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Dental Anesthesia

Dental Anesthetic

12/15/2011

Question:

What are the names of one or more anesthetic for the dental office that contain no epinepherene and also no sulfite preservatives?

Answer:

Sulfites are chemicals to prevent oxidation (chemical breakdown) of vasoconstrictors like epinephrine and levonordefrin. Vasoconstrictors are in most dental local anesthetics to make them last longer and reduce surgical bleeding. Sulfites are also in red wine for the same purpose, to prevent the wine from losing its flavor due to oxidation from air that might leak inside the bottle through the cork before it is opened. 
 
  • 3% mepivacaine plain and 4% prilocaine plain contain no epinephrine and therefore no sulfites. 
  • 2% Lidocaine plain without epinephrine also contains no vasoconstrictor and no sulfites, but it is so short-acting that it is rarely used in dentistry.    
  • 2% mepivacaine contains no epinephrine but does contain a somewhat similar vasoconstrictor (levonordrrin) and contains sulfites. 
  • 4% prilocaine with epinephrine is another prilocaine product that does contain epinephrine and sulfites.
There are many other local anesthetics used in medicine that do not contain vasoconstrictors or sulfites, but these do not come in the small glass cartridges that dentists like to use in their syringes. However they can be used in standard syringes for dentistry -- 0.25%, 0.5%, and 0.75% bupivacaine, 0.5%, 0.75%, 1% ropivacaine, and 0.25%, 0.5%, and 0.75% levobupivacaine are excellent local anesthetics without vasoconstrictors or sulfites.

For more information:

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Response by:

Joel M Weaver, II, DDS, PhD
Faculty Emeritus
Dentistry Administration
College of Dentistry
The Ohio State University