J Am Dent Assoc. 2023 Dec;154(12):1058-1066.e4. doi: 10.1016/j.adaj.2023.08.005. Epub 2023 Oct 1.
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.
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.
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).
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.
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.
局部麻醉是牙科的重要组成部分,但对于执业牙医使用的技术和局部麻醉解决方案,人们的理解有限且难以量化。在牙科中,关于其功效和感觉异常风险,人们对使用阿替卡因的看法存在很大争议。本研究的目的是通过一项大规模调查,扩大对美国牙医局部麻醉实践的了解,并特别关注与阿替卡因使用相关的潜在影响因素。
这项 23 项的调查被发送给美国 10340 名执业牙医,收集人口统计学数据和局部麻醉方法以及关注问题。统计分析包括描述性、双变量和多变量逻辑回归分析。
共有 1128 名牙医完成了调查。97.6%的受访者表示有使用阿替卡因的经验,其中 3.3%的受访者不再使用阿替卡因。60%的受访者表示他们在进行大多数局部麻醉注射时使用阿替卡因。多变量回归分析发现,那些报告在所有涉及血管收缩剂的局部麻醉注射中都使用阿替卡因的医生更有可能是男性(比值比,1.59;P =.002)或全科牙医(比值比,1.63;P <.001)。
阿替卡因对从业者有明显的好处,因为大多数受访者表示将阿替卡因作为他们的主要局部麻醉剂。从业者的性别和类型被发现会影响阿替卡因的使用模式。
收集基于证据的局部麻醉实践将有助于确保美国从业者以最安全和最有效的方式更标准化地管理局部麻醉剂,特别是阿替卡因。