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Module 7 Objectives:

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• Injection Fundamentals: State why needle gauge is important, understand why we aspirate before injecting, and demonstrate proper aspirating and local anesthetic injection technique.
• Needle Safety: Demonstrate safe needle re-capping techniques.
• Palatal & Mandibular Infiltrations: Deliver more comfortable palatal infiltrations, supplement a lower block with a lingual infiltration when appropriate, and identify cases where mandibular infiltrations alone can be effective.
• PDL & Interseptal Techniques: Describe the periodontal ligament (PDL) infiltration and its applications, demonstrate proper PDL infiltration technique, be familiar with the interseptal injection, and demonstrate the proper interseptal technique.
• Papilla Injection & Pain Control: Deliver atraumatic palatal anesthesia via the papilla injection technique, describe the gate control theory of pain, and apply it to make injections and exodontia more comfortable.
• Palatal Nerve Blocks: Competently utilize the greater palatine nerve block and nasopalatine nerve block.
• PSA, ASA & AMSA Blocks: Describe and demonstrate proper techniques for the posterior superior alveolar (PSA) nerve block, anterior superior alveolar (ASA) nerve block, and anterior middle superior alveolar (AMSA) nerve block.
• Maxillary (V2) Blocks: Understand and demonstrate two different approaches to maxillary (V2) nerve blocks.
• ICPAT & Mental Block: Discuss the intraoral cervical plexus anesthetic technique (ICPAT) and its merits, perform a supplementary ICPAT injection, describe the mental nerve block and its applications, and demonstrate proper technique for the mental nerve block.
• Vazirani-Akinosi & Buccal Block: Understand the applications for the Vazirani-Akinosi nerve block, perform it successfully, discuss the buccal nerve block, and utilize a more predictable buccal block technique.
• Gow-Gates & IAN Blocks: Describe and demonstrate the Gow-Gates nerve block, describe proper inferior alveolar nerve (IAN) block technique to deliver more predictable anesthesia, and recall and demonstrate less-conventional IAN block approaches.
• Block Failures: List reasons why mandibular blocks fail and how to limit these failures.
• Allergies & Adverse Reactions: List types of anesthetic allergies and learn how to circumvent or manage them; explain what methemoglobinemia is and how it can be triggered.
• Tachyphylaxis & Infection: Discuss tachyphylaxis and how it affects anesthesia quality, and appreciate why infection counteracts profound anesthesia and how to overcome this.
• Facial Nerve Paralysis: State the cause and management of temporary facial nerve paralysis.
• Carpules & Agents: Recall useful facts about anesthetic carpules, learn the properties of the five most commonly used local anesthetics in dentistry, and select the appropriate anesthetic for a given procedure.
• Articaine: Discuss the properties of articaine, its applications in exodontia, and the controversy surrounding its use for lower blocks.
• Topical Anesthetic: Describe types of topical anesthetic, demonstrate proper application, and discuss a potent, novel custom-compounded topical agent for practice use.
• Oraverse® & pKa: Describe the properties and dosage of Oraverse® (phentolamine), understand when to use it, and explain the significance of anesthetic pKa.
• Onset & Buffering: Understand why we must wait for anesthetic to take effect and discuss anesthetic buffering and its advantages.
• Diagnostic & Complex Cases: Utilize anesthesia to help diagnose toothaches in select cases, anesthetize pediatric patients more confidently, and understand how to safely anesthetize patients for multiple extractions or full-mouth clearance.