Incidence of lingual nerve trauma and postinjection complications in conventional mandibular block anesthesia

Article Abstract:

A common technique for injecting anesthetic for dental procedures is the mandibular block. This injection is considered to be difficult, because the needle penetrates more deeply than for other dental injections and patients have individual differences in the locations of various structures, such as underlying nerves. Not only nerves, but blood vessels, bone, and connective tissue can be injured by the mandibular block injection. Patients may also experience a systemic (general) reaction, such as dizziness, overdose reaction, or toxicity. Nerve injuries often heal within a period of weeks or months, while the injured nerve regenerates. In this report, the incidence of complications from mandibular block is discussed, with an emphasis on injury to the lingual nerve, which innervates the tongue. Patients who had undergone mandibular block at the office of general dentists were surveyed about complications they experienced after the procedure. Questionnaires were mailed to 2,289 adult patients who had 9,587 mandibular blocks (using the conventional procedure). Based on their responses, it was determined that 9 percent (206 patients) had experienced a traumatic episode to the lingual nerve during mandibular block anesthesia. The researchers calculated that there is a 3.62 percent chance of injuring the lingual nerve each time a mandibular block is performed. After the lingual nerve is injured, there is a 15 percent chance of post-injection complications, such as numbness. Eighty-one percent of these post-injection complications resolved within two weeks. It is important for the dentist to provide thorough follow-up and reassure patients, so that the incident does not cause undue anxiety or fear of dental procedures. (Consumer Summary produced by Reliance Medical Information, Inc.)

Physiological aspects, Nerves, Tongue

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Prevalence of upper extremity neuropathy in a clinical dentist population

Article Abstract:

Injuries that are the result of repetitive motion or neuropathic disorders play a major role in the amount of time and energy expended in accomplishing a task. Dentists are at great risk for these types of injuries because of the upper extremity movements they are required to make. A survey of dentists in Nebraska revealed that 29% reported altered sensations in their hands, arms, forearms, cervical area or neck that led to pain, numbness and a tingling sensation. Although the survey did not look at nonoccupational exposure, it appeared that these symptoms arose from occupational exposure and that they affected the dentist's ability to pursue his or her profession. More detailed studies are required that elicit greater detail regarding these self-reported symptoms so that objective measurements of peripheral neuropathy can be taken.

Health aspects, Dentists, Arm, Peripheral nerve diseases, Peripheral nervous system diseases, Extremities, Upper

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Four common mandibular nerve anomalies that lead to local anesthesia failures

Article Abstract:

There are several anatomical nerve abnormalities that can cause a dental patient to be improperly anesthetized. Much of the lower jaw is innervated by the mandibular nerve, which branches off from the trigeminal nerve before entering the mouth through the mandibular foramen in the jaw. Another nerve called the mylohyoid nerve also innervates the lower jaw and it can be too far from the mandibular nerve to be anesthetized by the usual injection. Patients may also have accessory nerves that may escape anesthesia.

Teeth

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