My first encounter with EMLA cream - Mothering Forums

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Old 05-04-2007, 05:57 AM - Thread Starter
 
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Our daughter fell yesterday evening and knocked her upper front milk teeth moving. So this morning we went to dentist. She took x-rays and said that we better take the teeth away since they were almost without roots allready and coming off soon anyway.

Dentist put some gel on the gum before putting the actual numbing shot. She told me that this is EMLA cream. I asked how effective it was/when it is used for pain relief and she said that it is only used to numb the area where shots are put....

I told that I have lived in USA and there they use it often as only pain relief in infant circumcision.

Both dentist and her nurse (hunky,young guy)went white and did not first believe me. I explained that I have lived in USA and my spouse is American and I know quite a lot of this mutilation business in USA.

They were absolutely horrified and said that here a doctor like that would be arrested and kicked out from medical community. I kinda felt sorry for the hunky young male nurse, poor guy was still all white when we left.

- and now getting ready to tooth fairy visit tonight...
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Old 05-04-2007, 09:34 AM
 
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No offense to your dentists, but EMLA cream takes a couple hours to take effect...so they were using it pointlessly on your daughter's gums, and maybe that is why they were horrified at its "other" use.

Amy, USCG wife and homeschooling, ebfing, homebirthing Mama to M (8), L (6), L (2.5)
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Old 05-04-2007, 09:44 AM
 
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I am amazed that EMLA is used for circumcision at all. I am a Pedi RN and I worked in a Pedi ER for a long time. We used EMLA cream for IV starts. It would be left on for a minimum of 30 to 45 minutes prior to IV starts.

We were given a training class in the use of EMLA. We were told that it should NEVER be used on the tip of any extremity such as the end of a finger, the end of the nose, and they specifically said it should never be placed on the penis. The reasoning that was given for this is that EMLA cream causes Vasoconstriction. We were taught that if you use EMLA in one of the above mentioned areas that are so rich in tiny capillaries that it could completely vasoconstrict blood flow to the area thereby causing the tissue to die.

I have seen it mentioned here many times that EMLA is used for circumcision and it always amazes me because of what we learned in that class. :
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Old 05-04-2007, 10:30 AM
 
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Originally Posted by CalenandEllasmomma View Post
We were taught that if you use EMLA in one of the above mentioned areas that are so rich in tiny capillaries that it could completely vasoconstrict blood flow to the area thereby causing the tissue to die.
I guess they don't see this as a problem because they are cutting the tissue off anyways.

I have gotten a gel on my gums before an injection and it didn't take long to take effect... I wonder if there's more than one type of EMLA cream? I would think a gel on the inside of your mouth would absorb much quicker than a cream on the skin.
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Old 05-04-2007, 10:31 AM
 
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No offense to your dentists, but EMLA cream takes a couple hours to take effect...so they were using it pointlessly on your daughter's gums, and maybe that is why they were horrified at its "other" use.
Nope, it works much more quickly on mucous membranes. I've had my dentist use it and it worked better than the shot he gave me.
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Old 05-04-2007, 11:33 AM
 
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I guess they don't see this as a problem because they are cutting the tissue off anyways.
Yes, but they didn't want it used on ANY penis. My concern would be the effect on the surrounding tissues that they weren't going to cut off.
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Old 05-04-2007, 12:52 PM
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No offense to your dentists, but EMLA cream takes a couple hours to take effect...so they were using it pointlessly on your daughter's gums, and maybe that is why they were horrified at its "other" use.
As someone else said, it works very quickly on mucous membrane. I've had the oral EMLA and it took about...45 seconds before I was numb.

Long distance Mom to boarding school superstars E (9) and Layne (6).
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Old 05-04-2007, 02:23 PM
 
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As someone else said, it works very quickly on mucous membrane. I've had the oral EMLA and it took about...45 seconds before I was numb.
My regular EMLA cream says not to use on mucous membrane. It also needs to be covered with something for about 45 mins to be considered effective. My little tube came with plastic patches.

I've had the oral at the dentist before too and it helps alleviate the pain of the shots but not entirely IMHO.

So I wonder if the doctors that claim they use this for circ cover the penis and wait around for 45 minutes before performing the procedure? Somehow I doubt it.

Mama to 5 busy bees (12, 9, 7, 3, 2) and expecting #6 June/2014

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Old 05-04-2007, 05:27 PM
 
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The person I know who used EMLA for circumcision was told to use an occlusive dressing (plastic wrap) and apply it 2-3 hours ahead of time to ensure effectiveness. I do think we underestimate some care providers around here. Just like not EVERY OB is evil nor every midwife a saint, kwim?

Amy, USCG wife and homeschooling, ebfing, homebirthing Mama to M (8), L (6), L (2.5)
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Old 05-04-2007, 05:37 PM
 
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As someone else said, it works very quickly on mucous membrane. I've had the oral EMLA and it took about...45 seconds before I was numb.
Is Oragel like an EMLA?

Mama to 14yo, 9yo, 7yo, and babe born 9/2012
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Old 05-04-2007, 07:04 PM
 
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Originally Posted by True Blue View Post
The person I know who used EMLA for circumcision was told to use an occlusive dressing (plastic wrap) and apply it 2-3 hours ahead of time to ensure effectiveness. I do think we underestimate some care providers around here. Just like not EVERY OB is evil nor every midwife a saint, kwim?

Granted, there are those practitioners you describe are out there but I think that the majority of folks performing circs don't take the required steps to provide adequate pain relief for babies. As a student nurse in the newborn nursery I witnessed "circ time" which was like an assembly line, a well-oiled machine. The boys to be circ'd were lined up in their bassinets outside the circ room waiting their turn. This would have been an opportune time to apply the EMLA cream or other topical anesthetic, give pre-op Tylenol, anything, but doing so would have required an extra step, a break in the routine.

While I'm not happy about circumcision in the least I do commend docs who do at least realize babies feel tremendous pain from the trauma of circ and provide adequate pain relief for their tiny patients.

Ashley~certified nurse-midwife mama to 6 little novaxnocirc.gifhomebirth.jpglotbirth.gif loves, including sweet Cordelia Jane born at home waterbirth.jpgon 11/12/10.
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Old 05-04-2007, 09:36 PM
 
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The EMLA used here for RIC is an opaque white cream, not a gel.

That being said, an Orajel-type numbing gel applied to the gums will cause some local, superficial, almost instantaneous numbness. I've had it used before Novocaine shots for dental work and I've also used it in the past for other oral pain, like when my wisdom teeth were bothering me. It numbs the tongue pretty noticably, too.

Jen
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Old 05-05-2007, 01:42 AM
 
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Yes, but they didn't want it used on ANY penis. My concern would be the effect on the surrounding tissues that they weren't going to cut off.
Didn't even think about the remaining tissue :
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Old 05-05-2007, 12:24 PM
 
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EMLA is contradicted for infants.

I contacted the people who make the stuff and they told me quite clearly it should not be used on infants.

Also circ causes harm to the part of the penis that isn't cut off.
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