Petite pain management

Oct. 1, 2005
When a person is tall, shopping for pants may present some challenges. Once a slack is selected, it is pulled from the rack and examined closely.

When a person is tall, shopping for pants may present some challenges. Once a slack is selected, it is pulled from the rack and examined closely. The color works well and the fabric is pleasing, so the tag is checked to address length and size. Unfortunately, the tag has a bold “P” embossed on it, and the shopper realizes she is shopping directly beneath a sign that reads “Petites.” For the shopper with a tall physique, this spells no sale. However, when it comes to aspirating syringes for anesthetic delivery, a petite selection may be just the right size, even for a tall person.

Thwarting patient discomfort during dental procedures is always a goal. Sometimes local anesthetic must be administered. Syringe delivery anesthetic has been available for 100 years, since it was first synthesized procaine hydrochloride (novocaine), and the formulation has continued to improve. The armamentarium for administering anesthetic by allowing the carpules of anesthetic agent to puncture tissues has remained basically unchanged. Local anesthetic syringes may be reusable or disposable, made of metal or plastic, with the design of a thumb ring, finger grip, bar, or barrel and piston with a sharp harpoon. Bulky syringes have been replaced with streamlined designs, and modifications to the thumb rings and finger bars have improved the ergonomics of delivery.

Septodont, makers of anesthetic and syringe systems, has introduced a line of manual aspirating syringes for clinicians with small hands. The Petite syringe has a brilliant blue finger bar that holds the clinician’s finger close to the barrel. This modification provides smooth retraction of the piston during aspirating. The harpoon firmly engages in the plunger, and steady delivery by thumb pressure allows a desired volume of local anesthetic to be effortlessly administered. The barrel accepts standard 1.7 to 1.8 ml dental anesthetic cartridges. Better control of the flow of anesthetic can be anticipated with the use of a small gripped syringe. With the use of a Septodont Petite syringe, the clinician with small fingers no longer must use the winged syringe designed for the dentist with large hands.

For the hygienist limited by state practice acts and not allowed to administer local anesthetic, a system that deposits topical anesthetic into the periodontal pocket via a cartridge and cannula is a possible alternative. When a clinician seeks pain relief in a needle-free delivery system, Oraqix gel, distributed by Dentsply Pharmaceutical and Orapharma, Inc., is a good choice. Oraqix periodontal gel is lidocaine and prilocaine in a cartridge mode. The liquid mixture, upon insertion into the pocket or pockets, is gelled by the temperature of the body, stays at the placement site and has a 30-second onset time.

Unlike most topical medicaments, the gel remains where it is placed so the tongue and surrounding tissues do not experience any numbing. The periodontal gel will take the edge off for about 20 minutes. Additional applications can be safely administered.

Patients who fear injections will appreciate the blunt tip that delivers the gel. However, the tipped applicator resembles the traditional type tissue injection, so clinicians should address concerns with patients before administering. The delivery body of the unit uses the depression of a paddle and ratchet type mechanism. The cartridge is unique in that a bubble within it shows the user whether the formula is liquid oil or gel. If the bubble is stationary or moving slowly in the cartridge, it may be gelling.

The cannula tip on the dispenser may be bent for easy access. Treatment in furcation sites is better attained if the tip is bent when necessary. An even and consistent flow deposits solution in a desired manner, and steady, consistent flow of Oraqix works best. First, place the gel on the gingival margin and allow 30 seconds for the product to begin numbing. Next, load the pocket with Oraqix until the pocket fills and gel can be seen seeping out of the space. Treatment should begin in 30 seconds with the pockets filled and gel remaining in the space. The gel thermosets, meaning it transforms from a liquid to a gel when it is exposed to body temperature. The carpules easily treat a quadrant of teeth. Patients appreciate the no needle local anesthetic technique.

It isn’t easy to manage patient comfort with an injectable or topical anesthetic. Success via a sized-to-fit syringe, or needle-free cannula, suits many treatment modalities. Heighten patient acceptance of treatment by alleviating any uneasiness or apprehension patients may have during intense scaling procedures. Simple pain management techniques are a perfect fit into any hygiene routine.

The author did not receive compensation for product endorsement. Elevate your knowledge by visiting the web at, or

Karen Kaiser, RDH, graduated from St. Louis’ Forest Park dental hygiene program in 1994 and currently practices at the Center for Contemporary Dentistry in Columbia, Ill. She has written several articles for RDH and other publications, sits on dental hygiene panels, and is an evaluator for Clinical Research Associates. She can be contacted at [email protected].