Anesthesia and Sedation

Color Coding of Local Anesthetic Cartridges

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 1 detailing the corresponding band color for local anesthetic agent and concentrations

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.

Diagram

Source: ISO standard 11499

Dental Anesthesiology
Dental Anesthesiology is a recognized dental specialty per the National Commission on Recognition of Dental Specialties and Certifying Boards. The recognition was awarded in March 2019 after the proposed specialty showed that it is distinct, well-defined, and requires unique and advanced knowledge and skills; and that it contributes new knowledge, education and research to the dental profession.

ADA Policies on Anesthesia and Sedation

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).


Last Updated: November 9, 2021

Prepared by:

Department of Scientific Information, Evidence Synthesis & Translation Research, ADA Science & Research Institute, LLC.


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