Local and Topical Anesthetics in Dentistry with Tom Viola, R.Ph., C.C.P. – On A Tale of Two Hygienists Podcast

For this bonus episode—powered by Crest+Oral B—we’re happy to invite back Tom Viola, R.Ph who appeared in another bonus episode earlier this January.

Tom Viola is a speaker, writer, consultant, and expert in the field of dental pharmacology. When it comes to the anesthetics that keep dental patients from feeling pain during even the most invasive procedures, Tom is THE go-to guy. From Benzocaine to Xylocaine to good old fashioned (if out of fashion) Novocaine, he has the word on dosage, acidity, and side-effects.

In this special episode, Tom discusses the wide variety of anesthetics used in dentistry, the simple tool you can use to prevent complications, and why everything changes the moment your patient is a child.


Interview starts: 1:50

– Tom explains why Novocaine fell out of use as a standard anesthetic in dentistry.

– A breakdown of some of the most commonly used topical anesthetics.

– How do you choose which anesthetic you use with each patient?

– The hazards of mixing anesthetics with acids.

– Which is the best topical compound?

– Figuring out which type of local anesthetic you should use for a given situation.

– Sulphur, sulfa and sulfite: don’t confuse the three, especially when it comes to allergic reactions.

– Why needle trauma can play as much of a role in paresthesia as anesthetic does.

– Basically everything we know about anesthetics changes when administering to children.

– What can go wrong when administering anesthesia and how can we prepare for it?


“We’re applying a highly acidic gel to the patient’s already inflamed and potentially infected mucosa. What kind of sadist would do that? Well it would be the entire profession of dentistry.”

“We can do a lot to allay that discomfort by just using a different topical if they’re truly feeling that benzocaine burn.”

“I believe patients get more epinephrine sitting in a traffic jam, waiting to get to the office than they get in the office.”

“If there was an anesthetic that dared to be different it would be Carbocaine.”


Tom’s homepage – https://www.tomviola.com/

Pharmacology Declassified – https://www.tomviola.com/welcome-to-the-pharmacology-declassified-blog/

Thank you to Crest+Oral B for providing sponsorship for this episodes CE credits!

THIS EPISODE COUNTS FOR CE! – but read the disclaimer below as it might not count for your state.

Go here to take the test and get your CE Credit! https://www.cezoom.com/taketest/?courseid=3705&testid=1315

Approved Pace Program Provider FAGD/MAGD Credit Approval Does Not Imply Acceptance By A State Or Provincial Board of Dentistry Or AGD Endorsement. 1/1/18- 12/31/19 Provider #373236

A Tale of Two Hygienists homepage – https://ataleoftwohygienists.com/

AToTH on Facebook – https://www.facebook.com/aTaleOfTwoHygienists/

AToTH on Instagram – https://www.instagram.com/ataleoftwohygienists

AToTH on LinkedIn – https://www.linkedin.com/company/atoth/?originalSubdomain=ca

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