Practical regional anesthesia for dentistry and oral surgery (Proceedings)

Local anesthesia is employed prior to all dental procedures. Dental procedures can be very painful. The patient often can feel dental procedures while under inhalation anesthesia.

There are four methods of local anesthesia administration. A special dental anesthetic syringe and disposable needle expedites local anesthesia administration.

     1. Nerve Block

     2. Infiltration

     3. Inter-ligamentous

     4. Inter-osseous

Of the four methods, the inter-ligamentous offers the most versatility. It can be employed on all teeth successfully. A dental needle is bent at a 90-degree angle and inserted into the periodontal ligament. Anesthesia is delivered while digital pressure is employed holding the needle in place. The anesthesia is delivered in this manner on one or more aspects of the tooth.

Never blocks are limited to infiltration to maxillary dentition, infraorbital foremen block, mental foremen block, and mandibular block.

Infiltration anesthesia is reserved for maxillary teeth only. The maxilla is made up of cancellus bone lending it amenable to infiltration anesthesia. Anesthesia is delivered subperiostally over the apex of teeth to be treated.

Infraorbital anesthesia is performed with care. It is intended to provide anesthesia to the upper fourth premolar and adjacent dentition. However, the same anesthesia can be accomplished with simple and safer infiltration.

Mental block anesthesia will produce anesthesia to the lower canine and adjacent dentition.

Mandibular block anesthesia again should be considered with care. It provides anesthesia to the entire mandibular quadrant as well as the same half of the tongue. Post mandibular block anesthesia must be monitored during recovery. Make sure that the dog can control its tongue before dismissal. Traumatic tongue laceration can occur during recovery.