Long Buccal Nerve Block

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Preoperative Considerations

Consent:

  • None

Anesthesia/Positioning:

  • None

Other:

  • None

Armamentarium:

  • Syringe
    • Dental syringe: Specifically designed for delivering local anesthetics in dental procedures.
  • Needles
    • Long dental needles: Typically 25 to 27 gauge, used for deeper penetrations to reach the nerve.
  • Local Anesthetics
    • Lidocaine (2% with 1:100,000 epinephrine): Standard choice, offering a balance between duration and onset, with a medium duration of anesthesia.
    • Articaine (4% with 1:100,000 epinephrine): Known for better bone penetration, used commonly in the US and Europe for dental blocks.
    • Mepivacaine (2% or 3%, available with or without epinephrine): Offers a faster onset and is useful for shorter procedures; less vasodilation compared to lidocaine.
    • Bupivacaine (0.5% with 1:200,000 epinephrine): Long-lasting anesthetic, suitable for procedures requiring extended pain control.
    • Prilocaine (4% with 1:200,000 epinephrine): Less potent and toxic, suitable for patients where methemoglobinemia isn't a concern.

  • Topical Anesthetic
    • Benzocaine gel or Lidocaine gel: To numb the surface before injection and reduce patient discomfort.
  • Protective Equipment
    • Sterile disposable gloves: For hygiene and protection.
    • Eye protection: To safeguard against possible splashes or contact during the procedure.
  • Other Supplies
    • Cotton swabs: For applying topical anesthetics.
    • Gauze pads: To assist in drying the injection area before topical application and managing any minor bleeding post-injection.
    • Sharps container: For the disposal of needles and other sharp instruments safely.
    • Recapping device: Helps in safely recapping needles, reducing the risk of needle-stick injuries.
    • Dental mirror: To aid in visualizing the mouth and ensuring accurate needle placement.

Technique

Postoperative Considerations

Immediate:

  • Patient Instructions:
    1. Advise the patient that their gums will be numb .
    2. Inform them about the duration of the anesthesia and any post-procedure care needed.
  • Aftercare
  • Monitor the patient briefly to ensure there are no adverse reactions
  • Provide post-operative instructions, particularly if further dental procedures are performed that might cause pain after the anesthetic wears off.

Follow Up:

  • None

Operative Note

Coding

  • None

Forms

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