Every dentist knows that achieving patient satisfaction ultimately comes down to comfort during dental procedures. So, whenever I’m asked why I use Septocaine for my patients, I say that it has a scientifically proven success rate and its onset time and duration are predictable. I’ve had a lot of dentistry done in my own mouth over the years, and whenever I undergo any treatment, I insist that my partner use this product for both blocks and infiltration.
There's so much evidence about this local anesthetic. Unlike lidocaine-based local anesthetics that are commonly used in dentistry, Septocaine is articaine-based. Articaine has a short half-life of 27 minutes, compared to the 90-minute half-life of almost all other commercially available amide local anesthetics.
Predictable, Safe, and Effective
Septocaine has a predictable duration of anesthesia for up to 60 minutes for infiltration injections and up to 120 minutes for nerve blocks. This molecule not only has a reliable track record for infiltration success in the maxilla, but it also has proved valuable for performance in several mandibular areas. Ohio State University studies have shown that the lower first permanent molars are reliably infiltrated with Septocaine, whereas when lidocaine is attempted for infiltration for those same 2 first molars, it is statistically not as reliable.
Along with Dr. Paul Moore from the University of Pittsburgh, I did a research study dating back to 1976 and could not find a single death that was solely attributable to articaine overdose, even in higher-risk geriatric and pediatric populations. We concluded and published in Dental Clinics of North America that its safety may be due to its short half-life and the body's inability to build up toxic metabolites, thereby reducing the risk of overdose.
We should always consider contraindications, starting with allergies, specifically those related to the sodium metabisulfite antioxidant included in a cartridge for stabilizing epinephrine. It's important to note that patients do not generally exhibit an allergic response to epinephrine, since epinephrine (or adrenalin) is naturally present in our bodies. Although possible, allergy to sodium metabisulfite is relatively rare. Given that articaine functions as a potent vasodilator, its reliance on epinephrine is essential, since without it, the effect of articaine would be relatively short.
In conversations about Septocaine with fellow clinicians, I underscore both its predictable efficacy and its proven absence of neurotoxicity. It appears that the myth of articaine being causative of paresthesia in inferior alveolar blocks or lingual blocks is no longer valid
Reference: Albalawi F, Hersh EV. Effects of lidocaine and articaine on neuronal survival and recovery. Anesth Prog. 2018;65:82–88.
