Local anesthesia is a cornerstone of modern dental and surgical practices, providing effective pain control for various procedures leading to improved treatment experiences and ultimately, better patient care. To improve stability and shelf-life, the pH range of commercially available cartridges of dental local anesthetic solutions containing a vasoconstrictor, such as epinephrine, is between 3-5. Acidic anesthetic solutions, however, can lead to delayed onset, injection pain, and inadequate depth of anesthesia especially for sensitive areas like the palate or inflamed tissues. Buffering local anesthetics with sodium bicarbonate to raise the pH of these solutions closer to physiological levels immediately before injection has become a proven method to enhance patient comfort and improve the onset and effectiveness of the anesthetic.
The first chairside device for buffering lidocaine in dental cartridges was approved by the FDA in 2010. With the introduction of commercially available chairside buffering devices, some clinicians started experimenting with hand-mixing alternatives using medical syringes and sodium bicarbonate vials to reduce costs. The first study on this approach, published in 2016, examined the 'remove and replace' method and compared buffered solutions prepared using the same ratio of local anesthetic to sodium bicarbonate as the commercially available chairside buffering devices. Three years later, a simpler chairside buffering method, called the 'direct injection technique,' reduced the complexities of earlier strategies by simply adding sodium bicarbonate directly into the local anesthetic cartridge. A brilliant new product launched in 2025 has now reduced the effort of chairside buffering to less than three seconds: a brilliant breakthrough in optimizing anesthetic performance.
This interactive program examines the benefits of buffering dental cartridges of commercially available local anesthetic solutions with sodium bicarbonate immediately before injection to offer clinical benefits such as reduced injection pain, faster onset, and improved efficacy. These advantages enhance patient comfort and procedural efficiency, making buffered anesthetics a valuable option for both routine and more complex dental and surgical procedures. Case studies will augment the delivery of key points and a problem-based learning approach is encouraged so that each participant’s questions are addressed.
After completing this webinar, participants will be able to:
- Describe the pharmacology of current commercially available local anesthetics and some of the clinical challenges these drugs represent.
- Understand the principles of buffering and how this can provide additional clinical benefits of current commercially available local anesthetics.
- Discuss the role of a new one-step solution for buffering local dental anesthetics.
- Recognize at least three clinical benefits of buffering current commercially available local anesthetics.
