Article: Volume 46 Number 9 Page 837 - October 2019

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  Dent Update 2019; 46: 837-846

Oral surgery:  Local Anaesthesia in Dentistry – Achieving Effective Painless Injections

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Abstract: A feared aspect of dental care for patients is their expectation of pain and injections. Local anaesthesia in dentistry is an important means of reducing procedural pain and increasing patient comfort during treatment. However, it can be a source of pain in itself. Fear of needles and painful injections is a significant contributing factor to dental anxiety and is a commonly reported concern among patients. This review aims to discuss modes by which the painless and effective injection can be achieved, exploring the causative factors of discomfort and how they can be modulated. Although a wide array of techniques and technologies exist within the field of local anaesthesia (which are outlined in this paper), there is no definitive method for delivering the perfect injection for each and every patient. By being more mindful of current research and understanding with regards to local anaesthesia, however, clinicians may become more confident in their ability to provide a more atraumatic experience.

Clinical relevance: The aim of this review is to make clinicians aware of evidence-based suggestions for reducing the discomfort associated with delivering conventional local anaesthesia in routine dental practice, as well as to inform clinicians about alternative modes of administration of local anaesthesia which may serve as adjuncts in the management of anxious patients.

Author notes: Matin Ali Madadian, BDS Student, Guy’s Hospital, Great Maze Pond, King’s College London, London, SE1 9RT ( and Tara Renton, BDS, MDSc, PhD, FDS RCS, FRACDS(OMS) FHEA, Professor of Oral Surgery, King’s College London Dental Institute, Bessemer Road, London, SE5 9RS, UK.

Objective: To provide evidence-based suggestions for reducing discomfort and managing anxiety associated with delivering conventional LA in routine dental practice.


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