Preclinical Local Anesthesia Education in Dental Schools: A Systematic Review

Abstract

The aim of this systematic review was to evaluate the published literature on current educational techniques used to teach local anesthesia administration in U.S. dental schools to determine the methods by which potential complications may be minimized and efficacy maximized. A PubMed search was performed in June 2017 on the following terms: (local anesthesia, education, dental) AND (Humans[Mesh]). Out of 136 articles identified, 13 met the study criteria and were included for review. Of those, the nine with outcome measures were included in the qualitative synthesis. With a quality assessment tool designed for this study, the quality of each included article was assessed independently by three of the authors. Three main pedagogies were identified: didactic instruction based on textbooks and lectures, student‐to‐student injections, and use of anatomic models. However, the effects of these pedagogies on local anesthesia administration efficacy, patient satisfaction, and student confidence in administering local anesthesia were largely not assessed in these studies. Quality assessment of the reviewed articles yielded a mean score of 62% (range 44–83%) for the observational studies and a mean score of 56% (range 47–63%) for the interventional studies. Due to the heterogeneity of the studies assessed, no meta‐analysis could be performed. While the experimental and observational studies reviewed provided some insight into the efficacy of current educational techniques, they had numerous methodological inconsistencies. The inconsistency of the available evidence made it difficult to make fully informed curriculum recommendations based on the existing literature.

Evaluation of student‐to‐student local anaesthesia administration at the University of Barcelona: A cross‐sectional study

“…Universities around the world use different teaching and training models in order to allow the participants gain competency in LA administration . However, there is a wide variety of approaches to teaching LA, and learning how to carry out these techniques on humans can be challenging for the participants though they do facilitate the transition from the model to the patient …”

“…The vast majority of dental procedures require local anaesthesia (LA) in order to carry out painless treatments . The correct administration of local anaesthetics requires proper teaching and training programmes . There are a wide range of LA training methods such as practicing on laboratory models, cadaveric models or student‐to‐student practice .…”

“…The correct administration of local anaesthetics requires proper teaching and training programmes . There are a wide range of LA training methods such as practicing on laboratory models, cadaveric models or student‐to‐student practice . Despite this, it seems most students have a lack of self‐confidence when administering their first injection of LA…”

“…Anatomical laboratory models may be a useful tool when soft tissue and the mandibular bone are simulated. These models can also be equipped with sensors that give feedback when they match the target area . Practice on cadaveric models had been proposed but it is not usually done in the European universities due to ethical concerns and logistical problems .…”

Impact of immersion on the performance of haptic virtual reality for inferior alveolar nerve anesthesia training.

“…The procedure for the administration of anaesthesia to the inferior alveolar nerve is one of the most stressful in dental training (BRAND et al, 2010;KARY et al, 2018). In our previous work we developed an immersive VR simulator, named VIDA Odonto R 1 (TORI et al, 2016;TORI et al, 2018), for training the administration of anesthesia.…”