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The Fundamentals of Pain Control in Today's Dental Practice: Local Anesthesia (AGD 340)

Presenter: Natalie Kaweckyj, LDA, RF, CDA, CDPMA, COA, COMSA, CPFDA, CRFDAA, MADAA, BA


Pain control is the cornerstone of modern dental practice, with patients demanding better and more painless dental procedures through various anesthesia techniques. Local anesthesia was introduced to the dental profession in 1884 and today’s options for anesthetizing specific sites in the mouth have become more varied, with dental professionals having many more options to ensure the comfort and safety of their patients during any dental procedure. Most of today’s local anesthetics employ a cartridge, needle and syringe. The syringe is reusable, while the cartridge and needle are single use and disposable. Because an estimated 300 million anesthetic cartridges are used each year, it is critical to have a broad knowledge of the wide variety of products available, correct techniques for using them, and how to manage reactions or emergency situations, should they arise.

Allied dental staff plays an important role in assuring the comfort and safety of dental patients before, during and after administration of local anesthesia to patients within a dental practice. This course is intended to provide dental professionals with basic knowledge on local anesthesia used in practice today.


Margaret I. Scarlett, DMD
, is an accomplished clinician, scientist, and lecturer who retired from the Centers for Disease Control and Prevention after 23 years of federal service. She is a past author and editor of several dental publications, and a past president of the American Association of Women Dentists. As an innovator, including writing the very first 1986 CDC infection control guidelines for dental health-care workers, she continues to explore new and better ways to deliver prevention, care and treatment of the oral cavity. She consults on intraoral health and primary care and is a leading dental expert in infectious and chronic diseases and systemic-oral health issues.

This course has fully been updated and revised and published under a new name by:
Natalie Kaweckyj, LDA, RF, CDA, CDPMA, COA, COMSA, CPFDA, CRFDA, MADAA, BA – began her dental assisting career over 25 years ago after graduating from the CODA accredited program at ConCorde Career Institute. She spent twelve years working in a private practice where she worked clinically nine years and administratively the remaining three. She then moved onto teaching dental assisting and eventually became director of that program. Over lapping with teaching, Natalie began her tenure with Children’s Dental Services in 2007 in management and currently serves as clinical coordinator responsible for the day to day operations at over 600 locations where services are provided throughout Minnesota. Natalie enjoys the challenges of the public health sector and is gratified in serving those that are underserved, especially in a hospital setting under general anesthesia. With over a decade of restorative functions experience under her belt, she enjoys working with professionals new to dentistry as her love for teaching comes into play with the utilization of clinicians to the full scope of their licenses. The clinic keeps Natalie busy with billing management when not at the hospital. Natalie also graduated with a BA in Biology and Psychology from Metropolitan State University in 2005.

Ms. Kaweckyj served two terms as ADAA President (2017-2018; 2010-2011). She remains active on several councils, and serves as a President of the Professional Dental Assistants Educational Foundation (PDAEF). She served as a three-term president for MnDAA and remains as the state business secretary. Natalie has been recognized with several ADAA awards, was one of the first ADAA Fellows in 1999 and became the first ADAA Master in 2004. She has published numerous continuing education courses, over 200 articles and lectures on a variety of dental subjects locally, nationally and internationally. Organized dentistry gave Natalie the insight that you can make a difference as a dental professional, and she was instrumental in seeing licensure for dental assistants come to fruition in MN in 2009 as well as several expanded functions. Her dream would be to see mandatory credentialing become a reality in all states for protection of the public and maintaining integrity of the dental assisting profession.


Upon completion of this course, the dental professional should be able to:

• Briefly describe the historical background of local anesthesia for use in dental procedures.
• Prepare the setup for and apply, or assist with the application of, topical anesthetic, including appropriate placement for various injections.
• Describe the various local anesthetic agents and their uses.
• Identify the appropriate uses for a vasoconstrictor, and describe safety precautions when using a vasoconstrictor.
• Identify the various types of injections used for local anesthesia in dentistry.
• Describe the safety precautions and storage for local anesthetic cartridges.
• Correctly assemble an aspirating syringe with the appropriate needle (depending on the type and location of injection to be given) and anesthetic cartridge (depending on the procedure, and patient requirements).
• Identify the possible complications with the various anesthetic techniques.
• Discuss the differences between topical, local, jet-injection, and computer-controlled anesthetic techniques.
• Differentiate the anatomy of the oral cavity and the methods for administering local anesthesia.
• Summarize the importance of a patient's medical history and the need for updating regularly.
• Discuss the importance of recognizing medical complications and managing emergencies.
• List the different types of anesthetics and their usage.
• Describe the ideal characteristics of a local anesthetic.
• Discuss the regulatory issues as they apply to local anesthesia.
• Explain the disposal protocol necessary for used and unused anesthetic carpules.


The ADAA has an obligation to disseminate knowledge in the field of dentistry.  Sponsorship of a continuing education program by the ADAA does not necessarily imply endorsement of a particular philosophy, product or technique.

The ADAA cautions participants taking this course on the hazards of using limited knowledge when integrating new techniques into their practices.

Credits earned upon completion of the course may be used to meet DANB’s Recertification Requirements.


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