Dr. Aviv Ouanounou returns to speak to the Oasis Discussions audience. In this short video, Dr. Ouanounou provides an overview of local anesthetics which are commonplace in every dental office.
- Local anesthetics are hydrophilic with an amide (most common) or ester (less common) linkages.
- Topical anesthetics belong to the ester group.
- These drugs stop action potential propagation by blocking sodium channels.
- Onset and duration of anesthetic are affected by: pH and pka of the drug and tissues, concentration of the drug, area of administration, nerve morphology.
- Local anesthetic agents are generally very safe; however, they can induce psychogenic effects such as syncope.
- Allergic reactions are rare.
- 4% articaine with epinephrine should not be used for mandibular blocks.
- Clinicians should be aware of potential drug interactions with local anesthetics with epinephrine (e.g. beta-blockers, TCAs).
- Before administering local anesthetics to a child, the maximum dosage should be calculated after taking his/her weight and generally, a 4% solution should not be used.
- Elderly patients may have co-morbidities – epinephrine may be contraindicated and 2% solutions may be preferred.
Full Interview (14.50″)