Modern dental pain control.

Local anesthetics, on the other hand, deposited near a nerve between the surgical site and the brain, set up a chemical roadblock that prevents the pain impulse from ever reaching the brain (Figure 1). The patient’s level of consciousness remains unaffected when local anesthetics are administered, unlike the CNS depressants used in general anesthesia. The safety of local anesthetics may be garnered from the following statement attributed to Dr. Leonard Monheim, an icon in the history of dental anesthesiology, “Nobody ever died in the conscious state.” A number of local anesthetics are available for administration in dentistry in the United States. The major difference between these formulations is their expected duration of clinical anesthesia. Drugs are categorized as “short-acting,” “intermediate-acting,” and “long-acting.” Table 1 presents the current local anesthetic formulations available in the United States. According to the 2002 American Dental Association’s Survey of Dental Practice, the typical treatment period for a patient in a general dentistry office is approximately 47 minutes. “Plain” local anesthetics (LAs) provide neither the depth nor duration of anesthesia required for anything more than short, shallow procedures. In order to provide Modern dental pain control