Dentists will learn a lot of techniques as their careers progress, and the internet certainly helps. One of the most challenging tasks a dental practitioner will face is finding a good anesthesia for the lower molars which works consistently well. Most are taught to apply IANB, or inferior alveolar nerve block, only to have the patient still experience pain, requiring the dentist to apply more. However, there are always alternatives available.
Alternatives to IANB
Some dentists have experimented with an intra-osseous method referred to as X-tip. It involves a contraption which allows the dentist to open a hole in gingiva and the cortical plate with a needle that is attached to a hand piece with slow speed. Although it is effective, the downside is that it can be a bit traumatic to the patient and even dentists. It requires good aim and not striking the root.
Another option is PDL, or periodontal ligament injection. Many dentists consider this technique to be a last resort option, since by the time you start it; the patient is typically quite weary and rapidly losing their confidence. However, of all the methods available, PDL shows tremendous promise, and there are a number of reasons why.
Why PDL Should Be Considered First
Dentists who want to perform procedures faster and more efficiently will often experiment with various methods and tools. One which has been developed over the years is the usage of PDL regularly on lower molars as the main method for distributing anesthesia. Other dentists have tried it and have reported being surprised at its effectiveness. Most will modify the procedure to one degree or another, but when done correctly it is far more efficient than IANB. In fact, PDL has proven so effective that once becoming accustomed to it many dentists will abandon IANB completely.
The reason for this is because PDL will get the patient’s lower molars exceptionally numb, rapidly. It is reliable, and a real boost of confidence for patients. They will be able to relax, assured that they won’t feel anything, which then allows the dentist to do his or her best work as they don’t have to worry about the jumps and flinches which are associated with sudden, unexpected pain.
How PDL Should Be Done
PDL can be broken down into six steps, which are the topical application of the anesthetic, secondary anesthetic, syringe (PDL), regular syringe, short needle (thirty gauge) and then another needle which is extra short (thirty gauge). The topical anesthetic should be high in quality and the tissue should be dried. The best secondary anesthetic is Articaine (also known as Septocaine). It is absolutely essential to use a PDL syringe, since it will provide superior leverage and hand control. These syringes are pricey, but as with many things in life that are, they are worth every penny, as they will make the operation much predictable, relaxing and straightforward.
