Not your father’s Novicaine!

People who experience dentistry today have no idea what it was like for their parents. Technology has changed so much of the world, including the world of dental anesthetics. Today the drug of choice for many types of dental procedures and injection techniques is called Articaine. It is an amide that has an ester hydrolysis component combined with a highly lipid-soluble thiophene aromatic ring. Now, that sentence says alot. The fact that it is an amide means that it works better than the old types or anesthetics that were esters. It also means that people are not as likely to have allergic reactions to the anesthetic as they used to be.

Most of the major anesthetics today are amides such as lidocaine, mepivacaine, bupivacaine, etc. Articaine, though, has a wonderful thiophene ring that gives it a higher lipid solubility. The more lipid soluble the more it is able to diffuse through the tissue, the better it is at getting people numb. Articaine has 17 times the lipid solubility of lidocaine. Kanaa MD et al. in 2006 showed a statistically significant decrease in pulpal pain sensation with Articaine compared to Lidocaine (the standard local anesthetic used today). Now, which would you want?