Local anesthesia reversal— A review

Abstract

Local anesthetic agents are widely used in dentistry. It has major role in all field of dentistry especially in oral surgery, Pediatrics, Endodontics, Periodontics etc. The only drawback associated with LA is that occurrence of soft tissue anaesthesia can persist for three to five hours, while the procedure itself usually lasts for less than an hour. Patients experience limitation of function in terms of speech difficulty, drinking neating etc. All these events leave negative impact on minds of patients; hence they avoid visiting dental offices. In order to reverse these events, a new drug named OraVerse (phentolamine mesylate) is available to us. This drug is known for its LA reversal ability and effects of local dental anaesthetic.

Comparative evaluation of photobiomodulation therapy at 660 and 810 nm wavelengths on the soft tissue local anesthesia reversal in pediatric dentistry: an in-vivo study

“…This is one of the reasons why pediatric patients resist dental visits. In 13% of children, prolonged local soft tissue anesthesia results in soft tissue injuries [ 2 ]. These inflicted soft tissue injuries in children have a negative impact on the child’s and parents’ further compliance with dental practitioners.…”

“…Phentolamine mesylate is a pharmacological protagonist for local anesthesia reversal and has shown positive results in various studies conducted for the analysis [ 2 ]. Some of these studies were conducted on pediatric patients [ 15 18 ].…”

“…Since the 19th century, local anesthetic (LA) solutions have been the first-hand approach in dentistry to alleviate pain during different clinical procedures and are thus used routinely [ 1 2 ]. As the first and foremost requirement to start any type of dental procedure is to alleviate the associated pain, LA agents are extensively used in dentistry [ 2 ].…”

Enhanced Recovery of Local Anesthesia in Pediatric Patients: The Impact of Photobiomodulation on Reversing Anesthesia Effects

“…Patients experience limitation of function in terms of speech difficulty, drinking, and eating. However, children can misinterpret altered sensation due to lack of normal proprioceptive feedback [ 9 ]. When long-acting local anesthetics are used, this uncomfortable altered sensation can lead to painful self-harm [ 6 , 10 ], such as biting the lips associated with the strange, new, and rare sensation of numbness or in the absence of pain sensation during repeated unintentional biting.…”

“…When long-acting local anesthetics are used, this uncomfortable altered sensation can lead to painful self-harm [ 6 , 10 ], such as biting the lips associated with the strange, new, and rare sensation of numbness or in the absence of pain sensation during repeated unintentional biting. When the anesthetic sensation is reverted to normal, painful wounds can appear, often linked with the adverse effect of the injection itself, not with a child’s self-harm activity [ 8 , 9 ]. Thus, children who have challenging behavior and those with attention deficit hyperactivity disorder (ADHD) are at higher risk of self-injury, especially when undergoing the dental procedure under sedation [ 11 ].…”