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Local Anesthesia in Pediatric Dentistry-How Much is Enough?

Eliyahu Mass*, Yael Palmon and Uri Zilberman

Aim: To evaluate the doses of local anesthesia (LA) during routine dental treatment of children, used by specialists in pediatric dentistry (SPDs), residents in pediatric dentistry (RPDs) and general practitioners (GPs) and suggest recommendations for using minimal doses.
Study design: A prospective research. 120 LA cartridges were collected after provided dental treatment of children by 4 specialists (SPD-55 cartridges), 5 residents in pediatric dentistry (RPD-43 cartridges) and 3 general practitioners (GPs-22 cartridges).The doses of the used solution were measured by deducting the remains in the cartridge from the original 1.8ml.
Results: A significantly lower dose of LA solution was used by specialists and residents compared to GPs, (0.786/0.746 ml ± 0.4 Vs.1.65 ml ± 0.3, P<0.001).
Discussion: LA guidelines intend to achieve optimal effect, increase safety and reduce side effects. Various dentists have different training and experience, as well as personality and habits, which may affect their use of LA. This prospective study evaluated these factors.
Conclusions: The dentist training is a valuable predictor for the LA dose being injected to a child during dental treatment. The mean dose used in the study by specialists and residents was less than half compared to GPs, but effective enough for successful dental treatment, regardless of the number of treated teeth, the site, the type of the treatment and the patient's age. We suggest increasing the awareness of using minimal effective dose of LA in pediatric dentistry.