Purpose: This study assessed the use of local anesthesia administered by dental hygienists who completed continuing education (CE) courses in Minnesota in 1996. The aims of the study were to: evaluate the use of local anesthesia by these participants; the level of effective injections; the value the dental hygienists placed on this skill; and to provide data in areas less studied, such as injection techniques utilized, and the incidence of complications.
Methods: A pretested, 34-item questionnaire; cover letter; and return self-addressed, stamped envelope were sent in 1997 to dental hygienists (N = 355) who completed a CE course in local anesthesia offered by Minnesota dental hygiene programs between January and September 1996. A reminder postcard was sent to nonrespondents two weeks after the initial return date. The survey assessed the administration experience of dental hygienists including implementation of this skill, frequency of administration, types of clients receiving local anesthesia, treatments requiring local anesthesia, choice of injection techniques, level of successful anesthesia, complications observed, and value to practice. Data were analyzed using JMP version 3.1, Pearson's chi-square and one-way ANOVA.
Results: The response rate was 77.7% (N = 273). Ninety-five percent of the dental hygienists who responded reported delegation of local anesthesia to them by employers. A majority of respondents (64%) implemented this new skill within one week following completion of course work. Dental hygienists in periodontal specialty practice provided local anesthesia to adult clients more frequently than those in general practice. Respondents used nerve block techniques more frequently than supraperiosteal or infiltration techniques. In general, respondents reported high success rates in achieving adequate anesthesia with a very low incidence of complications. Dental hygienists most frequently administered local anesthesia for root planing or debridement (92%). A majority of respondents also administered local anesthesia to adults and children who were treated by the dentist. The frequency of administrations was strongly related (P = 0.00) to value placed on this skill and positive outcomes to their practice.
Conclusions: Dental hygienists who completed required CE course work in local anesthesia, provided safe, effective injections and reported this service to be of value to their practice. These data support the incorporation of local anesthesia into dental hygiene curricula to prepare future practitioners to provide this service to clients. Also, dental hygienists working in states not currently allowing this service, should consider these results when proposing change to their state practice acts.