and easier for us to deliver to our patients. As a hygienist, I am always searching for products that will allow my patients to be more comfortable and relaxed.

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One such product, Oraqix (lidocaine/prilocaine), is a needleless anesthetic gel that I have been using chairside for years that aids in the ongoing pursuit of patient comfort. I use Oraqix on most of my scaling and root planing patients, as well as localized scaling and patients with sensitive gums. Oraqix also helps in time management. This product has a short onset of 30 seconds, with a duration of about 20 minutes. Another product similar to Oraqix is Cetacaine (butacaine-buamben-tetracaine HCL) topical liquid. Again, in the form of a liquid delivered by a plastic syringe, Cetacaine has a 30-second onset with a duration of 30 to 60 minutes.

Whenever I use needleless anesthetic, I give each patient an explanation of the procedure. Within this explanation, I let them know that I will be using a needleless anesthetic gel for the procedure, and I will be placing it along the gum tissue and into any areas that have periodontal pockets. I explain that the numbness the patient is experiencing will be absorbed into the tissue and will begin to provide appropriate comfort, but that the anesthetic will not numb the tooth-root system. This process, although beneficial for scaling and root planing and for those with sensitivity, may not be the answer for certain root surface sensitivity, where local anesthesia may be a more appropriate solution. Needleless anesthetic is also not indicated or recommended for moderate to advanced periodontal disease patients with pocketing over 6 mm and/or heavy, tenacious subgingival calculus, root surface exposure, and severe decay. These types of cases require local anesthesia to allow for thorough cleaning of the subgingival areas without causing the patient any discomfort.

These products are used to eliminate the “needle” while still providing the comfort we all desire, which is why they get a thumbs-up from all my patients. And with their ability to allow for fast, effective, comfortable procedures, these products get a thumbs-up from me too!

Sarah Robinson, RDH, is a graduate of New Hampshire Technical Institute in Concord, N.H. She has been working as a dental hygienist in private practice for five years. As the lead hygienist, she has implemented a soft-tissue management program and educated the team on the standard of care for early detection and diagnosing periodontal disease. She is passionate about her profession and enjoys the many aspects of patient care that dentistry has to offer.