You’ll use Novocain, won’t you?

Tuesday, September 23, 2014


Novocain (procaine), has not been used in dentistry since the 1940’s. It was a direct derivative of cocaine, which was the original surgical anesthetic discovered in the 1860’s. Although procaine was not addictive, it was a poor anesthetic because it took a long time to work once injected and wore off very quickly once it did. About 1/3 of the population were allergic to it because it was what we call an “ester”.

In the 1940’s, the first modern local anesthetic was invented: lidocaine. Lidocaine is in a broad class of chemicals called “amides,” which are much less allergenic. The problem with lidocaine is that it, like procaine, penetrates the bloodstream quickly and does not work very long on its own. Therefore, a little bit of epinephrine (“adrenaline”) must be given with it, which narrows the blood vessels and prolongs numbness. 

In the past several years, many variations on the chemical structure of lidocaine have been developed which give dentists more anesthetics to choose from, each with different properties. Short-acting drugs don’t require epinephrine. Some drugs have varying concentrations of epinephrine to control the length of anesthesia desired. Most recently, a drug has been developed that many feel is even safer than the amides, called articaine. Articaine, modified amine, tends to penetrate tissues easier, provide more profound anesthesia, and break down faster in the blood stream.

Suffice to say, the science of numbing patents has come a long way since the days of whiskey and laughing gas! Novocaine is no longer available on the market, but we still commonly use the term “novocain” instead of the more appropriate term “dental anesthetic.” Most people that once were allergic to procaine years ago are probably not allergic to the new medications. However, sometimes the side effects of the small amounts of adrenalin (e.g., temporary elevation of heart rate) used with the anesthetics are mistaken as an allergic reaction. Rarely, someone may be allergic to the preservatives used to stabilize the properties of the drug itself. 

If you are concerned about a possible allergy, please ask us first when you visit our Delaware office!

You can read about our Anesthetics/Sedation by visiting this page ( and reading point number IV.

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