A happy patient becomes a longterm patient. A painless anaesthetic injection will quickly dispel any apprehensiveness in the dental practice, and get treatment off to a good start. A 2004 study showed that patients judge their dental practitioner first and foremost on their skill in giving pain-free injections. Injections do not have to be something to fear – on the contrary, they can be the first step in a relationship of trust with the practitioner.
To achieve this, the dental practitioner must be able to rely on supplies of the highest quality: not just the syringe and the needle, but also the local anaesthetic chosen. For although they may contain the same active ingredients, brands of local anaesthetic can differ considerably, depending on the manufacturing process, the way they are sterilized, the excipients they include, their pH level, and so on.

pH, an important aspect of local anaesthetics

The pH of the solution has an important place as one of the factors that distinguish between anaesthetics, as it varies from one product to another and one manufacturer to another. While human tissues are pH-neutral (7.4) under normal physiological conditions, solutions used in anaesthesia on the other hand need to be somewhat acidic.
Each cartridge of injectable solution includes a local anaesthetic, sometimes alone and sometimes mixed with a vasoconstrictor such as adrenalin.

The advantage of the vasoconstrictor is that it significantly increases the duration of anaesthesia. But the drawback is that adrenaline requires an acidic or even very acidic pH, if it is to remain stable and active throughout the product’s shelf life.
A solution that contains adrenaline will therefore be more acidic than one that contains anaesthetic alone.

For this reason, all manufacturers have to lower the pH of their anaesthetic solutions to prevent the vasoconstrictor degrading. Finally, the acidity level, which is set by the manufacturer, will depend on the formulation, and the excipients and preservatives included. The difficulty therefore is to offer the dental practitioner a solution that is stable and effective, but with the least-acidic pH possible.

Negative clinical consequences of an acidic pH

Unfortunately, injecting an acidic solution has clinical consequences for both patients and practitioners, which cannot be ignored. First of all, the more acidic the pH, in other words the further it is from the neutral physiological level, the more the patient will feel the injection… meaning a more painful injection, irrespective of the practitioner’s technique and experience.
This pain has to be taken into account, as it is the main determining factor in the trust between patient and his dental practitioner. Secondly, another pH-related clinical effect is that the more acidic the solution, the longer the onset time – that unavoidable wait between the moment of the injection and the time the anaesthetic takes effect.
There are actually two forms of anaesthetic compound in a solution, in an acid-base balance: ionized forms (which do not penetrate the cell) and non-ionized forms (which go to the heart of the cell, an essential stage in achieving anaesthesia). The balance between the two depends on the solution’s pH. The closer this is to physiological pH, the higher the proportion of non-ionized or “active” forms. When the solution is injected, the body buffers the solution, in other words it brings it up to physiological pH. During this process, the acidbase balance is altered and more active molecules are present.
This physiological buffering process takes time, and is a major factor in the anaesthetic’s onset time.
So the more acidic the pH of the injected solution, the longer the body needs to bring the solution to 7.4, with the effect of increasing the onset time.

Tailored pH for Septodont anaesthetics

Top quality anaesthesia is the highest priority for Septodont. That’s why the company focuses on making products with the lowest possible acidity, to limit their adverse effects for both practitioners and patients. The group has spared no expense in developing solutions with higher pH levels, investing over the years in projects to constantly improve and adapt its formulations. This has enabled Septodont research teams to gradually increase the pH of its leading products, such as Septanest, by developing unique formulations that are compatible with a standard shelf life and the least-acidic pH possible.
And now Septanest is available on the market, with a level that is considered to be low-acid compared to competing equivalent forms, at a pH of 4.0–5.5. Being totally committed to optimal quality, and making constant improvements, is of course a longterm approach for Septodont.

An emphasis on quality in product manufacturing

One feature of Septodont unique production process involves including a terminal sterilization stage, a gold standard for the health authorities in the manufacture of sterile pharmaceutical products. This method ensures the highest guarantee View Product of sterility for all the group’s local anaesthetics, including Septanest. As the world leader in dental anaesthesia, Septodont has the world’s largest production capacity: 9000 square metres over two manufacturing sites (in France and Canada). It produces over 500 million cartridges per year, all benefiting from this terminal sterilization stage.