Assessing the duration of mandibular soft tissue anesthesia

Dentists often employ solutions of 3 percent mepivacaine or 4 percent prilocaine without a vasoconstrictor in pediatric patients in an attempt to reduce the duration of mandibular soft tissue anesthesia. The authors compared the time course of soft tissue anesthesia produced by these solutions with that of 2 percent lidocaine plus 1:100,000 epinephrine in 60 adults. They found no reduction in the duration of soft tissue anesthesia when employing 3 percent mepivacaine or 4 percent prilocaine instead of 2 percent lido-epi. Combining these observations with local anesthetic dosage considerations, the authors recommend that 2 percent lido-epi be used when performing mandibular block injections in young children.