This lecture is for those who wish to expand their understanding of the pharmacologic mechanisms of local anesthesia and how to solve some of the difficulties that arise in obtaining profound anesthesia in the oral cavity. How do local anesthetic agents work for dentistry, and why don’t they always work? Simple calculations for maximum safe dosage levels as well as possible contraindications and interactions of local anesthetic solutions with patient medical conditions and medications will be presented. The controversy surrounding the use of articaine and prilocaine for block anesthesia injections will be addressed, and management of possible complications and injuries related to the delivery of oral local anesthesia agents — such as hematoma, paresthesia and trismus — will be discussed. Use of alternative anesthesia modalities, such as topical anesthetic formulations (Oraqix, compounded topicals), the anesthetic-reversal agent (OraVerse), and anesthesia buffering systems (OnSet and Anutra) will also be presented.
Learning Objectives:
Discuss the mechanisms and clinical importance of local anesthetic uptake and binding.
Discuss advantages and disadvantages for use of the available local anesthetic agents with and without vasoconstrictor additives.
Discuss potential adverse reactions to local anesthetics, such as syncope, allergy and toxicity, as well as how to minimize the risk of adverse reactions.
Have a thorough understanding of the pharmacology of available local anesthetic agents, including their advantages, disadvantages and safety profiles.
Be better able to assess and manage complications that may occur in the delivery of local anesthesia and be better able to avoid them when possible.
Discuss the science and effectiveness of new anesthetic delivery systems, such as nasal inhalation, buffering and reversal agents, that have been introduced to dental practitioners.
Learn how to apply the latest anesthetic agent technology to daily practice and describe the latest trends in achieving profound patient comfort.
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