How Long Does Novocaine Last?

One of the most common questions I see both in private practice and on this site relates to how long you will be numb after a dental procedure. In dentistry, there are a lot of factors that affect the duration, ranging from the type of the anesthetic to the location given, so there is no one correct answer.

In general, and this is a very broad generalization with many exceptions, you can expect to be numb for approximately 2 to 3 hours after you leave the office. Want to learn what factors affect how long you will be numb?

To use or not to use Epinephrine

lidocaine with epinephrine dental local anesthetic

Lidocaine with Epinephrine

Perhaps the most important factor that affects how long you will be numb is the presence (or absence) of epinephrine.

Epinephrine acts to constrict the blood vessels where the anesthetic is injected. By constricting the blood vessels, you have less blood flow in and out of the numbed-up area, and the local anesthetic does not get carried away from the teeth and nerves as quickly. As a result, you remain numb longer and the numbing sensation is much more profound.

Occasionally, some of the epinephrine can end up in the bloodstream, leading your heart to beat more rapidly and some other symptoms. Some people then mistakenly assume they are allergic to epinephrine which is impossible. See this MythBuster post and a follow-up article on why this is not possible.

If you receive an injection with an anesthetic without epinephrine, on average, you will be numb for about 1 hour or slightly less after you leave. This assumes your dentist uses one of the two most common: 3% carbocaine/mepivicaine or Citanest Plain/4% Prilocaine.

Type of Anesthetic

Besides the presence of epinephrine, the type of local anesthetic also plays a role. First off, novocaine is not used anymore, so I personally have no idea how long novocaine would last.

marcaine dental anesthetic will last a long time

This brand of dental local anesthetic can often last 8 hours.

Bupivacaine, which goes under the brand name Marcaine (at least in dentistry), can last a long time. In formulations without epinephrine, it can last 4 – 8 hours. When used in dentistry with epinephrine, it can last for 8 hours or more. In my experience, when I give bupivacaine with epinephrine for removing wisdom teeth, I tell patients that they can be numb until the next morning. Many of them report going to bed and still being numb.

Amount of Local Anesthetic Administered

Root canal procedure you need to be extremely numb

For a root canal, you typically need extra local anesthetic

This seems pretty obvious right? In general, the more you receive, the longer you’ll be numb. But remember that twice as much does not mean you will be numb twice as long. But you will be numb much longer.

For a straightforward filling, one shot (1.7 mL or cc) is typically sufficient, unless you are a patient who is difficult to get numb (see here and here on this phenomenon). For procedures that are a bit more involved, such as an extraction or root canal, dentists typically give more than one injection. The end result is you can often be numb for four or five hours afterwards.

Location, Location, Location!

Real estate is not the only area where this saying is relevant. The location – the area in the mouth where the local anesthetic is injected – plays a role in how long you will be numb.

a nerve block will last longer than other types of dental injections

A nerve block for a lower molar.

For a lower back tooth to be worked upon, you nearly always needs a nerve block. Nerve blocks last longer than infiltrations – which is when the anesthetic is placed directly next to the tooth.  In generalizing data from this paper, if you receive a nerve block, you will be numb approximately 25 to 30% longer than if you received an infiltration.

So what does all this mean? If you had a lower molar worked on, you were likely given a nerve block, and therefore you will likely be numb longer than if you received an injection for an upper front tooth.

Final Thoughts

This list is not exclusive. There are a lot of other factors – metabolism, genetics, hair color – but these four are the most common. I may do a follow-up post where I talk about the other factors. Comments are welcome.

 

Comments

  1. I had an extraction and was given numb stuff 4 times. Because I still had pain. It’s an hour later and it’s beginning to wear off. I don’t know what he used. But my tooth was in the back on the lower jaw. Which seemed difficult to remove. But what would be my case if it’s wearing off now ?

  2. alana garner says:

    Hi i had a wisdom tooth taken out Wednesday by fri i went back due to a dry socket he packed it for 5 min with something that taste like clove oil ? Then put a gel pad on it but within 2 hrs the gel pad fell away when taking panadole/nurofen and was told the pain would ease but the pain feels more intense now its kept me up all night

    • I had an extraction of tooth 15 prior to this it was a root canal they could not save the tooth extracted it and I had an implant put in 48 hours later my lower lip and chin area is still numb is this common I tried to reach my dentist but there is no emergency contact number can you please advise me what I should do

      • Marie,
        I can’t give you specific dental advice.
        However, generally speaking, being numb 48 hours after a dental procedure is NOT normal. I would contact the dentist ASAP.

      • Ronald J Ryes, Sr says:

        I had a root canal started and discontinued because of the pain. They gave me several injection to stop the pain but didn’t really completely stop it. The tooth had a bad infection, they drilled a hole in the tooth and relieved the pressure and puss. The numbness went away in some area but I am still numb under the chin area for about four weeks and my endodontist said to be patient it will go away with time. I am scheduled to go back in a week to complete the root canal. Have you ever heard of such a case and what was the outcome? Thank you, I am concerned and don’t know what to do.

        Sincerely,

        Ronald Ryes

        • Ronald,
          That is certainly unique. The key is that you communicated this to the endodontist. I can speculate on the reasons, but without all the clinical and x-ray info, it is speculation at best. But sometimes a bad tooth infection can exert pressure on the major nerve running through your lower jaw. I would give the office a call again to remind them about your symptoms.

  3. Hm. This morning I had a lower lip frenectomy done because of some bad gum recession down there. My dentist is awesome and very thorough when it comes to numbing–I didn’t feel a thing! This was at 8:15 am. It’s now 3:30 p.m. and my lips, tongue, and cheeks all seem back to normal (and have for a few hours). But, my chin and that area where he lasered definitely feel…different. Is it possible that it’s still under the influence of anesthesia? Should I call or wait until tomorrow to see if it kind of goes away? Since this is a blog and not a really great stand-in for actual care, I’ll call by tomorrow anyway. Purely curious if it’s a phenomenon of the frenectomy or of the anesthesia that my chin feels kinda numb.

  4. Had 3 fillings today
    Received 3 injections prior
    Left office 1 hour ago
    Still numb
    Hungry
    But can’t eat
    Praying this wears off in another 2 hours max

  5. Holly Gefaller says:

    I had a filling 3 weeks ago and when they put the novacaine in I had a very sharp pain on my bottom left lip – it felt like hot molten iron had hit that spot. Now, three weeks later I still have numbness in two teeth and that portion of my lip that has not gone away. Will this permanately affect those two teeth by restricted blood flow? Should I contact my dentist and tell him what has happened?

  6. I have had wisdom tooth 48 removed yesterday. I received 3 injections. Most of numbness is gone from the jaw and cheek but even after 24 hours, half of my tongue is still numb. I feel pain in middle of my tongue when I move it towards right side. Any Idea how long would that numbness last, I really hope it is not permanent.

  7. Ok I had to have some remaining teeth taken out where teeth had fell out, so now i’m into the 48 hour of numbness on my right side, where the dental work was done, having numbness on right side of chin,and right side of Lower Lip,is this normal after 2 day’s?

  8. Sharon Robertson says:

    I have a very strange thing that happens when I get dental anesthesia (carbocaine, artacaine with and without epinephrine) on the RIGHT side of my mouth, it affects my LEFT eye. I have seen a fair amount of articles about problems with dental anesthesia on the ipsilateral side but very little about problems on the contralateral side. There is an excellent article from Dental Update in 1999 called Neurological Complications of Local Anesthetics in Dentistry by St. John Crean and Alison Powis which discusses complications but again all are on the ipsilateral side. On the first occasion, in 2002, I had blurring of vision in opposite eye, double vision, ptosis of my eyelid and inability to move my eye to the side — which lasted for about 20 minutes – this was with carbocaine. I also had systemic weakness for several hours. Six years later, I had anesthesia with articaine without epinephrine on the right and experienced a strange pulling sensation in my left eye, heaviness of my eyelid and inability to move my eyeball for a similar time frame but with just a strange sensation in my eye for 3 hours longer. Nine hours post injection, my eye still felt strange and I also experienced some eye pain. Then again in 2015, I had one shot of anesthetic in my lower right jaw. I had delayed numbness. My chin didn’t numb up until after the appointment. I noted no immediate changes in my left eye until the next morning when I woke up with blurriness in my left eye which lasted into the evening. My eyeball also had a pulled sensation. No one has been able to figure this out but there are case histories of patients who have had problems on same side which became permanent problems. So I guess my only option now is to not have dental anesthesia with dental work. Do you have any thoughts or any direction on who might understand this phenomenon?

    • Sharon,
      You have presented quite a history and I can tell by your post that you’ve researched this phenomenon quite thoroughly. While ocular issues can occur in rare circumstances, all my experience and research has shown those issues to be on the same side as the injection. Unfortunately I don’t have any ideas for you, other than getting work done with sedation. However, if you live near a dental school, there may be a professor there who would be interested in evaluating you. Hope this helps.

      • Sharon Robertson says:

        Thank you for replying. I know I am quite an enigma. I had one dentist tell me — it is anatomically impossible. I agreed but said – it’s what happens. Thanks for the idea of seeking out a dental professor.

  9. I had a deep cleaning and was given injections too numb the area at 11 am it is now 7:30pm and i still have absolutely no feeling in my mouth. Last time I got it done two weeks ago it only took 3 hours to wear off. Is there anything to worry about?

  10. Mary anne says:

    Thank you for this post, Dr! I am 57 yo and had a lower wisdom tooth extracted today after several weeks of pressure sensitivity (Upper 2 were pulled back in high school). I moved last year and had to find a brand-new dentist after 25 years with the best dentist in the world, so it’s been nerve wracking – anyway, she said she was giving me local that would last for 7 or 8 hours. So Epinephrine? I got three different shots, the first one sent lightening down my tongue and lower lip. Nerve block, maybe? Didn’t feel a thing during, or still – it’s now 6 hours later and I decided to look up Novocain duration of action and your excellent post addressed my questions. I didn’t know that Novocain isn’t even used that much anymore, either.
    I don’t really have a question, just wanted to comment and say thanks. Time to take some Tylenol before it really starts to wear off.

    • Michelle Nutley says:

      I had an embedded wisdom tooth removed on Wednesday, March 15 around 9-10am. This tooth was very close to the nerves. I don’t know how many times I was injected, and I don’t know with what exactly to numb my jaw, but it is now Friday, March 17 and my face is still numb. My bottom row of teeth on the left side of my face, chin and lips are still numb. The dentist injected me several times during the procedure because I could still feel pain. My face is very swollen, my lips feel like they’re on fire. My face is redish. I went to the E.R. and they could see a pus pocket where the tooth was extracted. My lips are tingling like they’re trying to wake up, but it’s been a long time already feeling this way. I am scared to death. I can’t sleep. Could this be an allergic reaction to the injections? What should I do? The dentist wants to see me back in the office but I am frightened out of my mind what to expect. Everyone keeps telling me that dentist messed me up. If nerves were damaged do I have to live like this the rest of my life? I’m in so much pain. I feel numbness around my nose, as far up as my left eye, including a feeling of “tightness” up the left side of my face to my hairline. Is there such thing as repairative surgery? How about a reverse injection?? The E.R. physician first suggested what I am experiencing may be pressure from the swelling, but NO. I know the difference between pressure from swelling and numbness from the injections. Should I go to see a oral surgeon vs a dentist? Please help me. Please advise what you think I should do. My blood pressure is soaring up to 211 and higher & my blood sugar is crazy. I am diabetic, type 2. And I do take 3 meds for high blood pressure which is usually controllable. I can’t eat much, I can’t sleep, and I am pretty sure I am somewhat dehydrated. I am 55 years old and the E.R. keeps sending me home to follow up with the dentist and my M.D. that I am scheduled to see tomorrow. The tooth extraction was the worst pain I had ever felt. I even heard my jaw crack. The dentist didnt show me the tooth after they pulled it out. I was screaming it was so painful. I think I felt almost everything. The dentist put in sutures after the tooth was out. I feel like I’m dying. While in the E.R. they did blood work, a urine test, and an EKG because my anxiety was causing me chest pains. I don’t know how much more of this I can take. Can this ordeal kill me? Because of everything that’s been happening to me I have been nauseaus and dizzy. The E.R. doctor prescribed me nausea medication. I am all kinds of messed up. I am taking Levaquin antibiotic because I am allergic to penicillin and Codeine. I had to stop taking the Tramadol because it caused me to have blood in my urine. Please HELP.

      • Michelle,
        You need to follow up with the dentist who extracted the tooth ASAP so he/she can evaluate the source/reason for the numbness.

        • I went to an endodontist because I was having dental pain. My regular dentist couldn’t figure out where the pain was coming from so he sent me there. After receiving about 5 Novocain injections to figure out which tooth was the issue I was numb completely on my left side. It’s been 2 weeks. I’m still numb. They are saying it’s neurological and it’s nothing they did. I went to a neurologist and he told me they did nerve damage. I have read online this is actually very common. My question is how long does it take for the nerve damage to repair itself. Is there anything my dentist can do to help?

          • Amy,
            This is a rare and very complicated situation. There is no way I can answer this without knowing all the details. If a nerve is damaged during a dental injection, it can sometimes take months to heal. But there is no way to know if a dental injection caused it. Perhaps go back to your general dentist and ask him/her for a referral to an oral surgeon for evaluation?

  11. I had my wisdom teeth pulled yesterday (Thursday August 10, 2017) around 12pm…. it is now 8:30 pm the following day (Friday August 11, 2017) and I still feel numbness in my tounge. Is this normal?

  12. I had my #18 molar and wisdom tooth pulled 8/18/17. It is now 8/25/17. My lower left lip and jaw are still numb. What should I do? Can it be undone?

    • Karen,
      You should contact the dentist or surgeon who did the procedure. There are risks associated with some lower molar extractions. Those were likely discussed with you. Again, contact whoever did the procedure.

  13. I had a very large filling replaced on the lower last molar over a month ago. My tongue on the left side is still numb. And my whole tongue is swollen. I told the receptionist At the dental off this and she said as she would let the dentist know. Will this feeling ever go away?!

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