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