Pharmacology · single question
What is the BEST local anesthetic for children in dentistry?
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Correct answer: A. Lidocaine with vasoconstrictor (amide with epinephrine)
The best local anesthetic for children is an AMIDE anesthetic (lidocaine) WITH vasoconstrictor (epinephrine). The vasoconstrictor: (1) slows systemic absorption, reducing toxicity risk; (2) prolongs duration of action; (3) reduces total dose needed. Esters (benzocaine, procaine) are generally avoided for injections due to higher allergy risk and shorter duration. Bupivacaine is avoided in children due to risk of self-inflicted soft tissue injury (long duration) and cardiac toxicity concerns.
- A. CORRECT. Lidocaine (2%) with epinephrine is the gold-standard local anesthetic for pediatric dental procedures — the vasoconstrictor reduces systemic absorption and prolongs anesthesia.
- B. Incorrect. Lidocaine without vasoconstrictor has a shorter duration and allows faster systemic absorption, increasing toxicity risk — less ideal for children.
- C. Incorrect. Articaine is FDA Category C in pregnancy, and while used in children, it is not the established 'best' answer — lidocaine with epi is preferred.
- D. Incorrect. Bupivacaine's prolonged anesthesia in children risks self-inflicted lip/tongue injury (biting) and has greater cardiac toxicity potential — it is NOT recommended for children.