Alan Budenz, MS, DDS

Did you ever wonder why, when you gave a posterior maxillary infiltration, the skin around the eye blanched? Why is it that in some weeks you can't miss a mandibular block and other weeks you can't seem to hit one? All these questions and more will be addressed in this program designed for dentists and hygienists. Topics to be covered include: an overview of local anesthesia pharmacology, a review of head and neck anatomy relative to dental anesthesia techniques, reasons for anesthetic failures, and possible anatomical and physiological damage sites during local anesthesia procedures. (Half or Full Day)

This lecture course is designed for dentists and hygienists who wish to expand their understanding of the anatomical structures, pharmacology mechanisms, and delivery techniques of local anesthesia and to solve some of the difficulties that arise in obtaining profound anesthesia in the oral cavity. A wide range of both maxillary and mandibular block techniques are emphasized, including discussion of the Gow-Gates mandibular block technique, and techniques for recognizing and anesthetizing both accessory and anomalous nerve pathways are presented. Use of alternative anesthesia modalities, such as intraosseous techniques (Stabident, Cyberjet, X-tip needles), electronic units (TENS and Cedeta), and computerized delivery systems (the Wand), to obtain either primary or secondary anesthesia are also discussed. Management of possible complications and injuries related to the delivery of oral local anesthesia, such as hematoma, paresthesia, and trismus, will also be reviewed.

Dr. Budenz presents practical, useful information that can be directly applied to clinical practice in an informal, interactive style.

Topics to be covered include:

• An overview of local anesthesia pharmacology
• Appropriate usage of the various local anesthetic solutions available
• Contraindications and toxic reaction concerns with local anesthetics
• Review of oral anesthesia nerve pathways
• Discussion of accessory innervation pathways.
• Infiltration versus block injections: what to use when
• Oral anesthesia injection techniques, including the Gow-Gates and Akinosi techniques
• Comparison of alternative with conventional techniques
• Alternative anesthesia modalities: electronic, intraosseous, and beyond
• Reasons for failure to obtain anesthesia
• Unexpected side effects and their management
• Intravascular injection sequelae
• Arterial and venous hematomas
• Nerve damage: diagnosis and management

Dentists and dental hygienists attending this course should expect to return to their practices with greater confidence in their ability to deliver comfortable and efficient local anesthetic injections, an increased appreciation for the causes of local anesthesia failures and the knowledge to overcome these failures, and a greater sense of ease in recognizing and managing unexpected side effects and complications of local anesthetic injections. This will reduce  the anxiety level of the practitioner, and bring the practice another step closer to pain-free dentistry for the patient.