Mental & Incisive Block Lab Slides PDF

INCISIVE/MENTAL BLOCK DH 327 - Natalie Ferrigno, RDHAP, MS  Natalie Ferrigno - DH 327 INCISIVE BLOCK & MENTAL BLOCK Slide 2 COMPARISON OF MENTAL BLOCK & INCISIVE BLOCK  Difference:  Incisive block anesthetizes teeth...

INCISIVE/MENTAL BLOCK DH 327 - Natalie Ferrigno, RDHAP, MS  Natalie Ferrigno - DH 327 INCISIVE BLOCK & MENTAL BLOCK Slide 2 COMPARISON OF MENTAL BLOCK & INCISIVE BLOCK  Difference:  Incisive block anesthetizes teeth Natalie Ferrigno - DH 327  Differing amount of anesthetic solution  Pressure at mental foramen (Incisive)  Needle gauge & length: 27-gauge, short (same)  Operator position: same  Syringe stabilization: same  Landmarks: same  Needle insertion point, penetration, and location: same  Amount of anesthetic: 0.6 (mental) , 0.6 – 0.9 (incisive)  Length of time to deposit: same Slide 3 MENTAL & INCISIVE BLOCKS  Mental block is recommended for  Incisive block is recommended for anesthesia of the facial gingival tissue anesthesia of the teeth and (usually of the anterior teeth and periodontium and facial soft tissue anterior to the mental foramen, Natalie Ferrigno - DH 327 premolars) anterior to the mental usually the anterior teeth and foramen. It also anesthetizes the lower premolars lip and the skin of the chin to the midline.  Useful when there is a crossover of  Deposit location is where the mental the contralateral incisive nerve and nerve enters the mental foramen to there is still discomfort on the merge with the incisive nerve to form the mandibular anterior teeth after IA nerve. giving an IANB  Location of mental foramen is usually between the apices of the mandibular  Useful for nonsurgical perio or first and second premolars. routine maintenance of sensitive anteriors Slide 4  Slide 5 Natalie Ferrigno - DH 327 USE RADIOGRAPHS!  Natalie Ferrigno - DH 327 Target area for Mental & Incisive block Landmarks: Mandibular premolars, mental foramen, mandibular mucobuccal fold Needle insertion point: Depth of mucobuccal fold anterior to mental foramen (5-6mm) Amount of anesthetic: Approximately 0.6 ml or 1/3 of cartridge (mental) Approximately 0.6 – 0.9 ml or 1/3 -1/2 of cartridge (Incisive) Depth of needle penetration: Approximately 5mm – 6mm or 1/4 the depth of short needle Slide 6 Length of time to deposit: Approximately 30 – 60 seconds  Natalie Ferrigno - DH 327 Injection site for mental or incisive Vertical (taught in lab – most reliable) Horizontal (not taught in lab - more technique sensitive and target easily missed) Slide 7  Natalie Ferrigno - DH 327 Vertical approach Operator position - right & left-handed clinician - for either mental block or incisive block: 11 to 1 o’clock. With the operator positioned for the vertical approach. Hand placement (fulcrum) on side of forehead/face ipsilateral to insertion site (please ONLY use the stabilization techniques shown in lab) ** MIRROR to be used for Retraction during Mental and Incisive Injection** Slide 8  INCORRECT hand placement Fulcrum must be on same side as injection *ipsilateral* Never cross over patient Natalie Ferrigno - DH 327 face with a needle *critical error* Vertical approach Operator position - right & left-handed clinician - for either mental block or incisive block: 11 to 1 o’clock. With the operator positioned for the vertical approach. Hand placement (fulcrum) on side of forehead/face ipsilateral to insertion site (please ONLY use the stabilization techniques shown in lab) Slide 9 ** MIRROR to be used for Retraction during Mental and Incisive Injection**  Horizontal Approach Natalie Ferrigno - DH 327 Operator position of right-handed clinician for either mental block or incisive block Right-handed clinician: Horizontal approach right & left side: 8 – 9 o’clock Slide Left-handed clinician: 10 Horizontal approach right & left side: 3 – 4 o’clock  Natalie Ferrigno - DH 327 Syringe stabilization for either mental block or incisive block (please ONLY use the stabilization techniques shown in lab) Slide ** MIRROR to be used for Retraction during Mental and Incisive Injection** 11  INCISIVE BLOCK COMPLICATIONS  Inadequate anesthesia  Causes: inadequate volume of anesthetic or inadequate duration of pressure over mental foramen Natalie Ferrigno - DH 327  Correction: reinject in correct location and apply firm pressure to deposition site for minimum of 2 minutes  Hematoma  Same percentage as for mental block; occurrence is still rare  Apply pressure with gauze to the area  Reassure patient Slide 12 TECHNIQUE DIFFERENCE WITH MENTAL & INCISIVE BLOCK  Mental: Do not apply pressure to the injection area after the mental block injection Natalie Ferrigno - DH 327  Incisive: Apply gentle pressure to the injection area for at least 2 minutes after the incisive injection  Both: Also helpful to position patient upright or in semi-upright position after the injection to help with diffusion of anesthetic solution Slide 13 REFERENCES  Fehrenbach MJ, Herring SW: Illustrated anatomy of the head and neck, ed 3, St. Louis, 2007, Saunders  Logothetis, Demetra D. Local Anesthesia for the Dental Natalie Ferrigno - DH 327 Hygienist, St. Louis, 2017, Mosby Co. 2nd Edition. (ISBN # 978- 0323396632)  Malamed, Stanley. Handbook of Local Anesthesia, St. Louis, 2013, Mosby Co. 6th Edition. (ISBN#9780323074131)  Darby M, Walsh M: Dental hygiene theory and practice, ed 3, St. Louis, 2010, Saunders. Slide 14