8/3/2019 Common Local Anesthetic Injections for Dental Hygiene Procedures

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COMMON LOCAL ANESTHETIC INJECTIONS FOR DENTAL HYGIENE PROCEDURESINJECTION 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

molarsunilaterally

25- or

27-

gauge

long

8 or 9

oclock

In the vestibule,

distal and buccal to

the most distal molar

at the height of theocclusal plane

Mandibular molars,

buccal vestibule &

mucobuccal fold

Parallel to

the

mandibular

occlusalplane on the

buccal side

of the teeth

1-4 mm, often

only the bevel is

inserted

0.3-0.4 mL

Or one

eighth to

one quarterof a

cartridge

Approx.

10-20

seconds

Inferior

alveolar with

lingual nerve

block (IA)

IA: Inferior

alveolar,

incisive,

mental Li:

Lingual

IA: Mandibular

teeth (molars,

premolars,

canine &

incisors)

unilaterally to

midline, body of

mandible,

inferior portions

of the mandible,

facial tissue

anterior to the

1st

molar, lower

lip to midline, Li:

All lingual

gingival tissueunilaterally to

midline, anterior

two thirds of the

tongue, floor of

the mouth

unilaterally

25- or

27-

gauge

long

8 or 9

oclock

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

Approaches

from

contralateral

premolar

area,

parallel to

the occlusal

plane

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: 0.9-1.8

mL or one

half to one

cartridge

Li: 0.45 mL

or one

quarter of a

cartridge

IA: 60 -

120

seconds

Li: 10

15

seconds

Mental

Nerve Block

(M)

Mental

(terminal

branch of

Facial soft tissues

unilaterally from

the mental

25- or

27-

gauge

8 or 9

oclock 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

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inferior

alveolar

nerve)

foramen anterior

to midline, lower

lip, skin of chin

short oclock foramen foramen enter the mental

foramen

Incisive

Nerve Block

(I)

Incisive,

Mental

(terminal

branch of

inferior

alveolar)

Mandibular

second premolar

to central incisor

unilaterally,

facial soft tissues

from the mental

foramen anterior

to midline, lower

lip, skin of chin

25- or

27-

gauge

short

8 or 9

oclock or

11 or 1

oclock

Mucobuccal fold

directly over the

mental foramen

Mucobuccal fold,

mandibular

premolars, Mental

foramen

Directed

toward 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