Articaine hydrochloride has, over the past two decades, become one of the most widely used local anaesthetics in dentistry, distinguished from other amide agents by an additional thiophene ring and an ester side chain that confer enhanced lipid solubility and rapid hepatic and plasma hydrolysis. This narrative review synthesises current evidence on the pharmacology, clinical efficacy, safety profile and emerging delivery Keywords technologies associated with articaine, with the aim of clarifying its role as a “new generation” dental anaesthetic. A structured search of PubMed, Scopus and Google Scholar was used to identify systematic reviews, meta-analyses, randomised controlled trials and regulatory documentation published predominantly within the last two decades. Articaine demonstrates a rapid onset of action, superior diffusion through cortical and cancellous bone, and higher anaesthetic success rates than lidocaine for maxillary infiltration and as a supplemental buccal infiltration following failed inferior alveolar nerve block. For primary inferior alveolar nerve block, however, articaine does not show consistent superiority over lidocaine or mepivacaine, particularly in the presence of pulpal inflammation. Its short plasma half-life and rapid metabolism contribute to a favourable systemic toxicity profile, while chairside buffering and computer-controlled delivery systems have further reduced injection pain and shortened onset time. Concerns regarding a possible association between 4% articaine and paraesthesia following inferior alveolar nerve block remain unresolved by high quality evidence, and caution is advised for block techniques involving direct nerve contact. Articaine's efficacy and acceptable safety profile support its continued and expanding use across general, paediatric, and geriatric dental practice, while future research should prioritise dose-finding studies, pharmacogenomic factors, and prospective safety surveillance in vulnerable populations.

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