Novocaine is “Old School” terminology. Procaine, better known as Novocaine,  is not really used anymore. Today, we have access to  a various bevy of specialized local anesthetics that  get you numb the same way, however offer independent beneficial attributes such as varying degrees of anesthesia duration. The predosed anesthetic vial we utilize in the office, is not pure anesthetic. There are some additive component medications mixed in the vial as well as your basic preservatives. The volume in the dental syringe is an industry standard consistent at 1.8 cc/ anesthetic solution. Short acting anesthetics (Citanest Plain) can last 20 minutes.  Long acting  anesthetics (Marcaine) can last for 8-12 hours.

No one is really allergic to pure dental anesthetic.

“You  have got a greater chance of getting hit by lightning in your basement on a sunny day than being allergic to a dental anesthetic”.

You may be “allergic”,  or really sensitive to the additional pharmaceuticals mixed into the vial as previously mentioned. This is more probable and probably a moot point. The sensitivity is most likely associated with a particular “devil” in the vial. The compound is called Epinephrine, and it can make your day and my day miserable.  Many people are awfully reactive to the Epinephrine complaining of a rapid heart beat, sweating and nausea all upon the initial  30 second onset of the shot. I generally, minimize the usage of anesthetics with epinephrine for this reason. The Big Advantage of epinephrine is that it potentiates and allows the anesthetic component of the mixture to work longer, essentially lagging the metabolic breakdown of the drug, hence keeping you numb longer. I prefer no epinephrine, considering the deleterious side effects and as a result, I have learned to work quickly and efficiently.

To understand how pain is transmitted, you will need to know a bit of neurophysiology.   I will keep it simple!  It will suffice to know that a “sensation of pain” , interpreted by the brain,  is a result of a chemical/electrical imbalance of charge along the charged surface of a neuron. A neuron is the very special cell that communicates with your brain. Many neurons connect along a track ( like a railroad track ) all the way from the source of pain (your pulp chamber in your tooth has many neurons)  to your brain.

Anesthetic when administered locally to a site specific region, works by disrupting the chemical/electrical charge along the neuronal pathway to your brain . As a result, the transmission of pain to brain is impeded, hence you feel nothing and ready to take on Mike Tyson!



Dr. Emilio & Associates,  Always Accepts  New Patients. He especially exceeds at treating same day emergencies patients suffering from tooth ache pains.

His goal is to keep his patients’ Teeth and Gums Healthy For Life.

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Author: robertemiliodds

My Passion is People and the Teeth Connected To Them! General dentist

2 thoughts on “Novocaine”

  1. I love the way you have explained how dental anesthetic works. Is very important to know the different ways between all of them not just by their names. Is funny that you have mentioned about allergic reactions to anesthesia that is very rare to occur but last week we had a pt. That said she was allergic to epinephrine and she preferred Citanest Plain that doesnt have epinephrine in it..
    Do you think that shes really allergic to it or it might be something else?

    1. Thanks for the kind words. Super rare. The patient was reactive to the epi, for sure. Citanest is a safer Choice!

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