The impact of cigarette smoking on the efficiency of local anesthesia during simple tooth extraction

Noor Mohammed Al-Noori, Noor Sahban Ibraheem, Mohammed Majid Abdulmunem, Noor Mohammed Al-Noori, Noor Sahban Ibraheem, Mohammed Majid Abdulmunem

Abstract

Smoking is harmful to all organs of the human body and can affect nerve response to local anesthesia.This study aimed to determine the effect of cigarette smoking on the amount and onset of local anesthesia, as well as the chief complaint (symptomatic and asymptomatic), number of cigarettes, and duration of smoking.

Materials and methods: A selective clinical case-control study carried out at the Oral Surgery Clinic of the Teaching Hospital at the College of Dentistry. One hundred and three male patients participated in the study, and they were divided into two groups (55 smokers and 48 nonsmokers). The patients received a local anesthetic agent (2% Lidocaine) in a 1.8 ml dental cartridge. The number of cartridges and the onset time of local anesthesia were detailed for each patient in a special case sheet prepared for this study.

Results: There was a statistically significant difference between the smoker and nonsmoker groups regarding the amount of local anesthetic solution (p = .041) with a higher amount needed in the smoker group; however, the onset of action showed no significant difference between the two groups (p = 0.983). The symptomatic cases in smokers needed a higher amount of local anesthesia than the asymptomatic cases with a statistically significant difference (p = 0.002). There was no relationship between daily cigarette consumption and the amount of local anesthetic solution (p = .054) and also the onset of local anesthesia (p = .938). The duration of smoking has no significant relationship with onset time (p = .480) and the amount of local anesthesia (p = .418).

Conclusion: The amount of local anesthesia used in smoker patients was higher than that in nonsmoker patients, especially if there were symptoms like pain. The duration of smoking and daily cigarette consumption had no effect on the amount and the onset of local anesthesia.

Keywords: Cigarette smoking; Dental extraction; Lidocaine; Local anesthesia.

Conflict of interest statement

No Conflict of Interest

© 2020 The Authors. Production and hosting by Elsevier B.V. on behalf of King Saud University. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

References

    1. Aggarwal V., Singla M., Subbiya A., Vivekanandhan P., Sharma V., Sharma R., et al. Effect of preoperative pain on inferior alveolar nerve block. Anesth Prog. 2015;62(4):135–139.
    1. Becker D.E., Reed K.L. Essentials of local anesthetic pharmacology. Anesth Prog. 2006;53(3):98–109.
    1. Benowitz N.L. Pharmacology of nicotine: addiction, smoking-induced disease, and therapeutics. Annu. Rev. Pharmacol. Toxicol. 2009;49:57–71.
    1. Bigiani A. Nicotine and the taste allure for salty food. Science Proceedings. 2016;3:1133.
    1. Fowler S., Reader A. Is a volume of 3.6 mL better than 1.8 mL for inferior alveolar nerve blocks in patients with symptomatic irreversible pulpitis? J Endod. 2013;39:970–972.
    1. Fozzard H.A., Lee P.J., Lipkind G.M. Mechanism of local anesthetic drug action on voltage gated sodium channels. Curr. Pharm. Des. 2005;11(21):2671–2686.
    1. Furtado R.D. Smoking and anesthetic implications. Rev Bras Anestesiol. 2002;52(3):354–367.
    1. Joseph A. Giovannitti Jr., Rosenberg M.B., Phero J.C., 2013. Pharmacology of local anesthetics used in oral surgery. Oral Maxillofacial Surg Clin N Am. 25, 453–465.
    1. Komar K., Glavina A., Boras V.V., Verzak Z., Brailo V. Impact of smoking on oral health: knowledge and attitudes of dentists and dental students. Acta stomatol Croat. 2018;52(2):148–155.
    1. Milani A.S., Froughreyhani M., Rahimi S., Zand V., Jafarabadi M.A. Volume of anesthetic agents and IANB: a systematic review. Anesth Prog. 2018;65:16–23.
    1. Ozturka O., Fidancib I., Unalc M. Effects of smoking on oral cavity. J. Exp. Clin. Med. 2017;34(1):3–7.
    1. Patil A., Shigli A., Gunda S., Tamgond S., Patil S., Huddar S. local anaesthesia in dentistry- lignocaine too good or articaine the best? Emerg Med (Los Angel). 2016;6:4.
    1. Prochaska J.J., Benowitz N.L. Current advances in research in treatment and recovery: nicotine addiction. Sci. Adv. 2019;5:9763.
    1. Sayhan H., Beyaz S.G. and Çeliktaş A., 2017. The local anesthetic and pain relief activity of alkaloids. Chapter 3 from the book Alkaloids-alternatives in synthesis, modification and application. 57-84.
    1. Silva S.A., Horliana A.C., Pannuti C.M., Braz-Silva P.H., Bispo C.G., Buscariolo I.A., et al. Comparative evaluation of anesthetic efficacy of 1.8 mL and 3.6 mL of articaine in irreversible pulpitis of the mandibular molar: A randomized clinical trial. PLoS ONE. 2019;14(7):0219536.
    1. Wali M., Drum M., Reader A., Nusstein J. Prospective, randomized single-blind study of the anesthetic efficacy of 1.8 and 3.6 milliliters of 2% lidocaine with 1:50,000 epinephrine for inferior alveolar nerve block. J Endod. 2010;36:1459–1462.
    1. Weinberg L., Peake B., Tan C., Nikfarjam M. Pharmacokinetics and pharmacodynamics of lignocaine: a review. World J Anesthesiol. 2015;4(2):17–29.

Source: PubMed

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