Block or local anesthetic?

sudzs

I had a small filling in a lower premolar a couple of weeks ago and for it, was given a block anesthetic.

Today I had 2 large fillings, one in an upper molar, the other in a lower premolar (same side) and just had a local for each.


I hate anesthetics but really hate the block one!! Can anyone explain why a block anesthetic would be used for a small filling and just locals for much larger fillings?


Should mention that the small filling that required the block anesthetic was from scratch whereas the 2 larger ones today were old fillings being replaced as there was some decay beneath them.

ballsymchugh

lower bone is fierce dense, so everyday LA won't penetrate it, so for lower fillings, the injection is given in a site in or around where the nerve goes into the canal in the bone, so it numbs the lot.

upper bone is very porous, and the LA seeps through easily.

however, sometimes an infiltration can work on lower premolars, as that's where the nerve comes out of the canal.

sudzs

ballsymchugh wrote: »

lower bone is fierce dense, so everyday LA won't penetrate it, so for lower fillings, the injection is given in a site in or around where the nerve goes into the canal in the bone, so it numbs the lot.

upper bone is very porous, and the LA seeps through easily.

however, sometimes an infiltration can work on lower premolars, as that's where the nerve comes out of the canal.

Thanks, yet again (!) ballsymchugh!

But one of the large filling replacements was on a lower premolar. And I just got a local for that yesterday, whereas a couple of weeks ago, I had a block anfor a very small filling on a lower premolar. That was with a different dentist though, my NHS friend :rolleyes:

ballsymchugh

it's down to personal preference too. if i have a few patients in a row who all need the same work done on a premolar, and 4/5 don't anaesthetise with an infiltration, then everyone else that day will get a block.

it all depends exactly where the nerve canal ends, usually it's between the premolars, but sometimes it can be a little more towards the front, meaning that a block would be better, or a little more towards the back, where an infiltration would be fine.