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N OVOCAINE

A Descripti on by Catherine Pietrzak


PietPietrzak
Novocaine is a local anesthetic that is used in surgical and non-surgical
dental procedures, such as tooth restorations due to dental caries or
tooth extractions (i.e. removal of third molars or wisdom teeth).
Novocaine diminishes the pain due to the dental procedures.

BRIEF HISTORY In the early 1900s, Novocaine, scientifically known as


OF NOVOCAINE Procaine, was invented. Before this, Cocaine was most the
most used local anesthetic for common dental procedures.
Cocaine was used to numb tooth pain of the Incas and
societies that grew cocoa leaves. Cocaine constricts blood
vessels to reduce bleeding, but it has a major adverse effect
of being addictive. Due these unfavorable outcomes, a new
product was invented, Procaine. Upon the invention of the
syringe, Novocaine became available to the masses.

CHEMICAL The chemical structure of Novocaine is C13H20N2O2.


STRUCTURE
AND
PROPERTIES

http://upload.wikimedia.org/wikipedia/commons/7/77/Thc.pdb.gif

Novocaine is an odorless white, powdery substance. It is


chemically derived from Cocaine. It is also a water soluble
product. Typically, Novocaine is chemically combined with
hydrochloric acid to form Procaine hydrochloride. This is the
form that is typically administered to dental patients prior to
minor dental surgeries.

It is administered by injecting the mouth and gums. The


Novocaine’s numbing effects will be felt within 2-3 minutes
and it will wear off in 2-3 hours after application. Novocaine
acts by blocking the nerves in the mouth from so that the
body will not feel any pain.
HOW DOES The pain sensation is due to stimulation of the nerve
NOVOCAINE receptors in the targeted area of the body that send a pain
WORK IN signal to the brain. The signal is transmitted by moving
neurotransmitters from one nerve to the next. Essentially,
THE BRAIN? neurotransmitters act as the messengers of the brain.
Neurotransmitters contain chemicals that tell the brain how
to respond to various stimuli. In this case, the stimulus is
pain.

In order to not feel pain, a pain-relieving drug, such as


Novocaine, acts by interfering with the brain’s pain
receptors. The drug may block the neurotransmitters that
send the pain signal from nerve to nerve by either inhibiting
their release from the original nerve (presynaptic vesicle) or
by blocking the neurotransmitter receptors on the next nerve
(postsynaptic vesicle) that will pass along the signal as
depicted in Figure 1 below. A drug may also change the
brain’s interpretation of the signal. In this case, Novocaine
acts by interfering with the brain’s neurons to block
neurotransmitter receptors on the postsynaptic vesicle from
accepting the signal. Therefore, the mouth and gums will
feel no pain because the brain is not receiving the chemical
message from the neurotransmitters to feel any.

http://www.columbia.edu/cu/psychology/courses/1010/mangels/neuro/transmission/transmission.gif

Figure 1: The Process of Neurotransmission


WHEN NOT TO • The effects of Novocaine are not as effective when a
USE NOVOCAINE person has high levels of anxiety.
o It is recommended that dental patients come
in with a calm and clear mind so that fear
does not set in.
o Dentists should be informing and educating
their patients to the best of their ability to
lower the anxiety levels of their patients.
o Sedation dentistry is another option for
patients who have consistent dental anxiety.
• Some people may have an allergic reaction to
Novocaine and should avoid using it if certain
reactions occur such as:
o Flushing
o Hyperventilation
o Heart palpations (faster than normal heart
rate)
o Swelling
o Itching
o Emergence of hives
o Anaphylaxis (extreme allergic reaction that
may result in rapid decrease in blood
pressure, decreased amounts of oxygen
exposure to the brain, heart strain, swelling of
the vocal cords, etc)
• Dentists must look to alternative methods to numb
the pain from the dental procedures
o Septacaine
o Meprivocaine
o Lidocaine
o Sedation dentistry