Local Anesthesia: Section 7 Future of Pain Control


AGD Member:  $49.00

Student Member: $37.50

Speaker:  Stanley F. Malamed, DDS

Non-Member:  $70.00

Credit Hours:  1

Subject Code: 340 – Anesthesia and Pain Management

*AGD Member discount applied at checkout.

SKU: 925 Category:


Course Abstract

Though local anesthetics are safe and effective, considerable research is on-going to make them even more effective. Computer-controlled local anesthetic delivery systems (C-CLAD) and buffered local anesthetic solutions promise to allow painless injections to be delivered to dental patients almost anywhere in the oral cavity. Fear of injections is primarily based on the needle. The development of an intranasal local anesthetic mist has been shown to provide successful pulpal anesthesia of maxillary teeth – without a needle. Epinephrine is added to injectable local anesthetics to increase their effectiveness, duration and safety. However the duration of residual soft tissue anesthesia – usually unnecessary and occasionally a potential danger – is extended when epinephrine is used in the anesthetic solution. Self-inflicted soft tissue injury is a real problem associated with this anesthesia in all patient age groups but especially pediatric and geriatric patients. Phentolamine mesylate – an alpha adrenergic antagonist – has been shown to significantly reduce the duration of residual soft tissue anesthesia when administered at the conclusion of the traumatic part of dental treatment.

 Course Description:

This program looks at recent developments seeking to increase the safety, efficacy and comfort of injectable local anesthetics. It reviews buffered local anesthetics (the local anesthetic “ON” switch; phentolamine mesylate – the local anesthetic ‘OFF” switch; computer-controlled local anesthetic delivery and the use of an intranasal local anesthetic mist to provide pain control in maxillary teeth. 

  Learning Objectives:

  1. Discuss the current research on intranasal local anesthesia in dentistry
  2. Describe the effect of pH on the onset, depth & comfort of anesthesia with local anesthetics
  3. Describe the mechanism of action of the buffering agent sodium bicarbonate on local anesthetics
  4. List the benefits of local anesthetic buffering in dentistry
  5. Discuss the local anesthetic reversal agent – phentolamine mesylate
  6. Describe the advantages & disadvantages of Computer-Controlled Local Anesthetic Delivery (C-CLAD)
  7. Describe the clinical effects of the intranasal local anesthetic mist



Doctor Malamed, a dentist anesthesiologist, graduated from the New York University College of Dentistry in 1969 and then completed a residency in anesthesiology at Montefiore Hospital and Medical Center in the Bronx, New York before serving for 2 years in the U.S. Army Dental Corps at Ft. Knox, Kentucky. In 1973, he joined the faculty of the University of Southern California School of Dentistry (now the Herman Ostrow School of Dentistry of U.S.C), in Los Angeles, retiring from full-time teaching in 2013. Dr. Malamed is an Emeritus Professor of Dentistry Herman Ostrow School of Dentistry of U.S.C.

Dr. Malamed is a Diplomate of the American Dental Board of Anesthesiology, as well as a recipient of the Heidebrink Award [1996] from the American Dental Society of Anesthesiology and the Horace Wells Award from the International Federation of Dental Anesthesia Societies, 1997 (IFDAS).

Doctor Malamed has authored more than 160 scientific papers and 17 chapters in various medical and dental journals and textbooks in the areas of physical evaluation, emergency medicine, local anesthesia, sedation and general anesthesia.

In addition, Dr. Malamed is the author of three widely used textbooks, published by CV Mosby: Handbook of Medical Emergencies in the Dental Office (7th edition 2015); Handbook of Local Anesthesia (6th edition 2012); and Sedation – a guide to patient management (6th edition 2017) and two interactive DVD’s: Emergency Medicine (2nd edition, 2008) and Malamed’s Local Anesthetic Technique DVD (2004) (edition 2 – 2012)

In his spare time, Doctor Malamed is an avid runner, exercise enthusiast, and admits an addiction to the New York Times crossword puzzle, which he has done daily since his freshman year in dental school



Additional information

Expiration Date

October 23, 2021


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