Buffered "Novacaine" - What is that?.....It's a game changer!

I have been a dentist for almost 24 years. You can imagine that in that time a lot of advancements have been made in every part of our lives. Just the technological revolution alone is staggering. Pick your favorite: Facetime, Skype, Hangouts for my generation this is right out of James Bond and even 007 needed a whole suitcase to hold his mobile device! 

As dentists we are inundated with new products from something as simple as the toothbrush to digital impressions or soft tissue lasers. The new products come at us so fast that we could never even begin to try them all. Some of them are better, some of them are worse and some just the same old thing in a new package. They always cost more and half of the time they end up expiring on the shelf - because we just keep doing it  the old way and never really adopt the change. So when I say, after 24 years of trying new things or more importantly avoiding new things, that I have recently added a new technique that may be the most significant improvement I have ever made it really says something!

Disclaimer: This blog is meant for normal people, so forgive me if you already have a PhD in chemistry.

What is it....?

Lets start our chemistry class: 

First thing: Everyone in the world calls the shot at the dentist "Novacaine". Here is a secret: we don't use Novacaine anymore because too many people are allergic to it.  But unless you are going to take the pharmacology section of the dental boards just keep calling it Novacaine....your dentists knows what you mean.

What is pH: pH is a measurement that tells if something is acidic (like battery acid) or basic also called alkaline (like bleach). The pH scale goes from 0 -14. Things that are acidic have a low pH below 7 and things that are alkaline have a high pH above 7.  Here is a link to a pH graphic . Don't worry if you are a little confused...as long as you understand one thing...things that are on both ends of the pH scale hurt if you touch them! This is important because the pH of dental anesthesia is around 3.7 it is pretty acidic similar to lets say orange juice. The fact that anesthesia is acidic is the main reason it HURTS when we inject it.

Buffering: Buffering is when we change a solution's pH to make it come closer to the middle of the scale. You might have noticed on the graphic that our blood has a pH of about 7.4. Pretty close to the middle but just a little on the basic side. So all we have to do is change the anesthesia's pH (buffer it) to make it closer to our own pH and magically it does not hurt when it is injected!!

Here is some additional magic: When the "Novacaine" is the same pH as our blood and nerve cells it works much faster and much more profoundly. I have been buffering the 2% Lidocaine that I inject for local anesthesia for about 6 months. WOW, what a difference!! Every single patient agrees that it does not hurt, they are more numb and the whole procedure is completed faster!!  If you have a fear of injections you should look for a dentist that buffers the "Novacaine" it is a game changer!