dental disorders
How To Do a Supraperiosteal Infiltration
Step by Step Description of Procedure
Wear nonsterile gloves and mask and safety glasses, or a face shield. Instruct the patient to partially close the mouth and relax the jaw, lip, and cheek muscles. Using your thumb and index finger, grasp the cheek lateral to the tooth, and retract it away from the tooth, to delineate the mucobuccal fold. Use gauze to thoroughly dry the mucobuccal fold. Use suction as needed to keep the area dry. Apply topical anesthetic with cotton-tipped applicators and wait 2 to 3 minutes for the anesthesia to occur. Inject the local anesthetic Again retract the lip laterally, to delineate the mucobuccal fold. Keep the mucosa taut. Hold the anesthetic syringe such that the needle bevel faces the tooth. Insert the needle into the depth of the mucobuccal fold and advance parallel to the tooth until it contacts bone, aiming for the apex (1 to 1.5 cm to contact the adult maxilla). Aspirate, to exclude intravascular placement. If aspiration reveals an intravascular placement, withdraw the needle 2 to 3 mm, then re-aspirate prior to injection. Slowly inject about 1 to 2 mL of anesthetic. During the injection, use a finger to apply external pressure to the cheek near the site of anesthetic deposition, to prevent local tissue ballooning. If anesthesia is not satisfactory after 10 minutes, inject a small amount on the palatal/lingual side. This is commonly required for a tooth extraction. 