94 Goodell, Gallagher, and Nicoll ORAL SURGERY ORAL MEDICINE ORAL PATHOLOGYJuly 2000

anxiety was not caused by the use of the computer-controlled anesthesia device alone, because the CASItechnique produced an even greater decrease in anxiety.In addition, the CASI technique was clearly superior inreducing injection pain and promoting a positive overallinjection experience. The only differences betweenmethods appear to be techniques for needle insertion andadvancement, length of the aspiration cycle, and the typeof anesthetic flow rate. Our opinion was that, contrary tothe presumed major importance of maintaining aconstant anesthetic flow rate,4-7 use of a variable flowrate may enhance comfort. In the CASI technique, theflow rate can be manually adjusted while carefully moni-toring the patient for adverse sensation. A light-handedtechnique with excellent chairside manner4,5 are the mostimportant factors in reducing postinjection anxiety and inlowering injection pain.

REFERENCES1. Kleinknecht RA, Klepac RK, Alexander LD. Origins and char-

acteristics of fear in dentistry. J Am Dent Assoc 1973;86:842-8.2. Milgrom P, Weinstein P, Getz T. Treating fearful dental patients.

A patient management handbook. 2nd Ed. Seattle: University ofWashington; 1995. p. 14-20.

3. Kroeger R. Managing the apprehensive dental patient. Cincinnati:Heritage Communication; 1987. p. 23-30.

4. Krochak M, Friedman N. Using a precision-metered injectionsystem to minimize dental injection anxiety. Compend ContinEduc Dent 1998;19:137-48.

5. Levato C. Giving the Wand a shot. Dent Prac 1998;6:53-7.6. Friedman MJ, Hochman MN. A 21st century computerized injec-

tion system for local pain control. Compend 1997;18:995-1003.7. Wand product information. Milestone Scientific; 1998.

Reprint requests:

Gary G. Goodell, DDS, MS, MANaval Dental Center SoutheastNaval Air Station Jacksonville, Box 74Jacksonville, Florida 32212-0074

CALL FOR REVIEW ARTICLES

The January 1993 issue of Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology,and Endodontics contained an Editorial by the Journal’s Editor in Chief, Larry J. Peterson, thatcalled for a Review Article to appear in each issue.

These Review Articles should be designed to review the current status of matters that areimportant to the practitioner. These articles should contain current developments, changingtrends, as well as reaffirmation of current techniques and policies.

Please consider submitting your article to appear as a Review Article. Information forauthors appears in each issue of Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology,and Endodontics.

We look forward to hearing from you.