• MVP Mailhouse
  • renew digital
  • Medidenta
  • Adit
  • Lumadent

Dr. Stanley Malamed and Onpharma’s Onset Anesthetic Buffer

by | Mar 16, 2021 | Articles, Nifty Blog

Dr. Stanley Malamed - Onpharma

Dr. Stanley Malamed is a name that most dentists may recall from their days back in dental school. Personally, I still refer to my old yellow copy of Local Anesthesia by Dr. Malamed whenever a new question about administering local anesthesia arises. 

With patients continually scoring physical comfort as one of their top priorities in seeking dental treatment, it’s vital that we work to use local anesthesia in the most comfortable way possible. Curious about what fellow dentists were doing to reduce their patient’s pain, I sent out a survey recounting some common methods of pain reduction and was surprised by the results. 

Some dentists reported some common techniques such as cheek shaking or controlling the speed of their injections, but few reported buffering their anesthesia. Interested in Dr. Stanley Malamed’s view on local anesthesia buffering, I invited him on the show to discuss the best ways of reducing a patient’s pain during treatment. 

He agreed with dentists that the speed of injections is extremely important in pain reduction. Simply put, “speed hurts.” A nice slow injection from a 27 gauge needle may hurt your thumb, but rarely will it hurt your patient. However, even if your injection itself is painless, there is more to the story in determining the least painful and most effective way of administering local anesthesia. 

According to Dr. Malamed, other healthcare professionals such as dermatologists and plastic surgeons have been using buffered anesthetic to make injections much more comfortable for years. Only recently have dentists began discussing the benefits of buffered anesthetic. Dr. Malamed discussed two key benefits: 


  1. Local anesthetic buffering allows the anesthetic to set in faster. The average time it takes to achieve numbness with a traditional, unbuffered anesthetic is over six minutes. The average time for a buffered local anesthetic is less than two minutes.
  2. The process is more comfortable during the injection. Also, because the pH level is increased from a highly acidic one to a more basic level, the following day, your patient will experience far less soreness. No longer do you need to worry about the idea of putting “lemon juice” in a wound, joked Dr. Malamed. 


Inspired by these benefits, many dentists, including myself at one point, began buffering local anesthetics ourselves. This works, but because sodium bicarbonate bottles can vary in pH level, there is a good chance that the level will be too high and your patient may leave your office with a huge lump of a cheek.

You can imagine the reaction a parent may have after seeing their child get up from the chair with edema swelling upon their face. There was no consistent way to buffer the anesthetic so that it is the same each time. Without consistency, the benefits of buffered anesthesia cannot be maximized. 

Because of this, we dentists can turn to experts to help us buffer local anesthetic. 

After my conversation with Dr. Stanley Malamed came to a close, I hopped on a call with Craig Conrardy, the national sales director for Onpharma. 

Craig explained Onphrarma’s ability to produce a steady pH level that will not inflame cheeks or cause any other negative side effects when buffering local anesthetic. Their buffering system, called Onset, works to deliver a 7.35 pH level of sodium bicarbonate that mixes well with just about any type of local anesthetic. This means you can even pair it with articaine, which is recommended by Dr. Malamed for patients of all ages. 

Since its launch in 2008, Onpharma has continually improved its value. The universal pairing and longer-term shelf-life make Onset a fantastic and reliable product well worth the cost. This is especially true for Nifty Thrifty Dentists if they take up this week’s Nifty Thrifty deal. Check out the details below! 



Find out about:

The best alternative ways administering local anesthetic without a needle

Onpharma’s latest improvements to Onset 

The two key benefits of using buffered anesthetic according to Dr. Stanley Malamed 


Nifty deal:

Onset $499- 80 injections worth of sodium bicarbonate and delivery system.

$449 with a guarantee of 120 days with a 15-minute call about using the product and a 5 minute follow-up call will allow you to be refunded the unit. They also offer free shipping with this deal.


Onpharma Buffering system



This post contains affiliate links, which means we receive a commission at no additional cost to you.  The funds we receive are small and go towards running this site and our podcast.  For more information about our affiliate policy, please click this link.

Glenn Vo
Author: Glenn Vo