The Art of Periodontal Therapy without Anesthesia

Sept. 30, 2005
Electroanalgesia devices can help patients feel comfortable during procedures, and eliminate the frustration of waiting for the doctor.

Colleen Rutledge, RDH

Over a dozen states still require the doctor to administer anesthesia for patients on the hygiene schedule. The protocol for hygienists is the same every time: Review the medical history, set up the syringe, place topical anesthetic, notify the doctor, and wait.

Hygienists working under these circumstances have gotten accustomed to this routine. Many fall behind schedule 20 minutes or more while waiting for the doctor to administer anesthesia. They deal with these frustrating circumstances because they must. Or do they?

Piezoelectric ultrasonics coupled with electronic analgesic technology make it possible to forgo the long wait and help alleviate patients' fear. Electroanalgesia technology reduces pain by hyperpolarizing nerve endings which block the electric signal leading to the brain. These hyperpolarized nerves are now able to block the nociception messenger, preventing the action potential, which is the electric signal at the origin of pain.

This technology is not compatible with magnetostrictive ultrasonic technology or standard high speed or slow speed handpieces. Electronic analgesic technology is not advised for patients with pacemakers or pregnant patients.

The electroanalgesia device is easy to use. It plugs into the back of the ultrasonic unit increasing patient comfort during periodontal therapy sessions through a low intensity electrical signal. There are no electrodes or wires to place on the patient as with transcutaneous electric neurostimulation (T.E.N.S). There is also special attachment that ensures safety when used with children. The handheld device allows patients to control the instrument by turning the regulating knob in the direction of either (+) for higher comfort or (-) for lower comfort levels.

According to a Belgian survey, 5 percent of patients reported that they had "avoided, cancelled or failed to show for dental appointments because of fear of dental injections" and 32 percent indicated that they were willing to "accept mild to moderate pain to avoid an anesthetic injection." Another study concluded more than 25 percent of adult dental patients have some degree of fear regarding dental injections. Isn't it time to start listening to what our patients are saying?

Piezoelectric ultrasonics paired with electroanalgesia technology allows definitive periodontal therapy to be accomplished without local anesthesia in approximately 75 percent of the population. Patients are more than ready to try alternatives to local anesthesia. This technology can enhance patient care as well as compliment the clinical practice of the dental hygienist.

Colleen Rutledge, RDH, can be contacted at [email protected].


1 Brickley-Raab, RDH, M., Local Anesthesia for Dental Hygienists. Pennsylvania State Board of Dentistry Newsletter, Summer 2005; 5

2 Brebion, N., Vachey, E, Managing Pain during Odontological Procedures: Application to Ultrasonic Treatments. Clinical and Scientific Booklet, 2002

3 Milgrom P, Coldwell s, Getz T, Weinstein P, Ramsey D. Four Dimensions of Fear of Dental Injections. Journal of American Dental Association 1997; 128: 756 ¿ 162

4 Garmyn P, Geers L, Marechal M, et al. Patients' Experience of Pain and Discomfort during Instrumentation in the Diagnosis and Non-surgical Treatment of Periodontitis. Journal of Clinical Periodontology 2000; 27:52 (Abstract 135)