This course qualifies the enrollee for 3.5 CE credit hours and the cost is $75. Register for the course on Local Anesthesia: Pathways for More Effective and Timely Pain Management here. (log-in with CE ID is required)

Course Description

Sound local anesthesia practices can serve as a backbone for timely practice efficiency and positive patient feedback. Routine local anesthesia injection practices of nerve blocks and infiltration techniques provide a high degree of success although in many cases of acute pain or unique 'tough to numb' patients these will often fail to provide profound anesthesia leading to poor procedural and patient satisfaction outcomes. Intraosseous anesthesia techniques have an ability to provide fast acting and predictable local anesthesia in both acute and routine practice situations. Their effective implementation provides a large span of benefits to both practitioner and patient, although require a comprehensive understanding of their delivery practices to avoid procedural errors and post-operative complications. A review of the literature, technique fundamentals, and patient examples will provide attendees the confidence to implement intraosseous anesthesia into their daily practice following the course. We will switch gears after the break to Part II:  Anesthetizing the Endodontic Patient: Why Such a Challenge?

Anesthetizing our patients is often difficult. There are biologic and psychological reasons why.  Topics to be covered will include these factors (particularly with mandibular irreversible pulpitis), and some proposed explanations. There are myths; these will be debunked. Also presented will be alternative (supplemental) techniques to enhance anesthesia and some approaches that are helpful in delivering “painless” injections.


Participants should be able to:

Part I

  • Recognize the mechanisms and contraindications of intraosseous anesthesia; and
  • Describe the products and equipment available that aid with the effective delivery of intraosseous anesthesia.

Part II

  • Explain why endodontic patients and procedures present anesthesia challenges;
  • Describe techniques that are available with what anesthesia situations; and
  • Use supplemental techniques to employ to attain anesthesia.

Course issued: 3/2022; expires 3/2025


Robert Bowers
Robert Bowers

Dr. Robert Bowers, D.D.S., joined the Department of Family Dentistry in 2020 as an Assistant Professor following serving as the Dental Director at the Meskwaki Health Clinic with the Indian Health Service. Dr. Bowers research involves fear based dental considerations including local anesthesia techniques and etiologies for pain management inadequacies in practice.

Rick Walton
Rick Walton

Dr. Richard Walton, D.D.S., M.S., earned a DMD at the University of Oregon in 1965. After two years in the US Army, he trained at the University of Illinois to obtain a Certificate in Endodontics and an MS in Histology. From 1983-2011, Dr. Walton was Professor of Endodontics at the University of Iowa College of Dentistry and Chair from 1983 –1996 and is now Professor Emeritus. He was on the faculty at the University of Connecticut and was Chair at the Medical College of Georgia. Dr. Walton is a Diplomate of and has been an examiner on the American Board of Endodontics. He has published numerous scientific and clinical articles and has contributed extensively to Ingle’s Endodontics as well as to several other textbooks. Dr. Walton co-authored a textbook, Endodontics: Principles and Practice, which is in several editions and translations. Dr. Walton received awards for teaching and research. He has been honored by the naming of the Walton Endodontics Clinic at Iowa.