Anesthesia and Sedation

About Anesthesia and Sedation

• Guidelines and Resources
• Color Coding of Local Anesthetic Cartridges
• Science Brief

Guidelines and Resources

• 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 Policy Statement: The Use of Sedation and General Anesthesia by Dentists (PDF)
• ADA Sample (Filled-in) Sedation - Anesthesia Record (PDF)
• ADA Center for Evidence Based Dentistry

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 1:100,000	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

• Science Brief on Acetaminophen and Liver Injury—ADA Council on Scientific Affairs (PDF)