Small study found that pre-operative ibuprofen improved efficacy of inferior alveolar nerve blocks


Inferior alveolar nerve block (IANB) is a routine technique for achieving regional anaesthesia. However, it is not always successful, with inflammation being a potential cause.  The aim of this study was to evaluate the effect of preoperative oral ibuprofen (IBU) on the success of inferior alveolar nerve blocks (IANBs) with mepivacaine containing 1: 100 000 epinephrine for [read the full story…]

Reducing soft tissue anesthesia after dental visits with phentolamine

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The effects of dental local anaesthetic often prolonged, particularly soft tissue numbness. This may affect appearance, the ability to speak, smile or eat following dental treatment. Phentolamine mersylate has been shown to accelerate the return of soft tissue feeling after routine dental procedures and was licensed by The Food and Drugs Administration for dental use [read the full story…]

Small study finds limited benefit for lavage to supplement local anesthetic treatment for treatment of temporomandibular disorders


It has been estimates that 20% to 30% of the adult population will experience temporomandibular joint dysfunction. The aim of this study was to assess the short-term efficacy of two treatments for patients with permanently displaced discs and temporomandibular disorder (TMD) pain. Adult patients( ≥ 18)  with TMD  pain and disk displacement without reduction (DDwoR)  [read the full story…]

Trail suggests rapid injection technique for inferior alveolar nerve block was more uncomfortable but more effective

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The aim of this study was to compare both the effectiveness of the anaesthesia and the pain with deposition between fast and slow inferior alveolar nerve block (IANB) injection techniques. Patients attending a dental emergency department and requiring endodontic management were randomised to receive either fast (n=30) or slow (n=30) IANB injections using 3.6 mL [read the full story…]

Side effects of local anaesthetics


Local anaesthetic use is widespread in dentistry and while lidocaine has been in use for more than 50 years an increasing number of agents are now available. The aim of this study was to analyze adverse drug reactions (ADRs) associated with local anesthetics (LAs) and to characterize the safety profile of LAs in clinical application. [read the full story…]

Evidence suggests that 4% articaine provides superior pulpal anaesthesia to 2% lidocaine

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The ability to provide pain- free dentistry is important  and the American Dental Association Center for Evidence-Based Dentistry (ADA-EBD)has just published this critical summary of  a 2011 systematic review by Brandt et al . The review compares the efffecacy  of  two local anaesthetics ( 4% articaine and 2% lidocaine)   in providing successful pulpal anaesthesia. The [read the full story…]

Articaine had slightly better local anaesthesia success than lignocaine when used as buccal infiltration for posterior mandibular teeth in children


The aim of this study was to compare the efficacy of articaine 4% with 1:100 000 adrenaline and lignocaine 2% with 1:80 000 adrenaline, delivered either as an inferior alveolar nerve block (IANB) or buccal infiltration (BI) for routine restorative procedures in mandibular posterior teeth among children. What did they do Children in need of  [read the full story…]

Supplementary injections to increase numbers of patients receiving pain-free dental treatment

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Unfortunately for patients  with irreversible pulpitis inferior alveolar nerve block (IANB) is not always successful in achieving satisfactory levels of anaesthesia. The aim of this study was to compare the efficacy of supplementary repeat inferior alveolar nerve block with 2% lidocaine and epinephrine, buccal infiltration with 4% articaine with epinephrine, intraligamentary injection, or intraosseous injection [read the full story…]

Increasing the pH of lidocaine solution decreases pain on injection and improves patient comfort and satisfaction

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This is a critical appraisal of a Cochrane review first published in December 2010.  The appraisal was prepared under the auspices of the American Dental Associations Centre for Evidence-based Dentistry The objective of the Cochrane review was to determine if adjusting the pH of lidocaine had any effect on pain resulting from non-intravascular injections in [read the full story…]

Adding mannitol improved the effectiveness of local anaesthesia


Modern local anaesthetics have transformed the practice of dentistry. However  a proportion of  injections fail to achieve pulpal anaesthesia.   This trial set out to find if  the addition of mannitol to lidocaine with epinephrine improved its efficacy. Forty patients were randomised to receive  an inferior alveolar nerve (IAN) block  in 3 separate appointments spaced at [read the full story…]