Educational and Clinical Experiences in Administering Local Anesthesia: a study of dental and dental hygiene students in California.

The purpose of this study was to examine the differences in educational preparation and practical educational experiences between dental and dental hygiene students in the administration of local anesthesia (LA) and management of LA related complications in the state of California. Course instructors responsible for teaching LA or the program directors of the 6 dental schools and 29 dental hygiene programs in California (n=35) were invited to participate in this study. A computer-based descriptive survey, a comparative checklist of LA instruction requirements and semi-structured interviews were used for the data collection. Descriptive statistics were used to analyze results. Eighteen LA course instructors or program directors participated in the study for a response rate of 51%. One respondent was from a dental school while 17 were from dental hygiene programs. The majority of the dental hygiene (n=16) respondents reported teaching 12 types of intraoral injections; the dental school respondent reported teaching seven injection types. Fewer student-to-student injection experiences per injection type were required by the dental school (n=7) than the dental hygiene schools (n=12) and the dental school did not indicate a minimum number of student-to-patient injection requirements for graduation. Analysis of a checklist of required elements of LA instruction and individual syllabi revealed common elements of all courses; students are expected to choose the proper local anesthetic, identify the proper injection type, and manage any LA complications. The majority of the interview participants perceived that dental hygiene students had more educational preparation in LA than their dental student cohorts and that dental hygienists were educationally prepared to administer LA safely without direct supervision. Dental hygiene students in California programs appear to be well prepared through their education experiences to administer and manage complications related to local anesthesia. Consideration should be given to supporting changing the supervision requirements for the administration of local anesthesia by dental hygienists licensed in the state of California.