ARE YOU NUMB YET? Patients rate “painless injections” as PROBLEM-SOLVING THE DELIVERY the most important criteria in evaluating OF LOCAL ANESTHESIA their dentist or dental hygienist de St Georges J, How dentists are judged by patients, Dentistry Today, Vol. 23, August 2004 Alan W. Budenz, MS, DDS, MBA Professor, Dept. of Biomedical Sciences and Interim Chair, Dept. of Diagnostic Sciences University of the Pacific, Arthur A. Dugoni School of Dentistry San Francisco, California 90% of all patients report being anxious
[email protected] about going to the dentist or dental hygienist Friedman & Krochak, Using a precision-metered injection and receiving a shot. system to minimize dental injection anxiety, Compend Contin Educ Dent, Vol. 19(2), Feb 1998 Reasons for Anesthetic Failures Reasons for Anesthetic Failures 1. Anatomical/physiological 1. Anatomical/physiological variations variations 2. Technical errors of administration Wide flaring mandible Wide flaring ramus 3. Patient anxiety Long (A - P) ramus 4. Inflammation and infection Bulky musculature Large buccal fat pad 5. Defective/expired solutions Class III occlusion Missing teeth Children Wong MKS & Jacobsen PL, Reasons for local anesthesia failures, J Am Dent Assoc, Vol 123, Jan 1992 Accessory or anomalous nerve pathways Reasons for Anesthetic Failures Reasons for Anesthetic Failures 1. Anatomical/physiological 2. Technical errors of administration variations Too high Too low 2. Technical errors of Too anterior administration Too posterior These two are Too medial closely