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Subject: "Articaine/Septicaine what does the literature"     Previous Topic | Next Topic
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Conferences Injectional Nerve Injuries Topic #489
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Dr. B
unregistered user
 Jan-11-05, 02:38 PM (CST)
 
"Articaine/Septicaine what does the literature"
 
   I was just contacted by another patient who has nerve damage due to a Septocaine block. Does anyone know if there is literature which specifically says that it should not be used for blocks but infiltrations only? I would like to post his stuff on some dental sites so dentists would not use it for blocks.


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  Subject     Author     Message Date     ID  
  RE: Articaine/Septicaine what does the litera greg Jan-13-05 1
     RE: Articaine/Septicaine what does the litera Little Man Jan-14-05 2
         RE: Articaine/Septicaine what does the litera greg Jan-14-05 4
     RE: Articaine/Septicaine what does the litera Dr. B Jan-14-05 3
         RE: Articaine/Septicaine what does the litera greg Jan-14-05 5
             RE: Articaine/Septicaine what does the litera Dr. B Jan-14-05 6
                 RE: Articaine/Septicaine what does the litera CJ Jan-14-05 7
                 RE: Articaine/Septicaine what does the litera greg Jan-15-05 8
                     RE: Articaine/Septicaine what does the litera Dr. B Jan-15-05 9
                         RE: Articaine/Septicaine what does the litera greg Jan-18-05 12
                     RE: Articaine/Septicaine what does the litera Little Man Jan-16-05 10
                         RE: Articaine/Septicaine what does the litera greg Jan-18-05 11
                             RE: Articaine/Septicaine what does the litera stretch Feb-07-05 13
                                 RE: Articaine/Septicaine what does the litera Dr. B Feb-08-05 14
                                     RE: Articaine/Septicaine what does the litera stretch Feb-21-05 16
                                         RE: Articaine/Septicaine what does the litera D. B Feb-22-05 17
                                             RE: Articaine/Septicaine what does the litera DrCSK Feb-22-05 18
                                             RE: Articaine/Septicaine what does the litera Dr. B Feb-22-05 19
     RE: Articaine/Septicaine what does the litera louise ford May-15-06 20
         Hi Louise John D Jun-14-06 21
         RE: Articaine/Septicaine what does the litera CJ Aug-25-06 22

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greg
unregistered user
 Jan-13-05, 10:29 PM (CST)
 
1. "RE: Articaine/Septicaine what does the litera"
In response to message #0
 
   Dr. B. It says right on the septocaine package that it is indicated for blocks as well as local infiltration. My own opinion is that most nerve damage is caused by poor technique. Doctor's advance the needle too fast and inject too quickly. Your typical oral surgeon looks like a wild-west gunslinger when anesthetizing 4 3rd's. I've known more than one who took great pride in the speed in which he could anesthetize four quadrants. Septocaine is great for infiltration (even in mand posterior if the bone is not abnormally dense) and for ia blocks when profound anesthesia is indicated. Every procedure in dentistry has risks associated with it and only necessary procedures should be performed. IA blocks should not be performed when infiltration will do and septocaine should not be used for ia blocks when lidocaine is adequate. However, there are times when a more profound anesthesia is needed and I would say that the risk of nerve damage is greater for two separate injections of lidocaine than one of septocaine. The bottom line is that septocaine good stuff but needs to be used judiciously. Am I wrong? Dr. G


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Little Man
unregistered user
 Jan-14-05, 06:53 AM (CST)
 
2. "RE: Articaine/Septicaine what does the litera"
In response to message #1
 
   Greg, why do you say "septocaine should not be used for ia blocks when lidocaine is adequate"? If it is as safe as lidocaine, why not?


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greg
unregistered user
 Jan-14-05, 10:28 AM (CST)
 
4. "RE: Articaine/Septicaine what does the litera"
In response to message #2
 
   I never said it was as safe as lidocaine. I believe it should not be used unless there is an indication for it. It provides a much more profound anesthesia than lidocaine. If a patient comes in with an exteme toothache or I'm doing a procedure such as a root canal or a surgical extraction then I would consider using it for a block. There are documented cases of nerve damage resulting from injections from all anesthetics and like any medical procedure one should weigh the risks verses potential benefits. My understanding is that septocaine has about a 22% higher risk of parasthesia than lidocaine. The risk of nerve damage from lidocaine is about 1 in 25000 to 1 in 750,000 injections. That is very rare. There are many on this website that are saying septo has a 22 times greater risk. I believe that is misinformation. If I'm wrong, I'll quit using it. Looking at this website one might come to the conclusion that this sort of thing is commonplace but I've given a lot of blocks with it and never had anything bad happen and I do not know personally dentist who has either. That is not to say it should be anyone's first choice for every patient but that you should not throw the baby out with the bath water. greg


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Dr. B
unregistered user
 Jan-14-05, 10:17 AM (CST)
 
3. "RE: Articaine/Septicaine what does the litera"
In response to message #1
 
   Greg,
I wish I knew for sure, but I am tired of the drug industry lying to everyone including the health professionals. Look at the recent recalls of Celebrex et al. I do agree that poor technique plays a part in some injuries, but it seems to me that many more injuries have Septocaine involved vs. the other caines.


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greg
unregistered user
 Jan-14-05, 10:34 AM (CST)
 
5. "RE: Articaine/Septicaine what does the litera"
In response to message #3
 
   Dr. B

I'm keeping an open mind about it. Many on this website are saying that it carries a 22 times greater risk of parasthesia. I think I read somewhere that it was 22% greater. Are you familiar with the study that is being quoted (or misquoted)? If there is a legitimate study that concluded there is a 22 times greater risk, I'll absolutely quit using it for ia blocks. That is a case where the risks clearly outweigh benefits.


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Dr. B
unregistered user
 Jan-14-05, 01:50 PM (CST)
 
6. "RE: Articaine/Septicaine what does the litera"
In response to message #5
 
   I wish I could find such a study too. Howver Greg, why would you keep using it for blocks even if there was a "rumor" of increased injury? How would you feel if you injured a patient?

I have practiced for 25 years and never needed it. Why would I now?


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CJ
unregistered user
 Jan-14-05, 09:28 PM (CST)
 
7. "RE: Articaine/Septicaine what does the litera"
In response to message #6
 
   LAST EDITED ON Jan-14-05 AT 09:30 PM (CST)
 
There is a study that Dr. Dower did at the University of CA , San Francisco, I believe. Anyway, he has a website with the article he published on there at www.NoDentalPain.com

I am still having pain from injections and I believe that the Septocaine used played a role in the damage.


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greg
unregistered user
 Jan-15-05, 02:15 PM (CST)
 
8. "RE: Articaine/Septicaine what does the litera"
In response to message #6
 
   I have quit using it for ia blocks. I'll use it for infiltration and if I can't get good anesthesia I'll jump to x-tip or stabident. greg


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Dr. B
unregistered user
 Jan-15-05, 03:58 PM (CST)
 
9. "RE: Articaine/Septicaine what does the litera"
In response to message #8
 
   I think that is prudent. Do you ever use the Gow Gates technique?
I was taught 3 different techniques in dental school as our anes dept was headed by Bennet who co-wrote the original Bible of Locals done by Monheim. In any case, if I can't get a conventional over the retromolar pad hit, the Gow Gates will always do it.


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greg
unregistered user
 Jan-18-05, 00:04 AM (CST)
 
12. "RE: Articaine/Septicaine what does the litera"
In response to message #9
 
   never had a lot of luck with gow gates. seem to miss it a lot


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Little Man
unregistered user
 Jan-16-05, 08:18 AM (CST)
 
10. "RE: Articaine/Septicaine what does the litera"
In response to message #8
 
   Dr. G:
Thank you for being a careful, caring dentist. But I'm curious - what changed your mind about Articaine?


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greg
unregistered user
 Jan-18-05, 00:03 AM (CST)
 
11. "RE: Articaine/Septicaine what does the litera"
In response to message #10
 
   I checked out the study that suggested a 15 to 20 times incidence in parathesia. also, the package inside the septocaine package says in a study of 822 injections there were 11 incidences of parasthesia. I'm sure that those were transient and of little consequence but it is still too high for my comfort especially when there are many other safer ways to get good anesthesia. dr.m


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stretch
Member since Jan-25-04
35 posts		 Feb-07-05, 09:01 PM (CST)
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13. "RE: Articaine/Septicaine what does the litera"
In response to message #11
 
  
Dr. B
This is a hard shortcut to get to..you need to copy the entire listing into youraddress line. I think you will find the info interesting. I haven't had time to check the research.

Stretch

http://64.233.167.104/search?q=cache:2X2qJ7KrtDcJ:www.dentistrytoday.com/mod/forum/discuss.php%3Fd%3D40%26parent%3D41+Articaine+lingual+numb&hl=en


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Dr. B
unregistered user
 Feb-08-05, 11:33 AM (CST)
 
14. "RE: Articaine/Septicaine what does the litera"
In response to message #13
 
   Thanks, I got some other stuff too, I am more and more convinced that Septocaine should not be used for blocks.


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stretch
Member since Jan-25-04
35 posts		 Feb-21-05, 09:31 PM (CST)
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16. "RE: Articaine/Septicaine what does the litera"
In response to message #14
 
   Dr. B.,

Here's an article on the Comparison of Articaine vs. Lidocaine in Dentistry from the University of Oslo dated May 2004.

http://www.odont.uio.no/studier/semesterboker/Felles/prosjektoppgaver/H99/Johansen.pdf


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D. B
unregistered user
 Feb-22-05, 09:32 AM (CST)
 
17. "RE: Articaine/Septicaine what does the litera"
In response to message #16
 
   Thanks, I didn't have that one. I am not involved in any Septocaine suits but I am convinced it should not be used for blocks.


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DrCSK
Member since Sep-10-06
163 posts		 Feb-22-05, 11:59 AM (CST)
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18. "RE: Articaine/Septicaine what does the litera"
In response to message #17
 
   That article would imply that the chance of parasthesia for both lidocaine and articaine is similar. 1% chance for both.


Im not sure this is information you would want to use.



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Dr. B
unregistered user
 Feb-22-05, 06:00 PM (CST)
 
19. "RE: Articaine/Septicaine what does the litera"
In response to message #18
 
   I am collecting all, pro or con. Right now, I am not using anything as Septocaine is not an issue in any suits I am involved in at the time.


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louise ford
Member since May-15-06
1 posts		 May-15-06, 10:20 AM (CST)
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20. "RE: Articaine/Septicaine what does the litera"
In response to message #15
 
   LAST EDITED ON Sep-18-06 AT 06:24 PM (CST) by Ross (admin)
 
I've been sick since 1992 after having all my fillings renewed, and the dentist using articaine. It's been a nightmare, to cut a long story short, it damaged my nervous system and brain. Should you want any more information let me know. Have you seen the Martha Bosscher website? I'm slowly getting better.
A friend of mine ended up in a straight jacket in a mental home after having articain from the dentist. Should you want to know how I'm getting better, let me know. Louise Ford.


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John D
Member since Jun-14-06
1 posts		 Jun-14-06, 08:10 AM (CST)
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21. "Hi Louise"
In response to message #20
 
   LAST EDITED ON Aug-25-06 AT 10:36 AM (CST)
 
Glad you're feeling better -- if you could post what you have found that has helped you I'm sure anyone affected with this would appreciate it.


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CJ
Member since Sep-14-06
593 posts		 Aug-25-06, 01:14 PM (CST)
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22. "RE: Articaine/Septicaine what does the litera"
In response to message #20
 
   LAST EDITED ON Aug-25-06 AT 01:15 PM (CST)
 
Louise,
I am glad you are getting better from this. Can you post what you are doing that is helping? There are many people on this site who could benefit from that.
Thank you and I hope you continue to improve.
CJ


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