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Article: Volume 49 Number 1 Page 32 - January 2022

  Dental Update 496: 32-38  Read article

Local Anaesthesia:  Optimizing Local Anaesthetic Practice: Addressing Misconceptions and Minimizing Anaesthetic Failures

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Abstract: Local anaesthesia is a sine qua non for pain management in dentistry. Optimizing local anaesthesia practice reduces intra-operative pain, and ultimately ameliorates patient comfort. Many patients still report experiencing intra-operative pain despite being anaesthetized. This is commonplace with inferior alveolar nerve blocks, the current routine approach to mandibular anaesthesia. This technique has been shown, in many cases, to fail at first attempt and can be uncomfortable for patients. It has a higher positive-aspiration rate than other techniques, increasing the risk of systemic complications.

Clinical relevance: Clinicians should be aware of more effective techniques for mandibular anaesthesia for optimal and safe pain management, and ultimately a better patient experience.

Author notes: Negin Oghabi, Fourth year BDS student, Guy’s Hospital, King’s College London. Tara Renton, BDS, MDSc, PhD, FDS RCS, FRACDS(OMS) FHEA, Professor of Oral Surgery, King’s College London Dental Institute, London. email:

Objective: Clinicians should be aware of effective alternatives for mandibular anaesthesia, and choose their technique to suit the patient and procedure, for optimal and safe pain management.