What are the pros and cons of local anesthetics used in dentistry?
Presently, the majority of local anesthetics used in dentistry are amides with esters being rarely administered. Vasoconstrictors, such as epinephrine or felypressin (with prilocaine), are commonly added to increase the duration of anesthesia.
Although adverse reactions, such as toxicity, idiosyncratic or allergic reactions associated with local administration may occur, most reactions are due to the drug entering into the circulation inadvertently. Allergic reactions to local anesthetic can also be related to the addition of bisulphites as a preservative. Most local anesthetic agents are metabolized in the liver.
The table below lists the advantages and disadvantages of local anesthetics used in dentistry.
Click on the table image to enlarge
Source: Scully’s Medical Problems in Dentistry, Elsevier, 2014