Spot-On Local Anesthesia Technique

Local anesthesia can be frustrating even for the most skilled dentists. The study found that only 80-85% of mandibular blocks are successful.

Anesthesia Services And Products

When they aren’t it:

1. Anxiety in the patient
2. You will be frustrated by the dentist
3. It places undue pressure both on the patient’s and dentist’s schedules, as “having to wait” is a common term.
4. The dentist must try to give the patient the comfort they require. I have heard from patients that their Anesthesia Services dentists had dismissed them for not being able to get the patient “numb”.
5. Inadvertent arterial infections and paresthesia caused by mandibular nerve trauma can increase the risk of a faster heartbeat.
6. This increases your chance of getting a hematoma.

The “spot on technique” offers many benefits:

1. Instant anesthesia allows you to start treatment immediately
2. Patients receive less medication.
3. It is more comfortable than the mandibular block. Many patients will be asking, “Did you get a shot?”
4. More intense anesthesia Patients often claim that this is the first time they feel truly numb on this side. Patients often tell me their dentists said it was only them, and they were difficult to numb.
5. Intraosseus procedures are less traumatizing than those that involve intraosseus surgery. I have been able to witness the sloughing of tissue through this route.

Armamentarium

1. A intraligamentary needle-syringe. The one that activates using index fingers is my preference over the pistol grip. It’s easier to control and it gives you the “clicks” that indicate how much was administered.
2. A 30 gauge extra short needle
3. 4% Articaine, 1:100,000. Epinephrine
4. 4% Prilocaine HCl plain
5. A standard syringe or a shorter 30 gauge needle
6. The most important ingredient is the triple-compounded topical anesthetic mix of benzocaine lidocaine and tetracaine.
7. Carpule warmer

Allow the topical to dry for five minutes. The topical should be applied to the vestibule as well as the buccal gum margin. Use the Standard syringe to slowly inject 4% of the prilocaine into the vestibule. The difference should not be noticeable by the patient. Next, slide the needle with a 30 gauge under your gingiva margin. Apply light pressure to the area. You should increase the pressure to moderate pressure by moving from the line of your buccal teeth to the line angle. You can avoid bitter taste and leakage by making sure your aspiration is activated. You will need to rinse your mouth with lots of water.

Next, use an intraligamentary needle-syringe containing 1:00,000.0 and 4% Articaine to slowly engage the buccal bifurcation. Use a needle syringe containing 4% Articaine and 1:100,000. You will feel moderate pressure. Every dose should be followed by a click. You should click between 4 and 5 times per site. This technique is very precise and you need to feel the area. Because of anatomical differences between furcation (the free gingival margin) and the angle, you may have to adjust the angle by around 45 degrees. Think of the needle sliding in the area. I prefer to do it at the line angles. The patient should feel the “shots” sensations if the procedure is done correctly. It is possible to apply lighter pressure to increase the pressure for the last few clicks. The lingual may not always need to be followed, but the tooth might require the same treatment.

It is a wonderful feeling to be able to comfort patients and not have their lips or tongues swelling for up to three to four hours. Patients often complain about the “numb feeling” and it is a common complaint. Patients often refer to traditional mandibular block effects, which may only have been 90% effective. It is not easy to refer a patient suffering from any kind of pain while undergoing dental treatment.