Articaine use in children: A review

Background: Lidocaine has been considered the gold standard for local analgesia agents in dentistry for years. Articaine is now widely used but there has been a reluctance to use it in children. Review: Compared with lidocaine, articaine is 1.5 times as potent and only 0.6 times as toxic and has been shown to be superior in achieving successful anaesthesia following infiltration. The use of inferior alveolar nerve blocks (IANB) can be almost eliminated in children by using articaine due to its ability to effectively anaesthetise teeth up to the first permanent molar region. In addition, diffusion of the anaesthetic agent onto the palatal surface may also eliminate the discomfort of palatal infiltration. Soft tissue analgesia may be prolonged, but the risk of other adverse reactions is similar to other local anaesthetic agents. Conclusion: The use of articaine achieves successful pain control while reducing the volume administered and is advocated as a safe and effective alternative to lidocaine for use in children.