Section 1: Survey Response Overview
Chart 1 — Respondent Demographics. The survey captured 678 total respondents: 576 pediatric dentists (85.0%), 78 dental anesthesiologists (11.5%), and 24 other specialties (3.5%). Surveys were distributed via the AAPD and ASDA listservs.
Section 2: Key Comparisons Between PDs and DAs
Chart 2 — Frequency of LA Use During GA. PDs (n=551) and DAs (n=76). PDs are spread across all frequency categories, with "Sometimes (10-50%)" being the most common response (34.1%). Among DAs, "Often (51-90%)" was most common (25.0%) and "Always" was second (21.1%). 12.9% of PDs reported never using LA during GA vs. 17.1% of DAs.
Chart 3 — Primary Reason for Using LA During GA. PDs (n=419) and DAs (n=53). Both groups cite postoperative pain control as the top reason (58.2% PDs, 56.6% DAs). PDs prioritize hemostasis as the second reason (22.9%) while DAs emphasize decreasing systemic analgesic needs (11.3%).
Chart 4 — Does LA Significantly Reduce Postoperative Pain? PDs (n=485) and DAs (n=66). DAs are more confident in LA's pain reduction benefit (54.5% "Yes") compared to PDs (41.2%). PDs show more uncertainty (22.7% "Unsure") than DAs (7.6%), and more PDs believe LA does not reduce pain (24.3% vs. 9.1%).
Chart 5 — Should LA Be Routinely Used During Pediatric Dental GA? PDs (n=422) and DAs (n=64). A key divergence: 39.1% of PDs say "No" compared to only 21.9% of DAs. DAs are more likely to say "Yes" (35.9% vs. 23.0% for PDs). Both groups had respondents favoring a case-by-case approach ("It depends": 14.9% PDs, 32.8% DAs).
Chart 6 — Does LA Affect Postoperative Recovery Time? PDs (n=422) and DAs (n=64). Both groups largely agree that LA does not affect recovery time (61.8% PDs, 67.2% DAs). PDs show more uncertainty (19.4% "Unsure") compared to DAs (10.9%). DAs were more likely to believe LA does affect recovery (21.9% vs. 18.7%).
Section 3: Pediatric Dentist Practice Patterns
Chart 7 — Concern About Post-Op Soft Tissue Trauma (PDs Only). n=456. 85.1% of pediatric dentists express some level of concern about soft tissue injury from residual numbness (e.g., lip/cheek biting). 19.3% are very concerned, 29.8% moderately concerned, and 36.0% slightly concerned. Only 14.9% report no concern.
Chart 8 — How Often PDs Consult the Anesthesiologist About LA. n=456. While 44.3% of PDs always consult, 20.2% rarely do and 15.8% never consult at all. This represents a potential communication gap, given that the majority of DAs report that LA decisions affect their anesthesia plan (Chart 9).
Chart 9 — Injection Techniques Used During GA (PDs Only). n=449. Infiltration is overwhelmingly preferred (85.3%), with periodontal ligament injection a distant second (22.0%). Nerve blocks are used by only 16.3%, consistent with efforts to minimize widespread numbness and reduce soft tissue injury risk.
Chart 10 — Primary Reasons for NOT Using LA During GA (PDs Only). n=445. Concern about soft tissue injury is the dominant barrier (67.9%), followed by the belief that LA provides no additional benefit under GA (43.6%). Prolonged recovery/confusion postoperatively and anesthesiologist recommendation are also cited.
Section 4: Dental Anesthesiologist Perspectives
Chart 11 — Does LA Affect the Anesthesia Plan? (DAs Only). n=64. 84.4% of dental anesthesiologists report that the dentist's use of LA affects their anesthesia plan to some degree: 23.4% significantly, 25.0% moderately, and 35.9% minimally. Only 15.6% say it has no effect. This suggests that when PDs skip LA, the anesthesiologist may need to compensate with deeper sedation or more systemic pain medication.
Section 5: Pain Management and Recovery
Chart 12 — Pain Management When LA Is Not Used. n=499. When LA is not administered, the most common alternative involves IV analgesics during the case (67.1%), followed by oral analgesics post-operatively (72.1%). A majority (43.7%) use a combination of both IV analgesics during the case and oral analgesics afterward. Non-pharmacologic techniques alone are rare (5.4%).