Buffering local anaesthetics to reduce dental injection pain?

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14 RCTs were included in this review of the effect of buffering local anaesthetics in reducing infiltration pain and anaesthesia onset time in dentistry. While slight reductions in onset time was seen in inflamed tissues and for IAN block these were not considered to be clinically significant. However the overall quality of the evidence was low.

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Lidocaine: trial suggests that buffering may not improve success of inferior alveolar nerve block


A 2010 Cochrane review that was not able to include any dental studies did find that buffering lidocaine decreased pain on injection and augmented patient comfort and satisfaction. This new dental trial included 80 patients with symptomatic irreversible pulpitis but found no significant difference with success rates with buffered lidocaine.

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Use of buffered lidocaine did not provide better pain control than unbuffered lidocaine for incision and drainage procedures


A 2010 Cochrane review (Cepeda et al) found that there was less pain associated with pain on injection and augmented patient comfort and satisfaction with the use of buffered lidocaine compared with unbuffered lidocaine in both parallel and crossover trials. Although none of the 23 trials included in the review were dental.  The aim of [read the full story…]