Authors' response

The authors thank Professors Vigen and Skoglund for their letter adding further information about articaine following our recent paper (Kakroudi et al Dent Update 2015; 42: 88–93). We agree with the points raised and concur that reducing the volume of articaine administered would be expected to reduce the incidence of parasthesia following an IANB. However, avoidance or a reduction in the use of the IANB would be an even more significant factor in reducing the risk of paraesthesia. The beneficial properties of articaine, as outlined in our paper, allows alternative, and easier, techniques to be considered.

Dose is, indeed, a complex issue as, due to the difference in molecular weight between articaine and lidocaine, there are not twice as many molecules in articaine 4% as in lidocaine 2%; there are actually less than double and it is the number of molecules that is relevant to the efficacy of a dose-dependent drug. The key message for clinicians is that much less articaine is required.