Survey investigation of articaine use in the United States

J Am Dent Assoc. 2023 Dec;154(12):1058-1066.e4. doi: 10.1016/j.adaj.2023.08.005. Epub 2023 Oct 1.

Abstract

Background: Local anesthesia is an essential component of dentistry, but there is limited quantifiable understanding of what techniques and local anesthetic solutions are used by practicing dentists. Use of the local anesthetic articaine has been highly debated in dentistry regarding its efficacy and risks for paresthesia. The aims of this study were to expand the knowledge of local anesthesia practices of dentists in the United States through a large-scale survey and associate potential influencing factors regarding articaine use specifically.

Methods: The 23-item survey was sent to 10,340 practicing dentists in the United States, gathering demographic data and local anesthesia approaches and concerns. Statistical analysis consisted of descriptive, bivariate, and multivariate logistic regression analyses.

Results: A total of 1,128 dentists completed the survey. Previous experience with articaine was reported by 97.6% of respondents, with 3.3% no longer using articaine. Sixty percent of respondents indicated using articaine for most local anesthetic injections administered. Multivariable regression analysis found those reporting to use articaine for all local anesthetic injections involving vasoconstrictors were more likely to be male (odds ratio, 1.59; P = .002) or general dentists (odds ratio, 1.63; P < .001).

Conclusions: Articaine has a perceived benefit to practitioners as most respondents reported using articaine as their primary local anesthetic. A practitioner's sex and type were found to affect the profile of use of articaine.

Practical implications: Assembling evidenced-based local anesthesia practices would be beneficial to ensure US practitioners are more standardized in administering local anesthetics, particularly articaine, in the safest and most efficacious way.

Keywords: Dental anesthesia; articaine; dentist practice patterns.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anesthesia, Dental* / methods
  • Anesthesia, Local / methods
  • Anesthetics, Local
  • Carticaine*
  • Double-Blind Method
  • Female
  • Humans
  • Lidocaine
  • Male
  • Surveys and Questionnaires
  • United States

Substances

  • Carticaine
  • Anesthetics, Local
  • Lidocaine