In people scheduled to undergo extraction of maxillary premolars and molars, buffered local anesthesia considerably expedited anesthesia onset, decreased pain during injection (particularly on palatal side), and improved patient satisfaction.

A randomized controlled study was carried out to investigate the efficacy of buffered local anesthesia in tooth extraction.

The study incorporated 100 people who were scheduled to undergo extraction of maxillary posterior teeth. Participants were randomized into (a) Control group: Given non-buffered 2% lidocaine hydrochloride along with 1:80,000 epinephrine local anesthesia, and (b) Study group: Given an infiltration of buffered 2% lidocaine hydrochloride along with 1:80,000 epinephrine local anesthesia.

With the aid of local anesthesia buffering system, buffering was carried out. The endpoints ascertained were pain during injection (evaluated by Numerical rating scale [NRS]), anesthesia onset, volume of local anesthesia utilized, and patient satisfaction.

Profound differences were witnessed in pain during injection palatally and buccally in favor of the study group with a moderate effect size for buccal injection and a large effect size for palatal injection. The study group exhibited a higher satisfaction score and considerably faster onset of anesthesia on the buccal and palatal sides. Regarding the volume of anesthesia, a non-significant inter-group difference was noted.

During extraction of maxillary posterior teeth, buffering of local anesthesia effectively hastens anesthesia onset and improves patient satisfaction with the whole dental extraction procedure.