The American Academy of Pediatric Dentistry’s (AAPD) comprehensive guideline, “Use of Local Anesthesia for Pediatric Dental Patients”, provides an evidence‑based framework for safely managing pain in infants, children, adolescents, and those with special health care needs.
Updated in 2023 and featured in The Reference Manual of Pediatric Dentistry 2024‑2025, this best practice draws on systematic literature reviews, including data from PubMed/MEDLINE searches, and expert consensus to offer clear, patient‑centered recommendations.
Why This Guidance Matters
Local anesthesia is not just a technical adjunct—it’s a pivotal tool in shaping how young patients perceive dental care. Effective pain control:
✔ Encourages trust, reduces anxiety, and fosters positive long‑term dental attitudes.
✔ Minimizes the physical and psychological trauma associated with drilling, injections, and extractions.
✔ Reduces the risk of complications such as toxicity, paresthesia, allergic reactions, soft‑tissue injuries, and methemoglobinemia.
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Holistic, Child‑Centered Recommendations
The guideline emphasizes a multifaceted approach:
✔ Selection of anesthetic agents based on age, weight, medical history, and planned procedure.
✔ Use of topical agents to ease needle discomfort—while acknowledging the risk of systemic absorption and methemoglobinemia.
✔ Calculating dosages conservatively—with amides reduced by 30% in infants under six months.
✔ Clear documentation: agent, dose, method, injection site, and post‑op advice.
✔ Awareness and management strategies for LAST (local anesthetic systemic toxicity), allergic reactions, nerve injury, and postoperative self‑inflicted trauma.
👉 Dentists worldwide are encouraged to consult the full guideline to explore in‑depth recommendations on agent selection, needle technique, alternative delivery methods (e.g., PDL injections, computer‑controlled systems), integration with sedation or general anesthesia, and safety considerations for special populations—including pregnant patients and children with complex medical needs.
For a thorough, expertly curated review of best practices—backed by up‑to‑date research—download and read the complete PDF.
Dear colleagues in pediatric dentistry, deepen your expertise and elevate patient care by exploring the full article in PDF.
