An important aspect of providing painless endodontic treatment is the ability to provide profound pulpal anesthesia. With the time demands of practice, there is always an urgency to get procedures done quickly. However, providing profound, predictable pulpal anesthesia requires appropriate scheduling. I allow 15 minutes for anesthesia prior to accessing cases. I chose this time initially because it seemed to work. However there is research to support this concept. First, a slower speed of injection has been reported to provide increased comfort and higher success in achieving pulpal anesthesia; (60 seconds vs. 15 seconds). Second, it has been shown that pulpal anesthesia can take as long as 15 minutes. In my practice, I allow 15 minutes for anesthesia. This can seem like a long time, but patients only remember if they had pain during the procedure. So, I think this is time well spent! Additionally, efficient current techniques like XP-3D shaper, XP-3D finisher, and bioceramic obturation, easily compensate for this lost time. It does take discipline to wait 15 minutes prior to starting your endodontic treatment, but in the long run I think it provides for very predictable outcomes.
Considerations for use of local anesthesia
