Buffering Brilliance: Optimizing Anesthetic Performance

Credit Details
This electronically delivered self-instructional program is designated for 1 hour of ADA CERP and AGD PACE CE credit by Farran Media. AGD Code: 340.

The fee to view this course is $36. This cost includes the fee to take the exam and claim your CE credits.

Synopsis:
Local anesthesia is a cornerstone of modern dental and surgical practices, providing effective pain control for various procedures leading to improved treatment experiences and ultimately, better patient care. To improve stability and shelf-life, the pH range of commercially available cartridges of dental local anesthetic solutions containing a vasoconstrictor, such as epinephrine, is between 3-5. Acidic anesthetic solutions, however, can lead to delayed onset, injection pain, and inadequate depth of anesthesia especially for sensitive areas like the palate or inflamed tissues. Buffering local anesthetics with sodium bicarbonate to raise the pH of these solutions closer to physiological levels immediately before injection has become a proven method to enhance patient comfort and improve the onset and effectiveness of the anesthetic.

The first chairside device for buffering lidocaine in dental cartridges was approved by the FDA in 2010. With the introduction of commercially available chairside buffering devices, some clinicians started experimenting with hand-mixing alternatives using medical syringes and sodium bicarbonate vials to reduce costs. The first study on this approach, published in 2016, examined the 'remove and replace' method and compared buffered solutions prepared using the same ratio of local anesthetic to sodium bicarbonate as the commercially available chairside buffering devices. Three years later, a simpler chairside buffering method, called the 'direct injection technique,' reduced the complexities of earlier strategies by simply adding sodium bicarbonate directly into the local anesthetic cartridge. Other products now launched have further reduced the time and effort of chairside buffering.

This course examines the benefits of buffering dental cartridges of commercially available local anesthetic solutions with sodium bicarbonate immediately before injection to offer clinical benefits such as reduced injection pain, faster onset, and improved efficacy. These advantages enhance patient comfort and procedural efficiency, making buffered anesthetics a valuable option for both routine and more complex dental and surgical procedures.

Educational Objectives:
Upon completion of this course, you should be able to:

• Describe the pharmacology of current commercially available local anesthetics and some of the clinical challenges these drugs represent
• Understand the principles of buffering and how this can provide additional clinical benefits of current commercially available local anesthetics
• Discuss the role of a new one-step solution for buffering local dental anesthetics
• Recognize at least three clinical benefits of buffering current commercially available local anesthetics

Description of Speaker:
Dr. Mark Donaldson holds a baccalaureate degree from the University of British Columbia (UBC) and a Doctorate in clinical pharmacy from the University of Washington. He is currently the associate principal of clinical pharmacy for Vizient's Advisory Solutions in Whitefish, Montana. He serves as a clinical professor at the University of Montana's Department of Pharmacy and a clinical associate professor at OHSU's School of Dentistry, with affiliate faculty status at UBC. Donaldson has 28 years of experience delivering international lectures on dental pharmacology and therapeutics. He has published extensively and serves on the editorial board for the Journal of the American Dental Association. Additionally, he is board certified in healthcare management and has been recognized for his contributions, receiving the AGD's "Dr. Thaddeus V. Weclew Award" in 2016 and the Canadian Dental Association's "Special Friend of Canadian Dentistry Award" in 2019 for his exceptional support and service to the dental profession.

Disclosure:
At the time of release of this course, in the past 12 months, the speaker declares to have received remuneration by Vizient, Inc.

Legal Disclaimer:
The CE provider (Farran Media) uses reasonable care in selecting and providing content that is accurate. The CE provider, however, does not independently verify the content or materials. The CE provider does not represent that the instructional materials are error-free or that the content or materials are comprehensive. Any opinions expressed in the materials are those of the author of the materials and not the CE provider. Completing one or more continuing education courses does not provide sufficient information to qualify the participant as an expert in the field related to the course topic or in any specific technique or procedure. The instructional materials are intended to supplement, but are not a substitute for, the knowledge, expertise, skill and judgment of a trained health care professional.

Licensure:
Continuing education credits issued for completion of online CE courses may not apply toward license renewal in all licensing jurisdictions. It is the responsibility of each registrant to verify the CE requirements of his/her licensing or regulatory agency.

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Refund Policy
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CE Contact
For any questions, please contact Nareg Apelian, DMD, Director of Continuing Education at nareg@farranmedia.com