Dentistry/Inferior Alveolar Nerve Blocks
QUESTION: I take great care of my teeth and haven't had dental work done in many years. I've never had an inferior alveolar nerve block/mandibular injection (although I've read about them online), so I don't know what to expect or what it would feel like, but if I ever needed one for a procedure, I would be anxious about it. I guess I'm more worried about the needle passing through the tissues, esp. since they're 1 in. or longer and have to be advanced deep into the jaw to reach the nerve area. How badly does that hurt (on a 5-point scale, 5 being the worst), and how long does the pinching sensation last (e.g., a few seconds)? Also, will it lead to jaw-muscle or TMJ soreness after the anesthetic wears off? I know I should look at the cost-benefit analysis of it by mentally getting past any initial mild discomfort from the prick of the needle and focusing on the end result of total pain relief/numbness for dental work, which is definitely preferable than no anesthesia at all! Nevertheless, anything dentists could do that would minimize the discomfort from such injections as described would be greatly appreciated! Thank you.
ANSWER: hi michael...sorry about the delay in responding...this question just popped up today (friday). you ask some very good questions here. but if done slowly and carefully, a block should not be too bad at all. first off, you like topical anesthetic in place. this helps. next, you want to use a technique that is gently. position the needle very slowly and inject the solution very slowly. this is the key to keeping things painless during and after. if done like this, you should have very little discomfort. as far as pain later goes, some people can experience muscle soreness but ths happens very infrequently. discuss your fears with your dentist. talk about him/her going very slowly to minimize discomfort. another option is maybe using a little nitrous oxide analgesia first to relax you before getting the injection. we do that a lot for patients with similar fears. it helps a lot. good luck
jeff dalin, dds
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QUESTION: Thank you for your kind & thoughtful reply. If I may, I'd like to ask a follow-up question. Since there is a possibility of an electric-shock-type feeling if the needle touches the main nerve in the mandibular area, how common is that occurrence in dental practice, and is it a cause for anxiety/concern?
Also, even though I highly doubt I'll ever need that type of injection (or maybe even any anesthesia for that matter since I always keep my teeth clean), what do you think of me asking my dentist to give me a sample inferior alveolar injection at my next appt., even if I don't actually need to have dental work done? I know it sounds odd, but the reason I ask is that perhaps experiencing one would help me overcome my potential fear of it since you described it as causing little discomfort, although reading about it has been helpful to a certain extent. Thanks again.
the odds of this happening are very, very small. i would not ask for a sample injection...why get a shot if you have no need for one. i would go with your feeling that you will never need one. here is my recommendation for if that time comes: use nitrous oxide analgesia first before the injection. it will relax you enough that you will not be nervous. and just let your dentist know about your fear. he or she will be gentle and talk their way through the process to make you more relaxed. good luck
jeff dalin, dds