Drugs, diseases, and decisions: The interaction between injectable local anesthetics and systemic diseases

This course seeks to improve the dental care provider’s understanding of the interaction between injectable local anesthesia and various systemic conditions.

3 CE Credits

 A peer-reviewed course written by Katrina M. Sanders, MEd, BSDH, RDH, RF, and Thomas Viola, RPh, CCP 


Local anesthetics designed for use in the dental setting are safe and effective medicaments, yet their utilization requires careful consideration in an effort to reduce the risk of adverse reactions for the dental patient. The medical history is an integral key to this consideration, as there is a potential for drug interactions or complications in compromised patients. The relative and absolute contraindications affiliated with the safe delivery of local anesthesia for the dental patient vary widely in relation to the systemic disease or condition. Understanding these contraindications and applying these clinical decision-making modalities when considering local anesthesia selection, dosage, and delivery are critical in the safe and efficient delivery of injectable and noninjectable drugs in the dental setting. 

This course seeks to improve the dental care provider’s understanding of the interaction between injectable local anesthesia and various systemic conditions as well as aid in the clinical decision-making needed for the provision of safe local anesthesia delivery for compromised patients in a dental setting. 

Educational objectives 

  • Upon completion of this course, the dental professional should be able to: 
  • Understand the current scientific literature about the potential complications between injectable local anesthesia and systemic disease. 
  • Review injectable local anesthesia considerations in the management of oral pain. 
  • Discuss chronic diseases requiring modifications in the delivery of injectable local anesthesia, including cardiovascular disease, diabetes, thyroid disease, respiratory disease, hepatic and renal dysfunction, central nervous system disorders, endocrine disease, and hematologic disorders. 
  • Discuss conditions that may require modifications to the delivery of injectable local anesthesia, including allergies, pregnancy, and recreational drug use. 
  • Identify specific clinical decision-making strategies in the provision of safe injectable local anesthesia delivery. 

Katrina M. Sanders, BSDH, MEd, RDH, RF, is a clinical dental hygienist, author, and international speaker.  She is the clinical liaison, Hygiene Excellence and Innovation for AZPerio.  Known as “The Dental Resultant,” Katrina is the cofounder of the Core Group, LLC, a boutique-style consulting firm focused on high-level standards, excellence, and production.  Katrina is the founder, CEO, and keynote speaker for Sanders Board Preparatory and is a published author with Dentaltown and Today’s RDH, and a columnist and advisory board member for Modern Hygienist and brand ambassador for Dimensions of Dental Hygiene.

Thomas Viola, RPh, CCP, is the founder of “Pharmacology Declassified” and a board-certified pharmacist who also serves the profession of dentistry as a clinical educator, professional speaker, and published author. Tom is a member of the faculty of 15 dental professional degree programs and has presented over a thousand continuing education courses in the areas of oral pharmacology and local anesthesia. Through his informative, humorous, and engaging live seminars and webinars, Tom has earned his reputation as the go-to specialist for making pharmacology practical and useful for all members of the dental team.

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Quick Access Code: 21074

Not Enrolled

Course Includes

  • 26 Lessons
  • 1 Test
  • Course Certificate
  • CE credit(s): 3

    Course Type: Written

    Published Date: SEPTEMBER 2021

    This continuing education (CE) activity was developed by Endeavor Business Media with no commercial support.

    This course was written for dentists, dental hygienists, and dental assistants, from novice to skilled.

    Educational methods: This course is a self-instructional journal and web activity.

    Provider disclosure: Endeavor Business Media neither has a leadership position nor a commercial interest in any products or services discussed or shared in this educational activity. No manufacturer or third party had any input in the development of the course content.

    Requirements for successful completion: To obtain 3 CE credits for this educational activity, you must pay the required fee, review the material, complete the course evaluation, and obtain an exam score of 70% or higher.

    CE planner disclosure: Laura Winfield, Endeavor Business Media dental group CE coordinator, neither has a leadership nor commercial interest with the products or services discussed in this educational activity. Ms. Winfield can be reached at lwinfield@endeavorb2b.com.

    Educational disclaimer: Completing a single continuing education course does not provide enough information to result in the participant being an expert in the field related to the course topic. It is a combination of many educational courses and clinical experience that allows the participant to develop skills and expertise.

    Image authenticity statement: The images in this educational activity have not been altered.

    Scientific integrity statement: Information shared in this CE course is developed from clinical research and represents the most current information available from evidence-based dentistry.

    Known benefits and limitations of the data: The information presented in this educational activity is derived from the data and information contained in the reference section.

    Registration: The cost of this CE course is $39.00 for 3 CE credits.

    Cancellation and refund policy: Any participant who is not 100% satisfied with this course can request a full refund by contacting Endeavor Business Media in writing.

    Provider information:

    Dental Board of California: Provider RP5933. Course registration number CA code: 03-5933-21074. Expires AUGUST 2024. “This course meets the Dental Board of California’s requirements for 3 units of continuing education.”


    Endeavor Business Media is a nationally approved PACE program provider for FAGD/MAGD credit.
    Approval does not imply acceptance by any regulatory authority or AGD endorsement.
    11/1/2022 to 10/31/2024.
    Provider ID# 320452
    AGD code: 340


    Endeavor Business Media is designated as an approved Provider by the American Academy of Dental Hygiene, Inc. #AADHPNW (January 1, 2022–December 31, 2024). Approval does not imply acceptance by a state or provincial Board of Dentistry. Licensee should maintain this document in the event of an audit. AADH code:


    Endeavor Business Media is an ADA CERP–recognized provider.

    ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of dental continuing education. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry.

    Concerns or complaints about a CE provider may be directed to the provider or to CERP at ada.org/goto/cerp.



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