dental disorders
How To Do a Supraperiosteal Infiltration
Equipment
Dental chair, straight chair with head support, or stretcher Light source for intraoral illumination Nonsterile gloves Mask and safety glasses, or a face shield Gauze pads Cotton-tipped applicators Dental mirror or tongue blade Suction Equipment to do local anesthesia: Topical anesthetic ointment* (eg,lidocaine5%,benzocaine20%) Injectable local anesthetic such aslidocaine2% with or withoutepinephrine† 1:100,000, or for longer duration anesthesia,bupivacaine0.5% with or withoutepinephrine† 1:200,000 Dental aspirating syringe (with narrow barrel and custom injectable anesthetic cartridges) or other narrow barrel syringe (eg, 3 mL) with locking hub 25- or 27-gauge needle: 2 cm long for supraperiosteal infiltration * CAUTION: All topical anesthetic preparations are absorbed from mucosal surfaces and toxicity may result when dose limits are exceeded. Ointments are easier to control than less-concentrated topical liquids and gels. Excessbenzocainerarely may cause methemoglobinemia. † Maximum dose of local anesthetics:Lidocainewithoutepinephrine, 5 mg/kg;lidocainewithepinephrine, 7 mg/kg;bupivacaine, 1.5 mg/kg. NOTE: A 1% solution (of any substance) represents 10 mg/mL (1 gm/100 mL).Epinephrinecauses vasoconstriction, which prolongs the anesthetic effect. Patients with cardiac disease should receive only limited amounts ofepinephrine(maximum 3.5 mL of solution containing 1:100,000epinephrine); alternatively, use local anesthetic withoutepinephrine. 