Local Infiltration Techniques

what is an infiltration

Infiltration is aiming to numb the individual branches of CNV2 or CNV3 eg mental nerve

what is a nerve block

Block analgesia is aiming to numb the whole maxillary or mandibular branch

what needle for infiltration

short

what needle for nerve block

long

what is in the analgesic solution usually and why

lidocaine and adrenaline so that the adrenaline is a vasoconstrictor and reduces bleeding for better vision

why is patient always supine

reduces vasovagal attack

better vision for operator

how is topical analgesia given

dry area with cotton wool

small amount if analgesia at site of injection

wait 2 mins before injecting

how does a self aspirating syringe work

leaks blood into the cartridge when hit a blood vessel to stop intravascular injection

what nerve supplies the maxillary teeth

superior alveolar nerves

palataly nasopalatine

what nerve supplies hard palate

nasopalatine nerve

what innervates upper premolar

superior plexus (convergence of all superior nerves)

palatally is greater palatine

what innervates upper molar

superior posterior alveolar nerve

palatal for greater palatine nerve

where do we inject palatal injections

between median raphe and gingival margin of the target tooth

(centre point of gingival margin and the centre of the incisors)

avoid rugae and foramen

why do injections blanche

due to vasoconstrictor

how to we numb mandible

has to be nerve block for mandible

what innervates lower anteriors

incisive nerve

lies within ID canal

hit mental tuberence

how can we numb the 3 if unsuccessful with incisive nerve

mental block

this also does premolars

how is lingual nerve infiltration done

in the centre of the papilla

if none cos of perio, know the crest of the bone and stay above it

how is buccal infiltration done

point of entry is at lower 6 then take needle back to the 7 then inject

this is to avoid the inferior alveolar nerve

what are the post op instructions

POIG in notes

they will feel numb for a few hours but will return to normal gradually

this may be accompanied with itchiness and tingliness

dont bite tooth tongue cheek etc

be careful of temperatures of food

for painkillers after, tell them to take what they normally take for a headache (not ibuprofen as its antiplatelet)

how can analgesia fail

fatty tissue and scar tissue can cause it to not work

IV injection - no effect as it is carried by blood stream and can cause syncope

intramuscular - can cause paralysis of facial muscles

why do we not inject an infection site

analegesia works better in aklakine and an abcess is acidic so solution wont take

can also cause sepsis