Reversing Dental Local Anesthetic Anesthesia

Reversing Dental Local Anesthetic Anesthesia

Posted by Dental Didactics CE on Oct 1st 2022

Can Dental Local Anesthetic Injections be Reversed?

One of the major complaints of dental patients is the lingering numbness of gums, lips, cheeks, and tongues following the completion of an appointment where a local anesthetic injection preceded the dental procedure. This numbness can be prolonged for anywhere from 1-8 hours depending on the nature of the injection and the type of anesthetic used.

How to Shorten Local Anesthetic Numbness:

No matter what local anesthetic is used, the numbing effects are prolonged by the addition of epinephrine (like adrenaline) to the local anesthetic solution. The addition of epinephrine promoted constriction of blood vessels in the area of the injection. That lessens any bleeding at the site, provides a better working site for the dentist, and prevents the anesthetic from wearing off too soon while the procedure is being performed.

If the dental procedure can be performed quickly, a local anesthetic without epinephrine added (referred to as "plain" by dentists and dental hygienists) may be used. This "plain" anesthetic will usually wear off within a half hour. The advantage of this (especially when used for children and elderly patients) is that the patient will not inadvertently bite their cheeks, lips, and tongue while the anesthetic wears off. 

Recently, a new pharmaceutical answer to the problem has been available; an injection called OraVerse (phentolamine mesylate). Following the completion of a dental procedure, an injection of OraVerse will reverse the effects of epinephrine and allow normal blood flow to flush the local anesthetic out of the area. Patients can consult with their dentists and hygienists whether OraVerse is a good option for them.

Keep in mind that the use of OraVerse requires additional injections which have potential consequences such as additional bruising, bleeding, and inadvertent trauma to nerves. That must be considered before administering OraVerse to patients who request it.