dental disorders
How To Do an Infraorbital Nerve Block, Intraoral
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: 3-cm long for nerve blocks * 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. 