II. Indications
- Tooth Anesthesia for all but the molar teeth
- Most useful for the upper teeth
- Inferior alveolar Nerve Block is preferred for the lower teeth
III. Preparation
- Bupivicaine 0.25% with Epinephrine 2 cc in a 3 cc syringe (or dental control syringe)
- Needle 27 gauge 1.25"
- Topical benzocaine 20% gel
IV. Technique
- Apply topical benzocaine 20% gel to injection site
- Grasp the upper lip with gauze and retract
- Insert needle into the Buccal mucosa above the affected tooth
- Needle insertion site is at the mucobuccal fold
- Fold is where the upper lip meets the Buccal mucosa
- Angle the needle toward the Maxilla
- Advance the needle until it strikes the Maxilla
- Withdraw the needle 1 mm
- Aspirate and then inject the 1-2 cc of Bupivicaine
V. Resources
- Medscape EMedicine: Oral Nerve Block
VI. References
- Stine (1994) Practical Approach to Emergency Medicine, 2nd ed., Little Brown, Boston, p. 1033