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Local Anesthesia Part 9: What's New in Dental Local Anesthesia?
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Updated for 2018

Though local anesthetics are safe and effective, considerable research is on-going to make them even more effective. Computer-controlled local anesthetic delivery systems (C-CLAD) and buffered local anesthetic solutions promise to allow painless injections to be delivered to dental patients almost anywhere in the oral cavity. Fear of injections is primarily based on the needle. The development of an intranasal local anesthetic mist has been shown to provide successful pulpal anesthesia of maxillary teeth – without a needle. Epinephrine is added to injectable local anesthetics to increase their effectiveness, duration and safety. However the duration of residual soft tissue anesthesia – usually unnecessary and occasionally a potential danger – is extended when epinephrine is used in the anesthetic solution. Self-inflicted soft tissue injury is a real problem associated with this anesthesia in all patient age groups but especially pediatric and geriatric patients. Phentolamine mesylate – an alpha adrenergic antagonist – has been shown to significantly reduce the duration of residual soft tissue anesthesia when administered at the conclusion of the traumatic part of dental treatment.


Learning Objectives: 

  1. Discuss the current research on intranasal local anesthesia in dentistry
  2. Describe the effect of pH on the onset, depth & comfort of anesthesia with local anesthetics
  3. Describe the mechanism of action of the buffering agent sodium bicarbonate on local anesthetics
  4. List the benefits of local anesthetic buffering in dentistry
  5. Discuss the local anesthetic reversal agent - phentolamine mesylate
  6. Describe the advantages & disadvantages of Computer-Controlled Local Anesthetic Delivery (C-CLAD)
  7. Describe the clinical effects of the intranasal local anesthetic mist
Related Courses:


Local Anesthesia

Local Anesthesia Part 1: Introduction & The Drugs

Local Anesthesia Part 2: Armamentarium, Patient Evaluation & Basic Injection Technique

Local Anesthesia Part 3: Anatomy & Maxillary Techniques

Local Anesthesia Part 4 & 5: Mandibular & Supplemental Techniques

Local Anesthesia Parts 6 & 7: Local and Systemic Complications

Local Anesthesia Part 8: Articaine - Is it the IDEAL local anesthetic for dentistry? Facts & Fiction


Sedation and Medical Emergencies in Children

Sedation and Medical Emergencies in Children: Part 1

Sedation and Medical Emergencies in Children: Part 2


Managing Sedation Complications

Managing Sedation Complications 2018


Emergency Medicine

Emergency Medicine Part 1: Prevention

Emergency Medicine Part 2: Preparation

Emergency Medicine Part 3: Basic Management

Emergency Medicine Part 4: Altered Consciousness

Emergency Medicine Part 5: Respiratory Distress

Emergency Medicine Part 6: Drug Allergies

Emergency Medicine Part 7: Drug Overdoses

Emergency Medicine Part 8: Chest Pain

Emergency Medicine Part 9: Cardiac Arrest


2019 ADA Children's Airway Conference Optimizing Pediatric Airway Health: The Critical Role of Dentists 

2019 ADA Children's Airway Conference Session One: Identifying Children at Risk, Dental Practice Screening

2019 ADA Children's Airway Conference Session Two: Success in Practice: Facilitating Health Change Behavior for Patients and Their Caregivers

2019 ADA Children's Airway Conference Session Three: Anatomy Concerns: What's Important About This?

2019 ADA Children's Airway Conference Session Four: Clinical Procedures in Dental Practice, Anatomy Concerns: ENT Surgery, Success in Practice: Creating Your Interdisciplinary Pediatric Airway Team

2019 ADA Children's Airway Conference Session Five: Nasal Breathing 24/7: What Does That Even Mean?, Habit Correcting for Children and Dental Teams: Growth and Development


2018 Children's Airway Health - A Practical Conference 

Myofunctional Therapy and Airway

Orthodontics with an Airway Focus

An Airway Focused Approach to Dental Clinical Care: Pediatrics through Adulthood

Sleep Disordered Breathing - Non-Hypoxic Events

It's a Business --Getting Paid

Talking with Kids and Families about Integrative Health Care

Talking to Parents

Pediatric OSA: How do we achieve the Best Surgical Outcomes

Clinic Demo on Verbal Skills

Approaches to Diagnosis of Pediatric Obstructive Sleep Apnea

Typical Child Presentation of OSA: Role of the Sleep Specialist

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