Episode 87: Nifty Deals: Dr. Stanley Malamed- Onset Buffering System

November 3, 2019
Dr. Stanley Malamed discussed the chemistry and benefits of buffering anesthetic. Craig Conrardy from OnPharma explains the Onset buffering system.

In our poll we asked about different anesthetic options and suggestions included going slow, distraction, single tooth anesthetic, and buffering.

Going slowly is the key to painless injections.  Dr. Malumed was contacted to partner with OnParma to research and improve buffering. The day after an injection they are sore due to the pH level of the injection. Buffering raises the pH to 7.3 to mimic the pH of the body. This allows the anesthetic to work more rapidly and lessen the post effects. Buffering is done with sodium bicarbonate. In medicine, the most common local is lidocaine. In sodium bicarbonate bottles, the pH can range broadly. A pH off balance can create edema, but that is the only risk of DIY buffering.

Anutra medical has been doing buffering for medical and branched to dentistry. The doctors he has spoken with were unhappy with that option because it was a foreign syringe and process, and it was limited to lidocaine.

Single tooth devices can be a good option as well. The Wand is a good device to use, vibraject is okay, but emulates something we can do ourselves. Prescription grade topical is questionable because it is not standardized.

With DIY multidose vials, you can use them over and over again. Dr. Malamed did research for OnSet but is not a paid consultant for OnPharma. Using the system, the buffer quickly mixes. Wait 2 minutes to test, retreat if needed. There is no need to wait 10 minutes in between. This allows you to be more productive and better experience for the patient.

For a “hot tooth”, especially mandibular molars, they can be especially difficult to numb. Buffering is especially valuable in the mandible.

Prilocaine has shown there is a higher case of paresthesia in the mandible.

What about using articaine with children? The study only used children over age 4, but it is safer and a better option than lidocaine. The half-life is 27 minutes, so it is much less likely to create an overdose.

For a “hot tooth” would buffering help more? Yes, it is much more effective.

One of the biggest reasons a person likes and recommends their dentist is painless injections and procedures. Buffering meets both of these criteria.

There are also other options for nasal spray anesthetic or medicines to reverse anesthesia to increase the patient experience.

Craig of OnSet system- They have been in the market since 2012. The cartridge of sodium bicarbonate can be used within 7 days. There is both the sodium bicarbonate cartridge and a mixing connector. The system mixes the solutions, put it in the syringe and deliver as normal. An unused cartridge is good for 3 years. Once activated, you have 5 days to use it. This means it is half the cost as when it came out and could only be used for one day.

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

$449 with 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.

877-336-6738 prompt #2 Tell them you want the Nifty Thrifty Deal