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Controlling Pain in Dentistry in Selangor, Malaysia

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Toothache is well known to be one of the most debilitating types of pain in the body.
Toothache is well known to be one of the most debilitating types of pain in the body.

Controlling Pain in Dentistry in Selangor, Malaysia

Pain Control in Selangor, Malaysia

Pain associated with the mouth has always been a subject of concern. Toothache is well known to be one of the most debilitating types of pain in the body. Because of this pain, dentists have been leaders in the development of both local and general anaesthetic. Some persons believe it is necessary to feel oral pain during dental treatment. This incorrect belief has motivated many potential dental patients to avoid seeking proper periodic oral care. Is modern dentistry really that painful? What types of pain control concepts are available today? This chapter will inform you about the various methods dentists use to control pain, and it should convince you that most of today’s dentistry should be nearly painless.

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PAIN THRESHOLD 

Every Malaysian has a pain response to trauma to the body. However, the degree of pain experienced from patient to patient varies enormously. It has been estimated that about half of the population could have a simple filling (restoration) accomplished without feeling any pain. The other half cannot tolerate the slight pain associated with this restorative procedure. You probably know if you have a high tolerance to pain, or a so-called high pain threshold. If so, you are fortunate, not only because dental procedures are easier but also because many slight abuses to your body are not a problem. If you have low tolerance to pain, or a “low pain threshold,” one of the following types of anaesthetic is probably necessary for you to tolerate some dental procedures. Your dentist will quickly determine the level of your pain threshold, and he or she will plan your anaesthesia needs accordingly.

LOCAL ANESTHETICS in Selangor, Malaysia

Local aesthetics in Malaysia are the most commonly used type of pain control in dentistry (FIG. 5.1). Although you may think dentists use the old product Novocaine (Procaine), the most popular type of local anaesthetic in dentistry is lidocaine hydrochloride 2%. Usually, this anaesthetic has a slight amount of epinephrine (1:100,000) in it to constrict the blood vessels in the anaesthetic site and prolong the duration of the anaesthetic influence. This popular type of anaesthetic is usually effective a few minutes after anaesthetic delivery, and its duration is up to 3 hours. With very few exceptions, when this anaesthetic is delivered adequately, the patient does not feel anything during treatment. Properly delivered local anaesthetic should not be painful. The very small-diameter needles (FIG. 5.2), used carefully, and with pre-injection topical numbing, provide simple, easy, painless anaesthesia that dissipates soon after therapy is completed.

FIG. 5.1 Local anaesthetic setup. Local anaesthetic is highly effective, nearly painless, and has been proven for more than 100 years.
FIG. 5.1 Local anaesthetic setup. Local anaesthetic is highly effective, nearly painless, and has been proven for more than 100 years.
FIG. 5.2 Close-up of 30-gauge needle (by a nickel). Note the size of a modern dental needle for local anaesthetic delivery. It's so small you may never feel it.
FIG. 5.2 Close-up of 30-gauge needle (by a nickel). Note the size of a modern dental needle for local anaesthetic delivery. It’s so small you may never feel it.
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Other local anaesthetic types can be selected when shorter or longer anaesthesia duration is desired, or if a patient has allergies to a specific chemical type, or heart problems. Your dentist will know the best type of local anaesthetic for you and will be pleased to discuss the topic with you. There should be no reason to dread the delivery of local anaesthetic.

NITROUS OXIDE (LAUGHING GAS) in Selangor, Malaysia

Some of the dental clinics in Malaysia have nitrous oxide gas available for those persons who desire to have this relaxing chemical delivered during their oral treatment (FIG. 5.3). The nitrous oxide is monitored and delivered to you carefully. When nitrous oxide is administered properly, there is very little reason for concern. Certain groups, such as pregnant women, should avoid nitrous oxide.

FIG. 5.3 Nitrous oxide delivery device on a patient's nose. "Laughing gas" is safe, effective, and relaxing.
FIG. 5.3 Nitrous oxide delivery device on a patient’s nose. “Laughing gas” is safe, effective, and relaxing.

INTRAVENOUS (IV) SEDATION in Selangor, Malaysia

For some oral procedures that are potentially more painful or stressful, you can be made more comfortable by delivering a chemical into your bloodstream via a small needle inserted into a vein. Some dentists provide this service, and others do not. This procedure is not indicated for most oral needs, but your dentist can tell you if you are in need of some service for which IV sedation would be desirable.

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GENERAL Anaesthetic in Selangor, Malaysia

Some oral procedures are best accomplished when you are asleep, under the influence of general anaesthetic. Most dental procedures can be accomplished easily using local anaesthetic. Probably you have had a general anaesthetic before for some type of surgical procedure on your body. You know that you were required to have some dietary restrictions before the experience. Also, you were sleepy and relatively nonfunctional after the anaesthesia had worn off. However, while the anaesthesia was in effect, you did not feel pain.

Some Malaysian dentists, especially oral and maxillofacial surgeons, deliver general anaesthetic on a routine basis in their offices, a hospital, or surgical center environment. Many dentists do not use general aesthetics in their offices, and usually they will refer you to other practitioners who use general anaesthetic, if you need this service. When used properly on a healthy patient, general anaesthetic is safe and totally satisfies the need for pain control during the dental procedure.

HYPNOSIS in Selangor, Malaysia

Although hypnosis is often associated with the entertainers and a certain degree of mysticism, it is a legitimate form of pain control used in many areas of medicine, including dentistry (FIG. 5.4). Only a few dentists practice hypnosis. It is estimated that about 70% of the population is capable of using hypnosis for pain control. Another 20% can be somewhat hypnotised, and 10% have personalities that do not allow successful pain control through the use of hypnosis.

FIG. 5.4 Patient being hypnotised. If you can’t have or don’t want chemical anaesthesia, hypnosis can work for most people. However, it requires time and patience.

Why would hypnosis be used for pain control? Many people cannot take medications because of various physical conditions or allergies. These people are in need of non-chemical anaesthesia. Others have such fear of health practitioners that they cannot tolerate the delivery of anaesthetics using needles. For psychological reasons these people are well treated while using hypnosis. How does hypnosis work? Usually the dentist will have a pretreatment session with the patient to introduce him or her to hypnosis and to test the patient’s susceptibility to hypnotic techniques. Assuming the patient is capable of being hypnotised, the dentist will place the patient in a hypnotic trance for the oral procedure. It is amazing to see how this concept works. Under hypnosis, patients can control salivary flow, blood flow, pulse rate, and most importantly, pain. If this concept interests you, ask your dentist about availability of hypnosis for oral treatment in your community.

ELECTRICAL ANESTHESIA in Selangor, Malaysia

This anaesthesia concept is sometimes used by some dentists, and it is successful on many patients for minor oral procedures. Electrical anaesthesia is a valid medical concept used in sports injuries, muscle pain, veterinary medicine, and other situations (FIG. 5.5). When using electrical anaesthesia, a weak, non-painful electrical current is delivered to the specific body site, and the electrical impulses confuse the transfer of pain along nerve pathways. In studies by the author, many patients preferred electrical anaesthesia to injected local anaesthetic for simple procedures because the electrical anaesthesia did not require a needle penetration, and when the procedure was completed there was no lingering “numb” feeling. If this concept interests you, ask your dentist about it.

FIG. 5.5 Electrical anaesthesia device placed on a patient. Electrical current, mild and painless, can confuse nerve pathways and provide an anaesthetic result for some dental procedures.
FIG. 5.5 Electrical anaesthesia device placed on a patient. Electrical current, mild and painless, can confuse nerve pathways and provide an anaesthetic result for some dental procedures.

SUMMARY

There are many methods to control pain during and after oral treatment procedures in a Malaysian dental clinic. If fear of pain is one of your reasons for avoiding dental therapy, perhaps this article has calmed your fears. Discuss your pain threshold with your dentist and decide what method of pain control would be best for you. Some dental procedures can be accomplished without any anaesthetic, while others require one of the anesthesias concepts discussed in this article. You can be assured that an acceptable anaesthesia concept is available for you to make your oral procedures as pain free as possible.

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