Anesthesia and Sedation
This color-coding system, adopted by the ADA Council on Scientific Affairs in 2003, has been incorporated into ANSI/ADA Standard No. 190:2020 for Single-use dental cartridges for local anesthetics (identical adoption of ISO standard 11499 Dentistry – Single-use cartridges for local anesthetics). Each single-use cartridge should have two indelible bands indicating the name and concentration of both the anesthetic ingredient (Table 1) and the vasoconstrictor (Table 2).
The tables below, which utilize the Pantone Matching System (PMS) for color identification, illustrate the appropriate colors for both ingredients. Although color-coding is a useful adjunct for anesthetic identification, it is prudent for dentists to read the labels of all drugs they administer.
Table 1 — Band 1: anesthetic agent and concentration.
Local anesthetic agent and concentration | Band color (PMS) |
||||
2 % Lidocaine | Red 185 | Red 186 | Red 199 | Red 200 | |
3 % Lidocaine | Purple 266 | Purple 267 | |||
2 % Mepivacaine | Brown 477 | Brown 478 | Brown 498 | Brown 499 | |
3 % Mepivacaine | Tan 406 | Tan 407 | Tan 408 | ||
3 % Prilocaine | Orange 136 | Orange 137 | |||
4 % Prilocaine | Yellow 108 | Yellow 109 | Yellow 110 | Yellow 115 | Yellow 116 |
4 % Articaine | Gold 871 | Gold 872 | Gold 873 | Gold 874 | Gold 875 |
0.5 % Bupivacaine | Blue 300 | Blue 301 |
Table 2 — Band 2: vasoconstrictor and concentration.
Vasoconstrictor and concentration | Color | ||||
No vasoconstrictor |
White | None | |||
Epinephrine < 1:200 000 |
Yellow 108 |
Yellow 109 |
Yellow 110 |
Yellow 115 |
Yellow 116 |
Epinephrine < 1:100 000 to 1:200 000 |
Orange 136 |
Orange 137 |
|||
Epinephrine < 1:50 000 to 1:100 000 |
Brown 477 |
Brown 478 |
Brown 498 |
Brown 499 |
|
Epinephrine 1:50 000 |
Green 347 |
Green 348 |
Green 355 |
Green 356 |
|
Levonordefrin | Black | None |
|||
Nor-epinephrine 1:100 000 |
Tan 406 |
Tan 407 |
Tan 408 |
||
Nor-epinephrine 1:25 000 |
Purple 266 |
Purple 267 |
|||
Octapressin (felypressin) |
Blue 300 |
Blue 301 |
ANSI/ADA Standard No. 190:2020 (ISO standard 11499) outlines additional criteria required of single-use cartridge labels applicable to size and placement of the colored bands:
- Band 1 shall be 3.0 ± 0.5 mm wide and commence between 8 mm and 20 mm from the plunger end of the cartridge.
- Band 2 shall be 1,5 ± 0,5mm wide and commence at (2 ± 0.5) mm from the cartridge disc end of Band 1.
A detailed diagram of a single-use cartridge can be found in Figure 1.

Source: ISO standard 11499
Guidelines for the Use of Sedation and General Anesthesia by Dentists (2016). Download a copy of the Guidelines (PDF).
Guidelines for Teaching Pain Control and Sedation to Dentists and Dental Students (2016). Download a copy of the Guidelines (PDF).
Guidelines for Teaching Pediatric Pain Control and Sedation to Dentists and Dental Students (2021). Download a copy of the Guidelines (PDF).
ADA Policy Statement: The Use of Sedation and General Anesthesia by Dentists (2007). Download a copy of the Policy Statement (PDF).
ADA Sample (Filled-in) Sedation - Anesthesia Record (PDF)
Oral Health Topics: Nitrous Oxide
JADA: Benefits and harms of capnography during procedures involving moderate sedation
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 Catalog: Sedation: A Guide to Patient Management
- Preparing for Your Child’s Sedation Visit
- Policy for Selecting Anesthesia Providers for the Delivery of Office-based Deep Sedation/General Anesthesia
- Monitoring and Management of Pediatric Patients Before, During, and After Sedation for Diagnostic and Therapeutic Procedures: Update 2016
- Use of Anesthesia Providers in the Administration of Office-based Deep Sedation/General Anesthesia to the Pediatric Dental Patient
- Use of Local Anesthesia for Pediatric Dental Patients
- Use of Nitrous Oxide for Pediatric Dental Patients
American Academy of Pediatrics, American Academy of Pediatric Dentistry: Guidelines for Monitoring and Management of Pediatric Patients Before, During, and After Sedation
American Academy of Anesthesiologists: Practice Guidelines for Moderate Procedural Sedation and Analgesia 2018
Prepared by:
Department of Scientific Information, Evidence Synthesis & Translation Research, ADA Science & Research Institute, LLC.
Disclaimer
Content on the Oral Health Topics section of ADA.org is for informational purposes only. Content is neither intended to nor does it establish a standard of care or the official policy or position of the ADA; and is not a substitute for professional judgment, advice, diagnosis, or treatment. ADA is not responsible for information on external websites linked to this website.