Use of Local Anesthesia for Pediatric Dental Patients

Abstract

This best practice presents recommendations regarding use of local anesthesia to control pain for pediatric dental patients. Considerations in the use of topical and local anesthetics include: the patient’s medical history, developmental status, age, and weight; planned procedures; needle selection; and safety concerns such as risk for methemoglobinemia and systemic effects of anesthetic agents. Guidance is offered on the documentation of local anesthesia administration including anesthetic selection, dose administered, injection type, and injection location, and postoperative instructions. Potential complications such as toxicity, paresthesia, allergy, and postoperative self-induced soft tissue injury are discussed. Additional recommendations address alternative methods of local anesthesia delivery, concurrent use with sedation or general anesthesia, and use during pregnancy. Pain management is an important component of oral health care and can result in a more positive patient experience during pediatric dental procedures.

This document was developed through a collaborative effort of the American Academy of Pediatric Dentistry Councils on Clinical Affairs and Scientific Affairs to offer updated information and recommendations on using local anesthetics in the management of dental pain for pediatric patients and persons with special health care needs.

^{KEYWORDS: ANALGESICS; ANESTHESIA, GENERAL; ANESTHESIA, LOCAL; DELIVERY OF HEALTH CARE, METHEMOGLOBINEMIA, PAIN MANAGEMENT, PEDIATRIC DENTISTRY}