Prepared by Michael McCullough, Chair, Therapeutics Committee, Australian Dental Association

Dentists have traditionally been concerned about the potential risk of cardiac effects from the vasoconstrictor, either adrenaline or octapresin, in dental local anaesthetics. However, the evidence shows that there is minimal effect from either of these drugs in appropriate dosage. There is a much greater effect from effect from endogenous production of adrenaline if the dental procedure is painful.

Non-steroidal anti-inflammatory drugs are widely used for dental pain and dentists should be aware of the potential cardiac adverse effects, particularly with long-term use of these drugs. The concept of using these very effective drugs for the shortest time possible at the lowest effective dose is an excellent guiding principle for all patients. Concurrent use of other analgesics, as well as correct diagnosis and timely and effective provision of dental treatment, can go a long way in diminishing the long-term adverse effects of these drugs.