The concept of pre-emptive, multimodal analgesia is well-established. The role of local anaesthetics as a component is widely practised and this lecture will review the evidence base for that. Local anaesthetics address the neuronal element of pain processing, however there are non-neuronal components to pain transmission which must also be considered in order to totally prevent nociception. Is this a realistic goal and how can this be achieved? Does our current approach to dental analgesia leave the potential for the generation of chronic pain and which analgesics should we include in our analgesia plan?