Dentaltown November 2019 - 54

message board

I haven't used the end of a mirror/cotton tip pressure/cold cotton tip in years. What I provided
above absolutely works. On my hands. Good luck. I'm happy to share more tips that help me. ■
10/6/2019

tiger cub
Member Since: 09/08/02
Post: 6 of 22

Jack, it looks like the "debarbing of the injection needle" is the major cause of paralysis of the
marginal mandibular. It may not be the septo. I would love to see your office and talk dentures. ■
10/6/2019

fletch33
Member Since: 01/06/06
Post: 7 of 22

I routinely use the back end of the mirror and press on the tissue where the needle will be
inserted. It hides most of the pinch. You must inject slowly, or the fluid pressure will elicit a
reaction.
The only way I know that will really reduce if not eliminate pain is to come from the
buccal. Anesthetize the buccal, wait a minute, then go through the papilla M/D slowly. Watch
for blanching on the palate. Once that is complete, you can then go to the blanched area
and add more. I have posted this video before, so watch for any reaction of this extremely
apprehensive kid.
[Editor's note: To watch this video, view this message board online.] ■
10/6/2019

jefff95
Member Since: 11/04/16
Post: 8 of 22

TuttleNumbNow
Member Since: 11/02/15
Post: 9 of 22

Practice saying "OK, this last part is going to suck," in a very comforting manner. ■
10/6/2019

The wooden end of a cotton tip applicator works better than the mirror handle, in my experience. Substitute the pressure applied to the tissue with the applicator with the needle insertion
and subsequent anesthetic delivery and go slow for success. Reducing the palatals needed by
intraosseous penetration from the buccal to the palatal is what I strive for. ■
10/6/2019

D_Dentist
Member Since: 07/03/15
Post: 10 of 22

davidpalmer
Member Since: 04/14/00
Post: 11 of 22

Dr. Tuttle, how long do you apply pressure with the Q-tip on the palate before injecting? ■
10/6/2019

Most clinicians tend to do the palatal last when injecting. Big point. Change needles!
Don't use the now-dull one. New 30ga evolution needle, bend some in the middle so you get
a 90-degree penetration to the tissue, and use your other hand to press firmly with one finger
just distal to the injection. Keep the pressure with your finger as you slowly inject. Patients feel
mainly pressure.
If you use the same needle you used on buccal, etc., it will not penetrate as nicely. Palatals
are the only injections that seem to be impossible to make completely pain free. Not much of a
space for the local to go. ■
10/6/2019

Have any tips or
tricks to share?
It seems as if a lot of Townies are in agreeance
with how to make palatal injections less painful.
Do you do some of these things too? To share
your advice or let others know how their tips
helped you, go to dentaltown.com/magazine.

54

NOVEMBER 2019 // dentaltown.com
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Dentaltown November 2019

Table of Contents for the Digital Edition of Dentaltown November 2019
