Enhancing Local Anesthetic Training Through Dental Simulation

In this edition of Simulation Spotlight, we’re speaking with Dr. Martin Ling, Dental Education Lead at Immersify. A qualified and GDC-registered dentist, Martin previously held a clinical lectureship at the University of Birmingham, where he completed a PhD in periodontal research. He is also a Fellow of the Higher Education Academy.

Martin brings both academic and practical insight to his current role, where he helps shape dental education experiences designed to bridge the gap between theory and clinical practice.

In this Q&A, he shares his perspective on why local anesthetic is such a foundational (yet often nerve-racking) skill, how students learn to approach it safely and effectively, and how dental AR simulations and 3D digital assets strengthen dental training across the board.

What is local anesthesia and why is it so foundational in dentistry?

Local anesthesia refers to the loss of sensation in a targeted area of the body, achieved by delivering a pharmaceutical agent that temporarily blocks nerve signals. In dentistry, this allows practitioners to perform procedures painlessly, particularly in areas like the teeth and oral mucosa, which are highly sensitive.

It benefits both the patient and the clinician. The patient experiences greater comfort, and the clinician is free to focus on precise treatment without interruption. This is a core skill in dentistry, used in the vast majority of procedures and on a near-daily basis.

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What do dental students need to know before giving local anesthesia safely?

There are three key areas students need a grounding in before they can take on local anesthetic. First is anatomy: they need to understand the landmarks, the relevant nerves (like the inferior alveolar), and factors like bone density. For example, the bone in the lower posterior region may be too dense for infiltration, so you often need to give a nerve block rather than a local infiltration.

Second is patient impact. That includes their medical history, any allergies, and cardiovascular factors (especially when epinephrine is involved).

And finally, they need to understand the technique and the equipment: how the agent works (including its pharmacology and associated nerve physiology); how to choose appropriate LA agents and equipment and assemble everything safely; plus how to manage any potential complications.

How does patient variability affect local anesthesia in dental care?

Every patient presents a different combination of anatomy, medical history, anxiety level, and procedural need. Dosage, technique, and even choice of anesthetic can all be influenced by factors like age or systemic health.

Good practice is rooted in the all-important term ‘patient-centered care’. In this case, that means delivering the right anesthetic (including the right technique and dose) for the right procedure on the right patient at the right time.

Why do dental students need to understand nerve pathways when delivering local anesthesia?

Nerve pathways are notoriously complex (almost maze-like) and difficult to visualize using 2D resources. Last time I checked, patients are typically 3D!

This makes understanding where to deliver anesthetic and why it's effective in that location a challenging but vital element of training. Variation in anatomy can impact outcomes, so building an internal 3D map of these structures is essential for effective treatment.

How do dental schools teach local anesthesia?

Typically, the process starts with foundational theory delivered through lectures and small group teaching, often supported by visual materials like diagrams. From there, students transition to clinical application, often by practicing on one another under supervision. Injections are introduced in a graduated way, starting with simpler infiltrations before progressing to nerve blocks.

But translating knowledge into skill is hard for a variety of reasons. Many students won’t have encountered local anesthetic even from a patient’s perspective. At that point in your training, it’s entirely possible to have a healthy dentition and no personal experience of what you’re about to deliver.

There are also plenty of practical barriers, both for students and for educators. It can be difficult for a supervising clinician to see exactly where a needle is placed, and students often rely on tactile feedback they’re still learning to interpret. Many are also nervous about the act of injecting a peer or patient, making confidence a key hurdle.

Why is local anesthesia hard to teach through lectures alone?

The challenge lies in the transition from theoretical to practical. Visualizing where a needle should go during a nerve block (especially something relatively complex like the inferior alveolar nerve block) is difficult when you’ve been relying solely on static images. As I’ve mentioned, supervisors can’t always see the injection path clearly, and students may struggle to communicate what they’re feeling in real time.

And, of course, there's the emotional weight. Students are often nervous simply because, unlike holding a mirror or probe, this involves inserting a needle into a real human being. It’s a nerve-racking scenario, to the point that even keeping a steady hand can be a major challenge at first.

What challenges do dental students face when learning to give local anesthesia?

Confidence is a significant barrier. Students often know the theory but, as they step into real-world application, often remain unsure whether they’ve administered the injection correctly or whether it will be effective. No matter how much a student grasps the pharmacology in principle, seeing it in action for the first time (all while being responsible for a patient’s comfort) is a powerful and intimidating leap.

I can speak from personal experience here: I still remember the first time I gave local anesthesia to a patient. You’re delivering a clear liquid in a small volume to a precise location and then, moments later, carrying out quite a significant treatment that would otherwise be impossible without adequate local anesthesia. I remember thinking, “That’s amazing. How does this tiny injection make such a big difference?” It really brought the pharmacology and anatomy to life, but that experience can also really drive home the high stakes of this area of clinical practice.

How can AR simulation and 3D interactive assets improve local anesthesia training?

AR materials and 3D assets let students visualize complex anatomical structures in three dimensions. You can rotate, zoom, and explore in real time, which static resources just can’t offer. They also allow students to practise needle placement on a simulated patient, offering real-time guidance and feedback without the stakes of working on a real person. There’s an element of interactivity there that you just don’t get from a textbook.

Importantly, AR in healthcare allows you to do things that just aren’t possible clinically: for example, visualizing a fly-through of the nerve after injection, or seeing how anatomical variation impacts technique. Again: last time I checked, patients weren’t transparent!

Can digital dental simulation tools help build clinical reasoning as well as technical skill?

Both are absolutely on the cards. In fact, AR simulations support a raft of decision-making opportunities. What agent should be used? What size needle? Is anesthesia appropriate for this patient? These scenarios train students to assess and act, rather than just perform.

And when students do make mistakes in an AR simulation, they can fail safely. They receive immediate, guided feedback, which is just an essential part of skill development.

What role will digital simulation play in the future of dental education?

An increasingly central one. Digital education is becoming embedded in every part of life, and healthcare education is no exception. Digital simulation helps address real challenges, like limited access to patients or variability in clinical cases.

Clinics are, of course, an essential and irreplaceable part of dental training. But by giving students access to realistic, repeatable training experiences in their own time, AR-based dental simulation fills that gap between classroom theory and clinical practice. And as the technology improves, its role will only grow.

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Any final thoughts?

There’s no question that student-to-student delivery of local anesthesia will continue to have a place in well-rounded dental training.

With that said, there’s a big opportunity to enhance that experience with tools like AR. These interactive experiences offer a safe way to build skills and confidence before patients (or fellow students!) even enter the picture. That comes with benefits for educators, students, and patients alike.

Looking for more dental education insights straight from the experts?

Simulation Spotlight: Local Anesthetic in Dental Education Q&A