Local Anesthesia in Pediatric Dentistry
Lingual Nerve Block

Successful anesthesia of the inferior alveolar nerve will result in anesthesia of the lingual nerve with the injection of a small quantity of the solution as the needle is withdrawn. The clinician must not assume effective anesthesia is attained if the patient only exhibits tongue symptoms. The patient must also exhibit lip and mucosa symptoms.

Long Buccal Nerve Block

The long buccal nerve provides innervation to the buccal soft tissues and periosteum adjacent to the mandibular molars. For the removal of mandibular permanent molars or for placement of a rubber dam clamp it is necessary to anesthetize the long buccal nerve. It is contraindicated in areas of acute infection.

Technique:

• With the index finger, pull the buccal soft tissue in the area of the injection taut to improve visibility.
• Direct the needle toward the injection site with the bevel facing bone and the syringe aligned parallel with the occlusal place and buccal to the teeth.
• Penetrate the mucous membrane at the injection site distal and buccal to the last molar.
• Advance the needle slowly until mucoperiosteum is contacted.
• The depth of penetration is 1-4mm.
• Aspirate.
• Inject approximately ⅛ of a cartridge over 10 seconds.
• The needle is withdrawn and recapped.
• Wait 3-5 minutes before commencing treatment.