Oral Health Topics
Anesthesia & Sedation
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- Color Coding of Local Anesthetic Cartridges
- The Journal of the American Dental Association
- Additional Resources
This color-coding system, adopted by the ADA Council on Scientific Affairs in 2003, was designed to be part of the labeling on all injectable local anesthetics that carried the ADA Seal of Acceptance. However, it was implemented by most manufacturers for all of their injectable local anesthetics, whether or not their products had the ADA Seal.
The system was developed as a result of a resolution adopted by the ADA House of Delegates in response to dentist's concerns that color coding schemes currently in use often differed from manufacturer to manufacturer for the same anesthetic product. The ADA worked closely with local anesthetic manufacturers to come up with a reasonable and workable system. Although the Association believes that dentists should read the labels of all drugs they administer, it also believes that uniform color-coding will be a useful adjunct in identifying the specific anesthetic/vasoconstrictor in the product.
Injectable local anesthetics have not been in the ADA Seal of Acceptance Program since the end of 2007, at which time the ADA terminated the Seal Program for professional dental products. The ADA Seal Program still awards the ADA Seal to consumer products. Professional dental products are now evaluated in the ADA Professional Products Report program. Even though they are no longer in the ADA Seal Program, most injectable local anesthetics marketed in the US continue to use this color coding system.
Color Code Format
|Product||PMS Color Code*|
|Lidocaine 2% with Epinephrine 1:100,000||Red: 185, 186, 199 or 200|
|Lidocaine 2% with Epinephrine 1:50,000||Green: 347, 348, 355 or 356|
|Lidocaine Plain||Light Blue: 279|
|Mepivacaine 2% with Levonordefrin 1:20,000||Brown: 471, 477, 478, 498 or 499|
|Mepivacaine 3%||Plain Tan: 466, 467 or 468|
|Prilocaine 4% with Epinephrine 1:200,000||Yellow: 108, 109, 110, 115 or 116|
|Prilocaine 4%||Plain Black|
|Bupivacaine 0.5% with Epinephrine1:200,000||Blue: 300 or 301|
|Articaine 4% with Epinephrine 1:100,00||Gold: 871, 872, 873, 874, or 875|
|Articaine 4% with Epinephrine 1:200,000||Silver: 877C|
- The color code shall consist of a band 3.0 ± 0.5 mm wide at a distance of 15 ± 5 mm from the stopper end of the cartridge.
- The end cap of the cartridge may be either color-coded to match the ADA Color-Coding System or given a neutral color.
- The stopper will not be color-coded and should not be indicative of the drug or color code.
- Lettering on the cartridge shall be black and font size should follow FDA labeling guidelines (headings at least 8 point type and text at least 6 point type).
- Lettering shall be in durable print that will not be removed by normal office handling.
*Pantone Matching System (PMS), Pantone, Inc.
- Balancing Efficacy and Safety in the Use of Oral Sedation in Dental Outpatients (April 2006)
- Effectiveness of Computerized Delivery of Intrasulcular Anesthetic in Primary Molars (October 2005)
- Techniques for Reducing Anesthetic Injection Pain: An Interdisciplinary Survey of Knowledge and Application (September 2004)
- Anesthetic Efficacy of the Palatal–Anterior Superior Alveolar Injection (September 2004)
- Computer-Controlled Delivery Versus Syringe Delivery of Local Anesthetic Injections for Therapeutic Scaling and Root Planing (March 2004)
- Avoiding Complications in Local Anesthesia Induction: Anatomical Considerations (July 2003)
- The Key to Profound Local Anesthesia: Neuroanatomy (June 2003)
- Intraosseous Anesthesia: Implications, Instrumentation and Techniques (April 2003)
- Dental Local Anesthetics: Alternative Delivery Methods (February 2003)
- Local Anesthesia System for Intraosseous Injection (July 2002)
- Effectiveness of Local Anesthesia in Pediatric Dental Practice (December 2000)
- Assessing the Need for Anesthesia and Sedation in the General Population (February 1998)
Current Guidelines and Policy Statement
- ADA Policy Statement: The Use of Sedation and General Anesthesia by Dentists (PDF)
- Guidelines for the Use of Sedation and General Anesthesia by Dentists (PDF)
- Guidelines for Teaching Pain Control and Sedation to Dentists and Dental Students (PDF)
- ADA Sample (Filled-in) Sedation - Anesthesia Record (PDF)
- ADA Sample (Blank) Sedation - Anesthesia Record (PDF)