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Epinephrine in Dentistry

The gland in body called the adrenal medulla, produces epinephrine. Its job is to stimulate the central nervous system when the body encounters Stress, fear, and excitement. This results in a faster pulse, higher blood pressure, increased heart force, and the burning of carbohydrates for energy. Epinephrine is considered to be a vasoconstrictor, which means it narrows, or constricts, the blood vessels.

USE IN LOCAL ANESTHESIA

Epinephrine (adrenaline) is commonly used in combination with local anesthetics such as lidocaine, procaine, and bupivicaine. It comes already premixed with these agents in differing concentrations. With its vasoconstrictive properties, epinephrine lessens bleeding, decreases blood flow, and makes the anesthetic last longer. It also has the ability to increase the effect of an anesthetic while decreasing overall absorption of the anesthetic into tissues.

USE FOR GINGIVAL RETRACTION

Epinephrine is also used in gingival retraction when making impressions for crowns and bridges. It is presoaked into a cotton cord material that is placed over the gums prior to starting the procedure. Its purpose here is mainly to control bleeding and to reduce blood flow so that impressions can be made.

USE IN SURGICAL PROCEDURES

Epinephrine is used after surgical procedures because of its vasoconstrictive properties. Again, it is helpful in controlling postoperative bleeding and in reducing the spread of infection. Most of the time, it is used for this purpose in conjunction with local anesthetics to lessen postoperative pain.

USE IN SEVERE ALLERGIC REACTIONS

Epinephrine is very beneficial in the treatment of severe allergic reactions such as anaphylaxis. Such reactions may occur if the person is exposed to a certain antigen to which he or she is allergic. In this scenario, the tongue and eyes may swell and shortness of breath may occur, progressing into respiratory failure. Epinephrine is injected intravenously or intramuscularly to combat severe allergic reactions. Here, epinephrine is used to improve bronchodilation, increase the force and rate of the heart, and increase blood flow to the rest of the body while constricting tissues.

CONTRAINDICATIONS

The use of epinephrine is not warranted in all patients. There are certain disease processes which need to be evaluated before administering this medication. It is a question of risks versus benefits. Some of the situations, which need additional attention before the use of epinephrine, are as follows:

1. Heart disease

2. Diabetes mellitus

3. Thyroid disease

4. Anxiety disorders

5. Pregnancy

6.Breast-feeding

7. Infants

About Dr. Muna

Dr. Muna Taqi is a Dental surgeon from India who has more than 10 years of experience in the field of Oral & Maxillofacial surgery, Endodontics, & Pedodontics. She has worked in multinational medical corporates in Middle East and is also a consultant dental surgeon for many. She has authored many articles for medical journals & websites and is a consultant dental expert for Healthdrip.

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