There can be several reasons why someone might want to avoid injected local anaesthetics for dental treatment - an allergy or sensitivity to one or more of the ingredients, an aversion to needles, or simply a desire to avoid the prolonged numbing of the face which typically persists long after leaving the dental surgery.

We have become conditioned to thinking that anaesthesia is an essential precursor to any dental treatment, but I have found that anaesthesia is actually rarely necessary. I'm sorry if thinking about this makes you wince with imagined pain, but I had all my mercury amalgam fillings - 18 of them (far too much sugared medicine when I was little!) - replaced with composites, without a single shot of anaesthetic, and I was only aware of occasional mild discomfort.

I don't recommend this for anyone with red hair and some with a particularly low pain tolerance threshold may need to take a dose of a regular oral painkiller such as paracetamol or ibuprofen before treatment, to take the edge of any discomfort but, generally speaking, most people can tolerate even deep fillings without any pain relief.

The only discomfort usually occurs during the final moments of drilling, if the cavity is a deep one, but is usually only transient and easily coped with. I have a couple of friends who have also chosen to avoid injected dental anaesthetics and they have both confirmed my own experience, so it's not just a case of me being totally insensitive!

However, for those who can't bring themselves to join the anaesthetic-free dental club, there is another alternative - a remarkably simple breakthrough in pain management which completely removes the need for any drugs. This is a cryo-anesthetic mouthpiece called the gumEase G100, which is made from soft, latex-free biocompatible PVC and filled with a saline solution. After being chilled in a temperature-controlled freezer to minus 7 degrees C, the device is placed around the gums, where it feels very comfortable and acts to produce surprisingly powerful pain relief.

Up to three devices can be applied in succession, for 4 minutes each, until the required amount of anesthesia is achieved. In tests, the average patient experienced 100% pain relief in 2 to 3 minutes, and this lasted for up to twenty minutes.

The device is suitable for use with most procedures, including fillings, crowns, extractions and root canals, as well as brace application and adjustment.

As this is a disposable item, so far as the dentist is concerned, the patient can take their gumEase devices home with them and, after re-freezing them in a household freezer, can apply them post-operatively if any pain occurs after their procedure.

Most dentists are still unaware of the existence of the gumEase, so you will need to speak with your practitioner well in advance of your appointment to check whether this type of anesthesia is routinely offered to patients and, if not, suggest that the dentist obtain a supply to try them. As the device could save dentists both time and money, s/he will probably be grateful for the suggestion!

Supplies of the gumEase can be obtained in the US from CryoDevices or OlympicMD ($109.45, including shipping, for a box of 10) and, in the UK, by contacting George Harrell at gharrell@cryodevices.com (£69.77, including shipping, for 10).

Patients who have migraine and tension-type headaches who have tried this device have reported that, in addition to delivering effective dental anesthesia, the device has also provided relief from their headaches. In fact, such has been the success of the device in this respect that a trial is about to begin to test this new application.

I have obtained a supply of the devices myself and intend to try these as a treatment for my own migraines, and I shall report on this experiment in due course.

First published September 2009

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