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Local Anesthesia in Pediatric Dentistry
Local Infiltration of the Maxillary Primary and Permanent Incisors and Canines

Course Author(s): Jayakumar Jayaraman, BDS, MDS, FDSRCS, MS, PhD; Steven Schwartz, DDS

Local Infiltration of the Maxillary Primary and Permanent Incisors and Canines

Technique:

  • 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 with the syringe parallel to the long axis of the tooth. Advance the needle 2mm approximating the apex of the root (Figure 11).
  • Aspirate.
  • Inject a ¼-½ cartridge of anesthetic.
maxillary canine injection
Figure 11. Local Infiltration of the Maxillary Primary and Permanent Incisors and Canines
  • If it is necessary to anesthetize an adjacent tooth, partially withdraw the needle and turn the needle in the direction of the indicated tooth in advance the needle until it approximates the apex.
  • Aspirate.
  • Inject ¼-½ cartridge of anesthetic.
  • If palatal tissue anesthesia is necessary (extraction or incomplete anesthesia of the tooth due to accessory innervation from the palatal nerves), 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  • The needle is withdrawn and recapped.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. The patient should exhibit numbness in the area of administration and absence of pain during treatment.
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