Emerging from tabloid scandal: Dr. U.K. Mayo's Vegetable Vapor extends nitrous oxide's anesthetic duration.

Urial K. Mayo (1816-1900) was a successful Boston dentist who was plagued by personal scandal. In 1883 he patented extending the duration of nitrous-oxide anesthesia with an alcoholic tincture of hops and poppies.

A Nitrous-Oxide Pioneer Peddles His Own Dentifrice: "Dr Colton's Vegetable Dentonic".

During the latter half of the six-year long "Panic of 1873," nitrous-oxide pioneer G.Q. Colton developed, advertised, and sold his dentifrice, "Dr Colton's Vegetable Dentonic" to supplement his dental anesthetic enterprise.

The Perfect and Famous Anesthetic Known as Methyl in Boston in 1895.

Extravagant claims were made for proprietary dental anesthetics in Boston, MA, in the late 1800s. For instance, in 1883, Urial K. Mayo introduced an inhaled Vegetable Anaesthetic comprised of nitrous oxide that had been uselessly pretreated with botanical material. This misguided concept may have been inspired by homeopathy, but it was also in line with the earlier false belief of Elton R. Smilie, Charles T. Jackson, and William T.G. Morton that sulfuric ether could volatilize opium at room temperature. In 1895, the Dental Methyl Company advertised an agent they called Methyl, a supposedly perfect topical anesthetic for painless dental extraction. The active ingredient was probably chloroform. Anesthetic humbug did not cease in Boston on Ether Day of October 16, 1846.

The place of James Arnott (1797-1883) in the development of local anaesthesia in dentistry.

Dental disease in the form of caries and abscesses has been known since antiquity. Before the advent of anaesthesia, operations upon the mouth were painful. The introduction of general anaesthesia in the form of ether and chloroform seemed to provide a solution, but there was an unacceptable level of mortality. James Arnott introduced local anaesthesia by means of freezing with ice, which he considered safer. He waged a long campaign and his method received recognition and was used in France and the USA. His method stimulated the development of pharmacological anaesthesia.

Cultivating a "chairside manner": dental hypnosis, patient management psychology, and the origins of behavioral dentistry in America, 1890-1910.

Discussions regarding the use of hypnotism in dentistry featured prominently in dental journals and society proceedings during the decades around the turn of the twentieth century. Many dentists used hypnotic suggestion either as the sole anesthetic for extractions or in conjunction with local and general anesthetics for excavation and cavity filling. With the heralding of humanitarian dentistry and improved local anesthesia around 1905, a number of dentists advocated using suggestion psychology to calm nervous patients and increase their comfort and satisfaction levels while undergoing dental procedures. The practice of hypnotic suggestion with local and general anesthesia in providing patients with increasingly painless procedures constituted the earliest variety of behavioral dentistry, a discipline not fully developed until the closing decades of the twentieth century. Hypnosis and suggestion became driving forces for psychological applications in the formative years of behavioral dentistry.

The history of local anesthesia.

For hundreds of years, mankind has struggled with the problem of controlling pain during surgical procedures without putting the patient to sleep. In 1884, cocaine was discovered to have local anesthetic properties and soon became widely used in many types of surgery. The many undesirable properties of cocaine led scientists to find a safer alternative. Since then, more effective local anesthetics have been and continue to be developed.

Xylocaine: 50 years of clinical service to dentistry.

In today's dental practice, local anesthesia is safe and effective, and injectable agents only rarely cause allergy. Ester-type agents, like procaine, which served the profession for over 50 years, have now been abandoned and are no longer available in dental cartridges in the U.S. Modern practitioners know of their disadvantages only through historical accounts of local anesthesia, and utilize daily the excellent chemical and pharmacologic characteristics of the amide local anesthetics, a tradition begun with the introduction of Xylocaine in the late 1940s and a tradition which will likely continue into the 21st century. The reader is referred to Table III for a comparison of quantities and dollar-value of sales of amide local anesthetics available in dental cartridges (17). In order to supplant Xylocaine (lidocaine) as a preferred local anesthetic in dentistry, any new agent will have to prove that it is superior in terms of short onset, appropriate duration, stability, excellent safety record, low allergenicity, and topical efficacy. As our understanding of the molecular structure of ion channels and the interactions of local anesthetics with neural sodium channels increase, new agents can be developed rationally. In the meantime, the amide local anesthetics will continue to serve dentists and their patients by providing safe and effective control of pain to facilitate ever-advancing surgical and restorative techniques.

Clinical research-the silent partner in dental practice.

For 5,000 years innovative researchers, often anonymously, have been providing dentists and their antecedents with a rich inheritance of information, techniques, and materials. The giants of dental research of the past can still serve as role models today. This paper presents a history of clinical research and relates past work to current and future trends. In the last few decades, both technical innovation and oral biology and prevention have been progressing at an accelerated rate to provide a steady influx of new answers to dental practitioners and to elicit new questions from the next generation of dental investigators.

The use of intravenous anesthesia and sedation techniques in oral and maxillofacial surgery.

In 1943, Olson described a method for administration of thiopental for anesthesia during oral surgical procedures (J Oral Surg 1:197, 1943). Patients were instructed not to eat for 4 hours before the scheduled surgery and to bring an escort. Premedication with atropine or morphine was not routinely used. Following venipuncture, a 2- to 3-mL test dose of thiopental (Pentothal, Abbott Laboratories, North Chicago, IL) was injected. After a pause of 15 to 20 seconds, 6 mL was injected slowly over 40 to 50 seconds. Additional medication was titrated slowly in intermittent doses to maintain an adequate level of anesthesia. The mouth was packed and kept meticulously dry to prevent coughing or laryngospasm. The patient's color and respiration were continually observed and the airway maintained. Initially, a 5% solution was used by Olson; later it was changed to 2%. Use of this concentration made it easier to titrate to "upper levels" of anesthesia because profound depth was not required. Also, adverse effects (eg, coughing, laryngospasm) occurred less frequently, and there was less venous irritation with the 2% solution. Based on his experience of 8,203 cases, Olson claimed that most patients tolerated the anesthetic well, but he recommended avoiding this technique for children younger than 12 years of age.