The gold standard in local anaesthesia

UK dental professionals face a choice when selecting which dental local anesthetic (LA) to use although experts on the subject often apply the term “gold standard” to lidocaine. In his textbook on dental local anaesthesia Prof Stanley Malamed says lidocaine “represents the “gold standard”, the drug against which all new local anesthetics are compared.¹” whilst in his own textbook Dr John Meechan states more specifically that “two per cent lignocaine with 1:80,000 adrenaline represents the ‘gold standard’ dental local anaesthetic in the United Kingdom.²”

But what is a ‘Gold standard’? Wikipedia defines the term (in the context of medical science rather than extinct economic practice) by referencing a 1992 letter to the editor of the BMJ³ which states “gold standards are constantly challenged and superseded when appropriate.”⁴