What are the best medications for achieving local anesthesia (numbing) of the gums?

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Last updated: April 21, 2025View editorial policy

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From the Guidelines

For gum numbing, over-the-counter benzocaine products like Orajel or Anbesol (5-20% strength) are most effective, as they temporarily block nerve signals in the tissue, providing relief for 15-45 minutes 1.

Key Points to Consider

  • Apply a small amount directly to the affected gum area using a cotton swab or clean finger up to 4 times daily.
  • Lidocaine-based products (around 2%) like Zilactin-B are also effective alternatives.
  • For more severe pain, prescription-strength topical anesthetics containing higher concentrations of benzocaine or lidocaine may be necessary.
  • Clove oil (eugenol) provides a natural alternative with both numbing and anti-inflammatory properties - dilute with a carrier oil before applying.
  • If pain persists beyond 7-10 days, consult a dentist as this could indicate a more serious condition requiring professional treatment.
  • Avoid swallowing these products and use only the recommended amount to prevent potential side effects.

Important Considerations for Specific Patient Populations

  • Certain patient populations, such as those with red hair or African Americans, seem to be more sensitive to pain and to require higher doses to achieve similar anesthesia, with the concomitant increased risk of adverse effects 1.
  • Neonates and former preterm infants require specific management, because immaturity of hepatic and renal function may alter the ability to metabolize and excrete sedating medications, resulting in prolonged sedation and the need for extended postsedation monitoring 1.

From the FDA Drug Label

The dosages suggested in this table are for normal healthy adults, administered by submucosal infiltration and/or nerve block. Table 3. Recommended Dosages PROCEDURESeptocaine® Injection Vol (mL)Total Dose of Articaine (HCl)(mg) Infiltration0. 5-2.520-100 Nerve block0.5-3.420-136 Oral surgery1.0-5. 140-204

The best medication for gum numbing is articaine (INJ), as it is indicated for local, infiltrative, or conductive anesthesia in both simple and complex dental and periodontal procedures 2.

  • The recommended dosages for articaine are:
  • Infiltration: 0.5-2.5 mL (20-100 mg)
  • Nerve block: 0.5-3.4 mL (20-136 mg)
  • Oral surgery: 1.0-5.0 mL (40-204 mg) It is essential to follow the recommended dosages and guidelines to ensure safe and effective use of the medication 2.

From the Research

Gum Numbing Medications

The best medications for gum numbing are typically topical anesthetics such as benzocaine and lidocaine. However, these medications can have serious side effects, including methemoglobinemia, a condition where the blood has a reduced ability to transport oxygen.

Risks Associated with Benzocaine and Lidocaine

  • Benzocaine and lidocaine can cause methemoglobinemia, a potentially fatal disorder 3, 4, 5, 6, 7
  • Methemoglobinemia can lead to tissue hypoxia and death if left untreated 3
  • The condition may be hereditary or acquired, with benzocaine and lidocaine being common causes of acquired methemoglobinemia 3, 4, 5, 6, 7

Treatment of Methemoglobinemia

  • Methylene blue is the drug of choice for the management of methemoglobinemia 3, 4, 5, 7
  • Treatment with methylene blue can result in reversal of methemoglobinemia and clinical recovery in most cases 5
  • Physicians should be aware of the risks of methemoglobinemia and rapidly identify and treat the condition to avoid significant associated morbidity and mortality 4, 5

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Lidocaine-induced methemoglobinemia: a clinical reminder.

The Journal of the American Osteopathic Association, 2015

Research

Evaluation and management of acquired methemoglobinemia associated with topical benzocaine use.

American journal of cardiovascular drugs : drugs, devices, and other interventions, 2013

Research

Characterization of the methemoglobin forming metabolites of benzocaine and lidocaine.

Xenobiotica; the fate of foreign compounds in biological systems, 2017

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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