EQUIPMENT AND TECHNIQUE FOR LOCAL ANAESTHESIA

Topical anaesthesia

Gel

Spray

Adhesive patch

Ointment

Proper ways to inject

Do not inject on swollen area

Do not inject patient with heart problems more than twice

Bevel the needle towards the bone

Ensure that the aspiration is negative

Infiltration anaesthesia

Buccal

The point of needle intersection of 2 imaginary lines at 45 degree

1st line is the imaginary vertical line of long axis of the tooth

2nd line is the imaginary horizontal line along the mucobuccal fold

Lingual

The point of needle intersection of 2 imaginary lines:

1st line is a vertical line parallel to the long axis of the tooth

2nd line is a horizontal line above the floor of the mouth

Palatal

Point of needle insertion:                                            Midway imaginary line between gingival margin of the tooth and the median palatine raphe, along the long axis of the tooth at 90 degree to the palatine bone

Steps for injection

Retract cheek, lips, tongue depending on area

Apply topical anaesthesia

Position needle at targeted area

Insert needle until bone is contacted

Retract slightly

Aspirate (must be negative to proceed)

Inject solution slowly

Nerve block

Buccal nerve block

Inject 1mm lateral to 3rd mandibular molar at the anterior border of the ramus

Area anaesthetized:

The mucous membrane of the cheek, vestibule and sometimes a small patch of skin on the face.

Lingual nerve block

Inject on the lingual side of the second mandibular molar

Area anaesthetized:

The lingual nerve block anesthetizes the anterior two thirds of tongue

Mental nerve block

Inject at the junction of mandibular 1st and 2nd premolars and down 1 cm inferior to the marginal gingiva

Areas Anesthetized:

Buccal mucous membranes anterior to the mental foramen (around the second premolar) to the midline and skin of the lower lip and chin

Inferior dental nerve block

Insert the needle just superior and posterior to the lingual

Area anaesthetized:

mandibular teeth to midline,
body of mandible,
buccal mucosa anterior to mental foramen,
anterior 2/3 tongue and floor of mouth (lingual nerve)
lingual soft tissues and periosteum (lingual nerve)

Needle after use

Recap with scoop technique

Needle pliers

Needle guards

Positioning

Upper jaw injection
The chair should be positioned so that the operator will not have to bend too much forward and downwards.
The patient should be slightly tilted back in the chair.

Lower jaw injection
The operator should stand in front of the patient
The patient should be sitting upright in the chair
OR
Patient titled back and the operator stands behind the patient

topical/surface anesthesia

xylocaine ointment

flavoured xylocaine gel

lignocaine spray

ethyl chloride spray

LA solutions used for injection

xylocaine 2%

LA agent

vasoconstricter

reducing agent

preservative

fungicide

salt solution

citanest

3% prilocaine

infiltration & regional anesthesia

Basic requirements

needle

cartridge

syringe