One of the complications that can occur when administering local anesthesia in the dental office is paresthesia. Paresthesia occurs when there is a persistent tingling or numbness sensation around the injection site after administration, metabolization, and local anesthesia that should have subsided. It is caused by trauma to the nerve caused by the needle or solution used. Most cases of paresthesia end within eight weeks, but some may be permanent depending on the nerve damage (Malamed, 2004, p. 289). The purpose of this article is to determine which anesthetic is safest to use to induce mandibular paresthesias. Our PICO question is: In a patient receiving a mandibular block, will administration of the local anesthetic septocaine versus lidocaine increase the incidence of paresthesias? Septocaine, also called articaine, is a fairly new local anesthetic in the dental field. It is a four percent solution that contains epinephrine to help with the longevity of the anesthetic in the patient's body. It was first used in dentistry in 1976 in Germany; it began to become increasingly popular around the world and was approved in 2000 by the Food and Drug Administration in the United States (Yapp, Hopcraft, & Parashos, 2010). This local anesthetic has a thiophene ring that allows septocaine to enter neurons when used. administered at higher doses. The thiophene ring also gives it better lipid solubility compared to other anesthetics (Yapp, Hopcraft and Parashos, 2010). Lipid solubility is important because it allows the anesthetic to better diffuse through the injection site, allowing deep anesthesia. The half-life of this drug is twenty to thirty minutes, compared to the ninety-minute half-life of a regula... middle of paper ... M. (nd). Articaine: effectiveness and paresthesia in local dental anesthesia. Retrieved from ineedce: http://www.ineedce.com/coursereview.aspx?url=2071%2fPDF%2f1103cei_articaine_web.pdf&scid=14524John Nusstein, JB (2004). Comparison of injectable articaine and lidocaine pain in a primary intraligamentary injection administered with a computer-controlled local anesthetic delivery system. Anesth Prog 51, 126-133. KE Yapp, MH (2011). Articaine: a review of the literature. British Dental Journal, 210: 323-329. Malamed, SF (2004). Manual of local anesthesia. St. Louis: Elsevier Mosby. Weaver, J.M. (1999). ARTICAINE, A NEW LOCAL ANESTHETIC FOR AMERICAN DENTISTS: WILL IT REPLACE LIDOCAINE? Anesth Prog 46, 111-112. Webster's Online Dictionary. (nd). Extract from the definition: lidocaine: http://www.websters-online-dictionary.org/definitions/lidocaine