Local anesthesia forms the backbone of pain control in dental practices and are the safest and most effective drugs for periprocedural and postprocedural pain control and management – when used properly. We will compare the available dental local anesthetics and discuss their optimal clinical use, with a special emphasis on dentistry’s newest local anesthetic, articaine. We will also look at the potential for serious adverse events developing during the use of local anesthetics and discuss current research surrounding improving dental pain control.