CC BY-NC-ND 4.0 · European Journal of General Dentistry 2014; 3(02): 105-108
DOI: 10.4103/2278-9626.134832
Original Article

A survey to access knowledge and practice among dentists regarding local anesthetic dosage in three cities of Uttarakhand

Laxman Singh Kaira
Department of Dentistry, Veer Chandra Singh Garhwali Government Medical Sciences and Research Institute, Srinagar, Pauri Garhwal, Uttarakhand, India
Esha Dabral
1   Private Practionner, Srinagar Garhwal, Uttarakhand, India
› Author Affiliations


Objective: Local anesthetics are the most commonly used drugs in routine dentistry. Although they are considered effective and safe in controlling pain during dental procedures, complications related to their use appear inevitable. Many dentists use these drugs routinely but are unaware of the dose calculations required and the maximum safe and effective dose of the drug. Materials and Methods: This study was aimed to determine the knowledge that general dental practitioners and dental specialists, in three different cities in India, have regarding dose calculations and the maximum-dose required of the most commonly used local anesthetics. A one page survey questionnaire was used in this study and data were analyzed using standard SPSS statistical program version 11, software (SPSS Inc. Chicago, Illinois, USA). Results: The respondents comprised 71.4% general dental practitioners and 28.5% dental specialists, with ages ranging from 26 to 50 years; Nearly 75% of the total respondent was males and 25% females. Nearly 69% of the respondents were unaware of the maximum recommended dose for use on adult, healthy patients and 81% were still confused about the maximum numbers of syringes containing 2% lignocaine with adrenaline that can be given to a patient. A total of 49% of general dental practitioners and specialists do not perform aspiration when injecting local anesthetics, whereas only 38% performed the aspiration in inferior nerve block technique, while only 12% performed aspiration in all types of injection techniques. A high percentage of the dentists (84%) who responded are unaware of how to calculate the local anesthetic dose and 31% of them encountered complications during, or after, local anesthetic administration. Conclusion: General practitioners and dental specialists appear to have an inadequate knowledge about local anesthetics maximum-dose and dose calculations; further educational courses are recommended to update them regarding such important aspects of dentistry.

Publication History

Article published online:
01 November 2021

© 2014. European Journal of General Dentistry. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (

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  • References

  • 1 Ayoub ST, Coleman AE. A review of local anesthetics. Gen Dent 1992;40:285-7, 289-90.
  • 2 Wahl MJ, Brown RS. Dentistry′s wonder drugs: Local anesthetics and vasoconstrictors. Gen Dent 2010;58:114-23.
  • 3 Becker DE, Reed KL. Local anesthetics: Review of pharmacological considerations. Anesth Prog 2012;59:90-101.
  • 4 Nakai Y, Milgrom P, Mancl L, Coldwell SE, Domoto PK, Ramsay DS. Effectiveness of local anesthesia in pediatric dental practice. J Am Dent Assoc 2000;131:1699-705.
  • 5 Blanton PL, Jeske AH. Misconceptions involving dental local anesthesia. Part 1: Anatomy. Tex Dent J 2002;119:296-300, 302-4, 306-7.
  • 6 Jeske AH, Blanton PL. Misconceptions involving dental local anesthesia. Part 2: Pharmacology. Tex Dent J 2002;119:310-4.
  • 7 Malamed S. Handbook of Local Anesthesia. 6 th ed. Elseveir, Mosby; 2012.
  • 8 Liau FL, Kok SH, Lee JJ, Kuo RC, Hwang CR, Yang PJ, et al. Cardiovascular influence of dental anxiety during local anesthesia for tooth extraction. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008;105:16-26.
  • 9 Conrado VC, de Andrade J, de Angelis GA, de Andrade AC, Timerman L, Andrade MM, et al. Cardiovascular effects of local anesthesia with vasoconstrictor during dental extraction in coronary patients. Arq Bras Cardiol 2007;88:507-13.
  • 10 Rishiraj B, Epstein JB, Fine D, Nabi S, Wade NK. Permanent vision loss in one eye following administration of local anesthesia for a dental extraction. Int J Oral Maxillofac Surg 2005;34:220-3.
  • 11 Sapir S, Shapira Y, Amir E. Emergencies evolving from local anesthesia in the pediatric dental clinic: Prevention and treatment. Refuat Hapeh Vehashinayim 2003;20:28-34, 87.
  • 12 Brown RS, Paluvoi S, Choksi S, Burgess CM, Reece ER. Evaluating a dental patient for local anesthesia allergy. Compend Contin Educ Dent 2002;23:125-8, 131.
  • 13 American Academy on Pediatric Dentistry Council on Clinical Affairs. Guideline on appropriate use of local anesthesia for pediatric dental patients. Pediatr Dent 2008;30:134-9.
  • 14 Lipp M, Dick W, Daubländer M, Fuder H, Stanton-Hicks M. Exogenous and endogenous plasma levels of epinephrine during dental treatment under local anesthesia. Reg Anesth 1993;18:6-12.
  • 15 Mochizuki M, Yokota S, Murata Y, Watanabe H, Nishibori M, Suzuki N, et al. Changes in heart rate and blood pressure during dental procedures with local anesthesia. Anesth Prog 1989;36:234-5.
  • 16 Moore PA, Hersh EV, Boynes SG. Preface update of dental local anesthesia. Dent Clin North Am 2010;54:xiii-xiv.
  • 17 Meyer FU. Complications of local dental anesthesia and anatomical causes. Ann Anat 1999;181:105-6.