OCTOBER 2015

How Buffered Anesthetic is Revolutionizing Dentistry Buffering local anesthetics is an age-old science widely used throughout the medical community that has not been readily available in dentistry until now. In the following pages, we will explore how buffering equally benefits both the patient and the practitioner.

Flaws with Anesthetic Until Now For over a century, clinicians have gone to mind-numbing lengths to identify a way in which to anesthetize their patients. Prior to 1884, it was not uncommon for the local barber to give a child a shot of whiskey before pulling teeth. In 1884, none other than Sigmund Freud said, “A medical breakthrough just four days old opens the eyes of ophthalmologists at a medical convention—cocaine works as a local anesthetic.” Freud’s eccentric perspective on the drug led surgeon Carl Koller to the realization that cocaine could block pain and numb tissue. As you might imagine, it did not take long before the destructive and addicting properties of cocaine were discovered. So, in 1905 Alfred Einhorn synthesized procaine, which he then patented under the name Novoain (generically

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novocaine). In the half century following, novocaine became the primary local anesthetic. Due to shortcomings of novocaine, Nils Löfgren, a Swedish chemist, developed xylocaine in 1943. Xylocaine, more commonly referred to as lidocaine, is still widely used today in both the medical and dental community. Due to lidocaine’s low pH, it can take a while to numb the patient and could cause some burning sensation in the process. To neutralize the acid, healthcare professionals started to add sodium bicarbonate (a neutral solution) to the lidocaine nearly half a century ago. This process is referred to as buffering. Buffered anesthetics get the patients numb extremely fast, are more reliable, and reduce the patient’s pain.

Statistics from Contemporary Product Solutions Study on Anutra Local Anesthetic Delivery System:

Average 1.81 comfort On pain scale of 1-10, 1 being no pain and

92

%

2/3

of appointments were shorter

of practitioners used

than scheduled as a result of

the CO2 Microbubble

an average of 1.81 level of comfort–

using Anutra

as topical

virtually no pain

Average of

10 being extreme pain; Patients reported

of patients reached pulpal

64

%

More than

anesthesia in 3

minutes

16.7 minutes saved per case with Anutra

Science of Buffering The science of buffering has been leveraged for decades in the medical community. Buffering is simply a chemical process that neutralizes acids and bases. Lidocaine with epinephrine is the most commonly used local anesthetic by healthcare professionals. In order for lidocaine to be stabilized to ship, hydrochloric acid is added. It is this high level of acid that causes the significant burning sensation when injected. By adding sodium bicarbonate to lidocaine with epinephrine, thus buffering the solution, a clinician is able to reduce the amount of acidity found in lidocaine. The result of buffering lidocaine can increase a clinician’s efficiency while simultaneously reducing patient pain.

Though the science of buffering is age-old, the application in dentistry is more recent. Due to the antiquated metal syringes and limiting 1.7 mL or 1.8 mL cartridges used in dentistry, it has been next to impossible to leverage the science of buffering effectively or efficiently. One of the other difficulties is that sodium bicarbonate is a very sensitive drug and cannot be exposed to air for risk of losing efficacy and the potential for bacteria to grow. All of these things have been limiting factors, until this point, for buffered anesthetics to be widely utilized in dentistry. With recent innovations including a disposable, multi-dose, aspiration syringe as well as a new intricately engineered mixing dispenser, buffering is more accessible to dentists than ever before.

Though the science of buffering is age-old, the application in dentistry has been more recent.

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Why Practitioners Love Buffering Efficiency and Predictability

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Dr. Lisa Mayes, Preston Dental Center

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only does the Anutra Local Anesthetic Delivery System increase efficiency, it also allows practitioners to never leave their patients’ side and go to work immediately. “As a sedation dentist it is critical for me to not leave my patients side, as most of my patients are dental phobic.”

When Anutra entered the market, we finally had a solution for buffering that is cost effective and much easier to use in the practice. Dr. Ed Suh, Supremia Dentistry

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I anesthetize every patient with Anutra, and I go to work in two minutes. My team loves me because I stay on time and my patients got out on time. It's wonderful.

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Practitioners love buffering because it creates efficient and predictable appointments for them and their patients. Dr. Daniel Davidian, Founder of Anutra, stated, “As a practitioner who has dedicated his life to give painless injections, it allows me to exceed my patient’s expectations. Not only because of reduced pain, but the efficiency of the patient’s appointment as well.” Not

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Within two minutes, for a block, I had picked up my handpiece and started to work. As far as time savings, this is huge! I think this could revolutionize the way I practice dentistry. Dr. Anna Abernethy, Renaissance Dental Center

We had a patient come in, and from starting the prep to delivering the crown took and hour and a half, from start to finish. His crown was in his mouth when he left, so he didn’t have to come back again, and he was immediately numb and ready to go. It was flawless.

Nobody likes to sit alone in the chair in an operatory and wait through the stinging sensation as the anesthetic starts to work. With the Anutra Local Anesthetic Delivery System patients become numb in less than two minutes. By using the CO2 microbubble as a topical anesthetic, practitioners are putting a few drops on the mucosa, and proceed with the injection. Many patients claim they don’t even feel the needle go in. Acclaimed dentist, Dr. Jack Griffin of Eureka Smile Center said, “The numbness occurs quicker than they expect and they are more numb than with unbuffered anesthetic.” Not only does buffering reduce patient pain, but it allows them to feel more comfortable as they are being worked on.

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Why Patients Love Buffering

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Devon McCleery CDA, CDD

Once I heard about Anutra I said, ‘Okay, Im sitting in the chair and I want you to inject me.’ On a scale of 1-10, 1 being the best experience I've ever had, and 10 being the worst it was about a 0.2. I couldn't tell when it began and when it had ended. Bob Spiel MBA, Spiel Consulting

Anutra Local Anesthetic Delivery System With the Anutra Local Anesthetic Delivery System, buffering local anesthetics is as simple as twisting a knob. With Anutra you can get the exact amount of local anesthetic you need, no more, no less. The intricately engineered system is designed for precision buffering of the local anesthetic. No more carpules. No more waste. No more inefficiency. The immense attention to detail in the creation of the cassette allows for preservation of the drugs attached to the cassette giving it up to a four-day shelf life. This is four times the usable shelf life of other buffering alternatives.

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Anutra is intricately designed for precision buffering of the local anesthetic to be delivered in a simple way. No more carpules. No more waste. No more inefficiency.

The Anutra Feedback Aspiration Syringe As if the Anutra Local Anesthetic Delivery System wasn’t revolutionary enough, the Anutra Feedback Aspiration Syringe® is the first known FDA approved one handed, multi-dose, disposable aspiration syringe designed by dentists for dentists. This allows practitioners to draw up to 5 mL’s of buffered or un buffered anesthetic in a single syringe. The Anutra Feedback Aspiration Syringe® makes precision injections simple. With built-in tactile and audible feedback, practitioners can both feel and hear a slight click within the syringe as each milliliter is administered. The capacity holds the equivalent of 3 dental

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cartridges meaning you don’t have to shuck the glass cartridge for multiple dose procedures. With an innovative, less intimidating look, the Anutra Syringe is optimized in diameter and length. The ergonomic, lightweight design is simple-to-use and easily allows one-handed aspiration. Not only does the Anutra Syringe allow you to administer multiple doses with ease and comfort, it fits securely with the Anutra Dispenser® via Luer Lock technology. With a simple twist, you can connect or remove the Anutra Syringe from the Anutra Dispenser® and affix your needle.

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With an innovative, less intimidating look, the Anutra Syringe is optimized in diameter and length.

About the Company Located in Research Triangle Park, NC, Anutra Medical is comprised of a team of experienced dental and healthcare professionals focused on providing solutions to enhance the patient experience and increase office efficiency. We are leveraging the science of buffering local anesthetics through our innovative and revolutionary delivery system. Our core belief is creating partnerships with practices. We foster these relationships by performing in-office implementations and utilizing technology for educating and training.

The preceding material was provided by the manufacturer. Statements and opinions are solely those of the manufacturer and not of the editors, publisher, or the Editorial Board of Inside Dentistry .

T H A N K YO U TO O U R S P O N S O R : A N U T R A M E D I C A L

ADDITIONAL RESOURCES

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To learn more about Anutra Medical and how they are revolutionizing buffered anesthetics. MORE INFO

To learn more about the Science of Buffering. MORE INFO

To hear patient testimonials on The Anutra Local Anesthetic Delivery System. MORE INFO