A Career Dedicated to the Pain-Free Dental Visit
Al Reader ’71 DDS, ’77 MS recalls the first time he heard of a link between dentists and pain: His father had met a dentist at the neighborhood pub who said he had just quit the profession because he didn’t want to hurt people anymore.
That was a long time ago—before Dr. Reader, now emeritus faculty with the College of Dentistry, embarked on his endodontic career that has made him an internationally recognized expert in local anesthesia and pain control.
“When I entered practice, I noticed that people weren’t always numb. We were taught in dental school that if people weren’t numb it was our fault for not giving accurate injections. But that’s not always true,” Dr. Reader says, pointing out that some dental schools still pass along that disproven idea to students.
Dr. Reader began studying supplemental techniques to ensure a pain-free experience for those undergoing root canal therapy and other dental treatments. His research findings on the rationale, advantages and limitations of various anesthetic agents and routes of administration have been published in over 150 articles in peer-reviewed journals, including the Journal of Endodontics, Journal of the American Dental Association, and Anesthesia Progress. He co-authored the textbook Successful Local Anesthesia (Quintessence Publishing), wrote fourteen book chapters in other texts, and presented over 90 lectures to learned societies and dental organizations, leading to widespread adoption of his techniques within the field.
When I started doing root canals, it wasn’t pleasant for me or the patient. We got them through it, but it was difficult. -- Dr. Al Reader
He marvels at the changes in pain management he has seen over his nearly 45-year career. “When I started doing root canals, it wasn’t pleasant for me or the patient. We got them through it, but it was difficult.” Now, with new technology and drug formulations, dentists and endodontists have the ability to successfully anesthetize patients initially, provide anesthesia for the full treatment and reverse some of the effects of soft tissue anesthesia if desired. “When people come in to see us they are already in pain; in some cases they have been up all night,” says Dr. Reader. “As endodontists, we are there to relieve pain—not cause it.”
Areas of Dr. Reader’s research have included the success rates of various types of nerve blocks, buffering solutions in local anesthetics, articaine effectiveness, pain of injection, topical anesthesia, oral conscious sedation and nitrous oxide administration. Other research areas include the effect of red hair color on anesthesia, reversing local anesthesia, supplemental techniques (PDL and intraosseous anesthesia), and endodontic (root canal) anesthesia.
Current studies are examining a new extended release anesthetic agent (Exparel) that has the potential to provide three to four days of numbness following endodontic treatment or surgery. Another avenue of research will be the use of microneedles to provide pain-free injections.
As an emeritus professor, Dr. Reader continues to be very involved with the college, leading seminars and spending time in the clinic with graduate students. He enjoys the university environment and its constant changes, including new students to mentor and new research ideas to explore. Ask Dr. Reader what he considers to be the strengths of the college, and he will tell you that it’s the people who work, teach and study there. He is especially impressed with the high quality of its students and faculty.
There is much more work to be done. “People fear pain from the dentist, so they don’t go and their symptoms worsen. They end up in the emergency room getting relief through medication although their teeth remain untreated.” This is unfortunate, says Dr. Reader, given the immense progress in dental pain management. “It’s very important that we have a comfortable patient. And with the knowledge we have now, we can do that. We can take additional steps to ensure a patient’s comfort.”