Dentistry and modern science developed local anesthetic (cocaine) in 1884. This has allowed dental and medical procedures to be performed in a painless way. The injectable anesthetic, Novocaine (procaine) was invented in 1905 (from Latin, Novus which means new, caine as in cocaine), but stopped being manufactured for dental injections 20 years ago. There are numerous modern replacements. The term Novocaine is still used as a general term, like the use of the word Kleenex to refer to all facial tissues.
Q: Why do I get shaky after getting Novocaine?
A: The modern replacements for Novocaine include lidocaine (xylocaine) introduced in 1948, articaine (2000), prilocaine (1960), marcaine (1983-longest acting) and mepivacaine (1960-shorter acting).
These anesthetics come in two forms, those with or without epinephrine (adrenaline). Epinephrine was added to the first injectable local anesthetic (cocaine) in 1903 to establish vasoconstriction to slow vascular uptake. Anesthetics with epinephrine produce a longer duration of action. After injection, the epinephrine causes some people to experience palpitations while waiting for the numbness to take effect. They begin to shake, and this usually dissipates within a few minutes. To prevent this side effect, a local anesthetic with one half the usual dose of epinephrine or the use of a local that uses no epinephrine or an epinephrine substitute to make the effect last longer should be used. Tell your dental professionals if you have experienced this side effect.
I quit using local anesthetics that include epinephrine over 25 years ago and never noticed a difference in the drug’s (mepivacaine) performance. I now occasionally use the newest product – septocaine (articaine) – utilizing the half-dose of epinephrine on patients who have never experienced any prior sensitivity.
Q: How does a local anesthetic work?
A: The dentist injects with a syringe the local anesthetic solution factory-sealed in a cartridge. A nerve block or infiltration technique is used to numb the teeth or oral tissues to be treated. Non-dental nerves are also anesthetized. Patients are advised to be cautious to avoid biting or traumatizing the numb lips, tongue, inside of cheeks or roof of the mouth during and after treatment.
Q: Are these injections safe?
A: This is a very safe procedure administered millions of times per year. The dentist controls the proper dosage, which should be the lowest amount that results in effective anesthesia, using the correct technique and adequate precautions with a readiness to treat any unusual result or emergency. Call the dentist if numbness persists or if a rash develops.
Remember to tell your health provider if you develop any symptoms from administered or prescribed medications.