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Anesthesia

4 Techniques (eventually combinations) of anesthesia are discussed.

1. mandibular block anesthesia
2. infiltration anesthesia
3. intraligamental anesthesia
4. intrapulpal anesthesia

ad a. To get sufficient anesthesia of the molars in the mandibule, a mandibular block is the best method. It is preferred to give the mandibular block 15 minutes before starting the treatment. When the anesthesia is not working sufficiently, one should give more. Sometimes a mandibular block alone will not be sufficient (pulpitis). Lingual and buccal infiltration around the element takes care of the rest of the anesthsia. When this is insufficient intraligamental and intrapulpal anesthesia can be given.

ad b. Infiltration anesthesia is sufficient for most other situations. To perform a painless endodontic treatment it is recommanded to give infiltration anesthesia buccal and lingual/palatal. Buccal one carpule and palatal half a carpule is enough. More is seldom necessary.

ad c. Intra ligamental anesthesia can give the finishing touch. The advantage is that the anesthesia works very quickly. The disadvantage is that it only works for a short time.

ad d. Intrapulpal anesthesia is more or less an emergency solution. The patient still feels pain during the first part of the treatment. Working as fast as possible is recommended.

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