The Roots of Pressure Anesthesia and its Contemporary Similarities.

For decades dentists have faced the challenge of achieving profound anesthesia in the presence of a severe tooth ache. Frequently this challenge was more acute when the tooth or teeth in question were mandibular molars. Over a 125 years ago this clinical dilemma was managed by using cocaine, both directly on an exposed dental pulp and often times using a solution of such injected directly into the pulp. Both clinical applications were considered as achieving "pressure anesthesia" sufficient to permit pulp extirpation. This historical perspective will focus on both the origins of this approach and its contemporary counterparts.