Local Anesthetic Guidelines for Pediatric Dentistry

I. Maximum Safe Dosage 2mg./lb. Or 4mg/kg

• Example: 30lb. Child: max dosage = 60 mg

II. 2% Xylocaine is supplied in 1.8 cc cartridges

• 2% x 1.80 gives 36 mg/cartridge
• for a 30 lb. Child maximum dose is 60 mg or is approximately 1 ½ to 1 ¾ cartridges (54-63 mg)

III. Use topical

• must be on non-keratinized site for minimum of 1 minutes

IV. Know anatomy

• e.g. inferior alveolar nerve block results in:

  a. ipsilateral lower lip numbness (test for effectiveness of block)
  b. ipsilateral gingival numbness anterior (mesial) to mental foromen
  c. ipsilateral tongue numbness is not a good test for a dental anesthesia (may have only blocked lingual n. branch)

• If rubber dam clamp impinges on gingival, buccal infiltration is required.