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Oral Health Topics

Anesthesia and Sedation

Proposed Revisions: ADA Sedation and Anesthesia Guidelines

The ADA Council on Dental Education and Licensure is considering proposed revisions to the ADA Guidelines for the Use of Sedation and General Anesthesia by Dentists and the Guidelines for Teaching Pain Control and Sedation to Dentists and Dental Students. The Council seeks comment from the communities of interest. The proposed amendment to both documents addresses the use of capnography during moderate sedation in an open airway system as well as the need for continual observation of qualitative clinical signs by monitoring for the presence of exhaled carbon dioxide (unless precluded or invalidated by the nature of the patient, procedure or equipment).

The Council will consider comments received by July 31, 2014 and determine whether to pursue revisions.

The deadline for comments is July 31, 2014.

Comments should reference the line number(s) and be specific.
Comments should be addressed to:

Dr. Teresa Dolan, Chair
Council on Dental Education and Licensure
American Dental Association
211 East Chicago Avenue
Chicago, IL 60611

Comments may be sent via ground delivery or e-mailed to JasekJ@ada.org.

Download the proposed revisions.
For best results, download the above PDF in either Internet Explorer 10, Firefox or Google Chrome.

Guidelines and Resources

Color Coding of Local Anesthetic Cartridges

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.

Science Brief