Technique to Supplement Block Anesthesia

• Retract the cheek so the tissue of the mucobuccal fold is taut.

• Apply topical anesthetic.

• Orient the needle bevel toward the bone.

• Penetrate the mucosa on the same side as the block close to the midline at the mucogingival margin and advance the needle 2mm approximating the location of the apex of the root. The needle is inserted in a diagonal direction and the solution is deposited on the opposite side of the midline. A ½ cartridge of solution should suffice.

• The needle is withdrawn and recapped.

• Wait 3-5 minutes before commencing treatment.

Technique for Anterior Restorations and Extractions

• Retract the cheek so the tissue of the mucobuccal fold is taut.

• Apply topical anesthetic.

• Orient the needle bevel toward the bone.

• Penetrate the mucosa labial to the tooth to be treated close to the bone at the mucogingival margin. Advance the needle 2mm approximating the apex of the root. Inject a ¼-½ cartridge of anesthetic.

• If it is necessary to anesthetize an adjacent tooth, partially withdraw the needle and turn the needle in the direction of the indicated tooth and advance the needle until it approximates the apex.

• If lingual tissue anesthesia is necessary (extraction), then one can inject anesthetic solution directly into the lingual tissue at the free gingival margin or one can insert the needle interproximally from the buccal and deposit anesthesia as the needle is advanced lingually.

• The needle is withdrawn and recapped.

• Wait 3-5 minutes before commencing treatment.