Phentolamine use results in a faster return-to-normal soft-tissue function and sensation after local anaesthesia

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Soft-tissue numbness after local anaesthesia is considerably longer than pulpal anaesthesia and the duration of the typical dental appointment. This often impacts on patients normal daily activities.  The aim of this randomized, single-blind study was to evaluate the reversal of soft-tissue anaesthesia using phentolamine in asymptomatic endodontic patients.

Adults patients requiring endodontic therapy in a maxillary or mandibular asymptomatic tooth were randomised toeither phentolamine ( n=46)  or sham treatment (39) at the end of the endodontic treatment appointment. Soft-tissue anaesthesia was monitored by patients every 15 minutes for 5 hours with postoperative injection site pain and tooth pain being reported using a Heft-Parker visual analog score every 30 minutes for the first 2 postoperative hours and every hour for 3 hours.

They found:-

  • A  statistically significant difference in time to return-to-normal sensation for the maxillary lip/cheek and mandibular lip
  •  Patients who received phentolamine experienced an 88-minute decrease in time to return-to-normal maxillary lip/cheek sensation and a 47-minute decrease in time to return-to-normal mandibular lip sensation
  •  Phentolamine was not significantly more painful than the sham treatment
  •  Patients who received phentolamine did not experience significantly more postoperative pain at the injection site
  • Postoperative complications were minimal, and no clinically significant adverse reactions to the phentolamine were reported.

The authors concluded:-

 Phentolamine would be beneficial for asymptomatic endodontic patients who would like to experience a faster return-to-normal soft-tissue function and sensation after the administration of local anaesthesia.


Fowler S, Nusstein J, Drum M, Reader A, Beck M. Reversal of Soft-tissue Anesthesia in Asymptomatic Endodontic Patients: A Preliminary, Prospective,Randomized, Single-blind Study. J Endod. 2011 Oct;37(10):1353-8. Epub 2011 Aug 5. PubMed PMID: 21924181.

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Derek Richards

Derek Richards is a specialist in dental public health, Director of the Centre for Evidence-Based Dentistry and Specialist Advisor to the Scottish Dental Clinical Effectiveness Programme (SDCEP) Development Team. A former editor of the Evidence-Based Dentistry Journal and chief blogger for the Dental Elf website until December 2023. Derek has been involved with a wide range of evidence-based initiatives both nationally and internationally since 1994. Derek retired from the NHS in 2019 remaining as a part-time senior lecturer at Dundee Dental School until the end of 2023.

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