COMMON LOCAL ANESTHETIC INJECTIONS FOR DENTAL HYGIENE PROCEDURES

INJECTION NERVES ANETHETIZED TISSUES ANESTHETIZED NEEDLE GAUGE AND LENGTH OPERATOR POSITION PENETRATION SITE LANDMARKS SYRINGE ORIENTATION PENETRATION DEPTH AMOUNT OF ANESTHETIC TO BE DEPOSITED LENGTH OF TIME TO DEPOSIT

Mandibular Arch Long buccal (LB)

Buccal

Soft facial tissues buccal to the mandibular molars unilaterally

25- or 27gauge long

8 or 9 o clock

In the vestibule, distal and buccal to the most distal molar at the height of the occlusal plane

Mandibular molars, buccal vestibule & mucobuccal fold

Inferior alveolar with lingual nerve block (IA)

IA: Inferior alveolar, incisive, mental Li: Lingual

Mental Nerve Block (M)

Mental (terminal branch of

IA: Mandibular teeth (molars, premolars, canine & incisors) unilaterally to midline, body of mandible, inferior portions of the mandible, facial tissue anterior to the st 1 molar, lower lip to midline, Li: All lingual gingival tissue unilaterally to midline, anterior two thirds of the tongue, floor of the mouth unilaterally Facial soft tissues unilaterally from the mental

25- or 27gauge long

8 or 9 o clock

Middle of the pterygomandibular triangle (formed by the pterygomandibular raphe medially & the internal oblique ridge laterally) at the height of the coronoid notch, 6-10 mm above the mandibular occlusal plane

Anterior border of the ramus, external oblique ridge, coronoid notch, internal oblique ridge, pterygomandibular raphe, pterygomandibular triangle, mandibular occlusal plane

Parallel to the mandibular occlusal plane on the buccal side of the teeth Approaches from contralateral premolar area, parallel to the occlusal plane

1-4 mm, often only the bevel is inserted

0.3-0.4 mL Or one eighth to one quarter of a cartridge IA: 0.9-1.8 mL or one half to one cartridge Li: 0.45 mL or one quarter of a cartridge

Approx. 10-20 seconds

IA: Until bone is gently contacted. Approximately 20-25 mm or 2/3 to of needle (withdraw 1mm before deposition), Li: Withdraw needle halfway after deposition for IA

IA: 60 120 seconds Li: 10 15 seconds

25- or 27gauge

8 or 9 o clock or 11 or 1

Mucobuccal fold directly over the mental foramen

Mucobuccal fold, mandibular premolars, Mental

Directed toward the mental

5-6 mm, or for the needle length (do not

0.6 mL or one third of a cartridge

Approx. 30-60 seconds

Incisive Nerve Block (I)

inferior alveolar nerve) Incisive, Mental (terminal branch of inferior alveolar)

foramen anterior to midline, lower lip, skin of chin Mandibular second premolar to central incisor unilaterally, facial soft tissues from the mental foramen anterior to midline, lower lip, skin of chin

short

o clock

foramen

foramen

enter the mental foramen 5-6 mm, or for the needle length (do not enter the mental foramen 0.6-0.9 mL or one third to one half of a cartridge Approx. 30-60 seconds

25- or 27gauge short

8 or 9 o clock or 11 or 1 o clock

Mucobuccal fold directly over the mental foramen

Mucobuccal fold, mandibular premolars, Mental foramen

Directed toward the mental foramen