Our presenter for December 4th was Dr. Carl Mentesana, DDS.
His topic was:
“EDS: A Dental Perspective“
Click Here for the recording
Note: the presentation slides start after about 7 minutes into the program
Addendum to the Patient Q & A
Question: Please post the different local anesthetics with your comments on each one?
Answer: My literature review indicated that the local anesthetic, Lidocaine with 1 to 100,000 epinephrine has a pH of 3.4 The body has to buffer this solution to ~pH of 7.4 so the anesthetic can cross the nerve sheath producing the required anesthesia.
Therefore, if a local anesthetic can begin with a higher pH it seemingly will be more effective. (Proper placement of the local anesthetic is of the utmost of importance to achieve the desired anesthesia, as well).
Mepivacaine or Carbocaine can be used as a local anesthetic with a reported pH of 6.8 ( Carbocaine and Mepivacaine are the same drug) This anesthetic contains no epinephrine and can be washed away from the site quicker than an anesthetic that contains epinephrine, such as Lidocaine. You may need a series of injections if the anesthesia starts to dissipate over time as your blood washes the anesthetic away from the site.
Articaine has a reported pH of 7.5. This pH is near the bodies pH therefore it could act quicker and with more profound anesthesia. Reports of paresthesia associated with articaine are not conclusive, but many practitioner’s will not use this anesthetic for this reason. Paresthesia is a prolonged or completely life-long numbness of the tongue and/or lip and/or cheek that is associated with dental injections to achieve local anesthesia. The anesthetic works but it also has limited ability to re-inject due it reaching its maximum dose level at approximately two carpules ( carpules—the carrier that local anesthetics are delivered to the patient for dental procedures).
Marcaine is the other anesthetic that someone in the meeting mentioned. Marcaine is long lasting local anesthetic but is reported to have a pH that ranges from 4 to 6.5. After reviewing the literature it was unclear on how to determine if the pH would be at 4 or 6.5
I hope this helps. Please check with your dentist concerning the accuracy of the above information when using local anesthetics. Allergies exist with the administration of anesthetics and can cause severe damage to patients, please perform allergy testing prior to use of local anesthetics. The pH levels and dosages reported have to be checked with the manufacturer to be considered accurate prior to administering the local anesthetics.
About the Dentist:
Dr. Carl Mentesana brings passion, education, the desire to positively impact his patients lives by offering a full service cosmetic and family dental practice, which includes full mouth smile makeovers, cosmetic veneers, implants, and restorative dentistry. Dr. Mentesana’s goal has always been to “Create Healthy Smiles” for his patients.
Graduating in 1981 from the University of Texas Health Science center at San Antonio, Dr. Mentesana has more than 30 years of experience. He is a board certified general dentist, an active member of the Dallas County Dental Society, a member of the American Denal Association, and on the faculty of the Center for Aestheic Restorative Dentistry. He is an active member of the Texas Dental Association and a member of the International Association of Dental Traumatology.
To maintain cutting-edge knowledge and skills, Dr. Mentesana stays up to date with the latest cosmetic dentistry, dental implant, and general cosmetic dentistry, dental implant, and general dentistry advancements by obtaining numerous continuing educational hours annually. As a faculty member of CARD (Center for Aesthetic Restorative Dentistry), he shares his knowledge of advanced techniques in dentistry with students as well as other practitioners. Interaction of this type allows Dr. Mentesana to stay at the forefront of treating patients.