The Role of Local and General Anaesthesia in Modern Dental Practice: Clinical Decision-Making Frameworks, Patient Selection, Trends, Challenges, and Outcomes.

Anaesthesia is essential in modern dental practice for ensuring patient comfort and enabling safe and effective dental procedures. Increasing procedural complexity, a growing population of medically vulnerable patients, and higher expectations for safe outpatient care intensify the demand for anaesthetic approaches aligned with contemporary clinical standards. Despite substantial advancements in pharmacology and monitoring, inconsistencies persist in clinical decision-making, patient selection criteria, and the integration of safety standards across diverse dental settings, creating variability in practice and outcomes. This review aims to synthesise updated knowledge on local and general anaesthesia in dentistry, with emphasis on techniques, pharmacological principles, clinical challenges, and emerging innovations influencing patient outcomes. A targeted search of major scientific databases is conducted to identify literature published between 2015 and 2025, using predefined inclusion and exclusion criteria to ensure relevance and currency. The narrative review integrates evidence related to patient selection, perioperative monitoring requirements, complication profiles, and considerations for high-risk populations. Technological developments, including ultrasound-guided techniques, computer-assisted delivery systems, and sustained-release local anaesthetic formulations, are examined for their role in improving precision and safety. Ethical considerations, informed consent, and global practice standards are addressed to provide a comprehensive perspective on current practice. Advances in anaesthetic pharmacology, monitoring, and delivery strengthen procedural safety and patient experience in dental care. Continued research, along with wider adoption of standardised guidelines, remains necessary to improve consistency, safety, and quality of dental anaesthetic practice across diverse clinical settings worldwide.