dental disorders
How To Do an Infraorbital Nerve Block, Intraoral
Step by Step Description of Procedure
Wear nonsterile gloves and a mask and safety glasses, or a face shield. Externally palpate the infraorbital ridge to identify the infraorbital foramen. Place and maintain your middle finger over the infraorbital foramen. Using your index finger and thumb, grasp and retract the upper lip laterally. Use gauze to thoroughly dry the mucobuccal fold adjacent to the 2nd maxillary premolar tooth. Apply topical anesthetic with cotton-tipped applicators and wait 2 to 3 minutes for the anesthesia to occur. Inject the local anesthetic Instruct the patient to slightly open the mouth and relax the jaw and lip muscles. Retract the upper lip laterally, to delineate the mucobuccal fold. Insert the needle into the mucobuccal fold above the 2nd upper premolar tooth, and advance the needle parallel to the long axis of the tooth toward the infraorbital foramen. Maintain a shallow angle of insertion and advance the needle cephalad until your middle finger can palpate the needle tip under the skin near the foramen (usually at an insertion depth of about 2.5 cm). A steeper angle of insertionwill hit bone before reaching the foramen. A too-shallow angle of insertionwill risk inserting too far and entering the orbit. Aspirate, to rule out intravascular placement. If aspiration reveals an intravascular placement,withdraw the needle 2 to 3 mm, then re-aspirate prior to injection. Slowly inject about 2 to 3 mL of anesthetic adjacent to, but not into, the infraorbital foramen. Massage the area externally for about 10 seconds to hasten the onset of anesthesia. 