Challenges in achieving profound local anesthesia: Insights from a patient survey.

BACKGROUND: Local anesthesia is fundamental for dental procedures, yet some patients report difficulty becoming fully anesthetized. There is little understanding of why this occurs in a segment of the population. METHODS: Patients self-reporting to be difficult to anesthetize on their dental history intake forms were invited to participate in a 16-item electronic survey. The questionnaire included items on demographic characteristics, dental history, and anxiety about dental scenarios as measured by the Modified Dental Anxiety Scale. Descriptive statistics and bivariate analyses were conducted. RESULTS: A total of 81 participants completed the survey (73.7% were female and 14.8% had natural red hair). A total of 27.1% of participants indicated always experiencing difficulty becoming fully numb. Red-haired participants were significantly more likely to report this issue than participants with other hair colors (50.0% vs 23.2%; P = .028). A total of 32.1% of participants were classified as highly dentally anxious (Modified Dental Anxiety Scale score >/= 19). CONCLUSIONS: The study results reaffirmed associations between being female, having red hair, or having high dental anxiety in a cohort of patients who reported local anesthesia challenges in dentistry. PRACTICAL IMPLICATIONS: This study identified new insights related to the commonly reported patient concern of difficulty achieving local anesthesia. The relative influence of genetic, physiological, psychological, and dental care practitioner-based variables on the outcomes of pain management requires further study.