Local anesthetics, the most used drugs in dentistry, are
the safest & most effective drugs for the prevention and management of pain.
However the act of receiving an injection – the ‘shot’ – is the most
fear-inducing part of the dental experience for most patients. 75% of all dental
office medical emergencies are ‘stress’ related and therefore preventable in
most situations. Techniques of managing fear including inhalation and oral
sedation are reviewed. The pain reaction threshold (PRT) is introduced followed
by a discussion of the effect of various clinical situations, e.g. pain,
infection and fear, on the PRT. The currently available (in North America) local
anesthetic formulations are discussed with an emphasis on their expected
duration of clinical action.
This program reviews the development of local anesthetics and the drug
formulations that are currently available in dentistry. The effect of fear &
anxiety on local anesthetic effectiveness is discussed along with an
introduction to sedation – a very important ally in the quest for effective pain