Local ComplicationsLocal Complicationsinin
Anesthesia AdministrationAnesthesia Administration
Local ComplicationsLocal Complications
Needle breakageNeedle breakage
Pain on injection Pain on injection
Burning on injection Burning on injection
Persistent anesthesia or paresthesiaPersistent anesthesia or paresthesia
Lip chewingLip chewing
Local ComplicationsLocal Complications
TrismusTrismus
HematomaHematoma
InfectionInfection
EdemaEdema
Sloughing of tissuesSloughing of tissues
Local ComplicationsLocal Complications
Facial nerve paralysisFacial nerve paralysis
Post-anesthetic intraoral lesionsPost-anesthetic intraoral lesions
Local ComplicationsLocal Complications
Written documentation is mandatoryWritten documentation is mandatory
Follow-up care should be arrangedFollow-up care should be arranged
Needle BreakageNeedle Breakage
CausesCauses
Unexpected movementUnexpected movement
Small needle sizeSmall needle size
Bent needlesBent needles
Defective needlesDefective needles
Needle BreakageNeedle Breakage
PreventionPrevention
Use large needlesUse large needles
Use long needles for deep injection,>18mmUse long needles for deep injection,>18mm
Never insert to hubNever insert to hub
Redirect only when adequately withdrawnRedirect only when adequately withdrawn
Needle BreakageNeedle Breakage
ManagementManagement
Remain calmRemain calm
Don't exploreDon't explore
Have the patient keep opening wideHave the patient keep opening wide
If the needle is out remove itIf the needle is out remove it
Refer to an Oral SurgeonRefer to an Oral Surgeon
Pain on InjectionPain on Injection
CausesCauses
Careless techniqueCareless technique
Dull needlesDull needles
Rapid deposit of solutionRapid deposit of solution
Needles with barbsNeedles with barbs
Pain on InjectionPain on Injection
PreventionPrevention
Careful techniqueCareful technique
Sharp needlesSharp needles
Topical anestheticTopical anesthetic
Slow injectionsSlow injections
Room temperature solutionsRoom temperature solutions
Burning on InjectionBurning on Injection
CausesCauses
pH of solutionpH of solution
Rapid injectionRapid injection
ContaminationContamination
Warmed solutionsWarmed solutions
Persistent AnesthesiaPersistent Anesthesiaor Paresthesiaor Paresthesia
CausesCauses
Trauma to nerve Trauma to nerve
Neurolytic agents (alcohol, phenol)Neurolytic agents (alcohol, phenol)
Intraneural injectionIntraneural injection
HematomaHematoma
Persistent AnesthesiaPersistent Anesthesiaor Paresthesiaor Paresthesia
PreventionPrevention
Careful injection techniqueCareful injection technique
Unavoidable at timesUnavoidable at times
Persistent AnesthesiaPersistent Anesthesiaor Paresthesiaor Paresthesia
ManagementManagement
Patient counseling and reassurancePatient counseling and reassurance
DocumentationDocumentation
Follow-upFollow-up
Appropriate referralAppropriate referral
TrismusTrismus
A motor disturbance of the trigeminal nerve A motor disturbance of the trigeminal nerve precipitating or resulting in spasm of precipitating or resulting in spasm of
the muscles of masticationthe muscles of mastication
TrismusTrismus
CausesCauses
Trauma to muscles or blood vesselsTrauma to muscles or blood vessels
Contaminated anesthetic solutionsContaminated anesthetic solutions
HemorrhageHemorrhage
InfectionInfection
Excessive anesthetic volumeExcessive anesthetic volume
TrismusTrismus
PreventionPrevention
Sharp needlesSharp needles
Proper care and handling of cartridgesProper care and handling of cartridges
Aseptic technique and clean injection siteAseptic technique and clean injection site
Atraumatic insertionAtraumatic insertion
Minimal injections and volumeMinimal injections and volume
TrismusTrismus
ManagementManagement
ExaminationExamination
Conservative therapyConservative therapy
passive ROM therapypassive ROM therapy
analgesicsanalgesics
heatheat
muscle relaxantsmuscle relaxants
HematomaHematoma
The effusion of blood into extravascular The effusion of blood into extravascular spacesspaces
Hematoma Hematoma
PreventionPrevention
Care with needle placementCare with needle placement
Minimize injectionsMinimize injections
Don't probe with needleDon't probe with needle
Modify techniqueModify technique
short needlesshort needles
penetration depthpenetration depth
HematomaHematoma
Management withManagement with
IAN blockIAN block
Infraorbital blockInfraorbital block
Mental Nerve blockMental Nerve block
Buccal blockBuccal block
PSA blockPSA block
InfectionInfection
CausesCauses
Needle contaminationNeedle contamination
Improper handling of armamentariumImproper handling of armamentarium
Infection at injection siteInfection at injection site
Improper handling of tissueImproper handling of tissue
InfectionInfection
PreventionPrevention
Disposable needlesDisposable needles
Proper care of equipmentProper care of equipment
Aseptic techniqueAseptic technique
InfectionInfection
ManagementManagement
Usual sign is trismusUsual sign is trismus
Trismus persists (1-3 day resolution )Trismus persists (1-3 day resolution )
Antibiotics, if suspiciousAntibiotics, if suspicious
EdemaEdema
CausesCauses
Trauma during injectionTrauma during injection
InfectionInfection
AllergyAllergy
HemorrhageHemorrhage
Irritating solutionsIrritating solutions
EdemaEdema
ManagementManagement
Address causeAddress cause
Treat accordinglyTreat accordingly
hemorrhagehemorrhage
allergyallergy
infectioninfection
Sloughing of TissueSloughing of Tissue
CausesCauses
Topical anestheticTopical anesthetic
Prolonged ischemiaProlonged ischemia
Sloughing of TissueSloughing of Tissue
ManagementManagement
ObservationObservation
DocumentationDocumentation
Lip ChewingLip Chewing
ManagementManagement
AnalgesicsAnalgesics
AntibioticsAntibiotics
Saline rinsesSaline rinses
Lip lubricantsLip lubricants
Facial Nerve ParalysisFacial Nerve Paralysis
CauseCause
Anesthesia of peripheral Facial nerve branchesAnesthesia of peripheral Facial nerve branches
TemporalTemporal
ZygomaticZygomatic
BuccalBuccal
MandibularMandibular
CervicalCervical
Facial Nerve ParalysisFacial Nerve Paralysis
PreventionPrevention
Bone contact when injectingBone contact when injecting
Avoid over penetrationAvoid over penetration
Avoid arbitrary injectionAvoid arbitrary injection
Facial Nerve ParalysisFacial Nerve Paralysis
ManagementManagement
Reassure patientReassure patient
Cornea careCornea care
DocumentationDocumentation
Consider deferring dental careConsider deferring dental care
Post Anesthetic Intraoral LesionsPost Anesthetic Intraoral Lesions
Recurrent apthousRecurrent apthous
Herpes SimplexHerpes Simplex