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Choosing local anesthetic

I have always used either Carbocaine or Lidocaine w/ epi when doing srp. I am now in a new office and the dr does not purchase Lidocaine. She insists on using Articaine 1:200,000. I was under the impression that this presents a higher risk for parasthesia when doing IANB. Which should I be using for IANB given my choices, 3% Carbocaine or 4% Articaine w/ epi 1:200,00?

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1 Answer

Excellent question! Many people are under the impression that Articaine has a higher risk of paresthesia when performing an IANB, however research shows this isn’t the case. If anything, the actual injection has higher risk for paresthesia than does the anesthetic. Here is a link with great information on the research on this topic: http://www.oralhealthgroup.com/features/articaine-and-paresthesia-in-dental-anaesthesia-neurotoxicity-or-procedural-trauma/
Personally, I would use an anesthetic with epi to control bleeding and for obtaining profound anesthesia. However, if you find your patients do just fine with Carbocaine/Mepivicaine without epi, then by all means use it. Overall, do what you feel most comfortable with!

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