Everyday Oral Surgery Local Anesthesia Pearls (with Dr. Dean DeLuke)
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Apr 7, 2025 Dr. Dean DeLuke, an oral and maxillofacial surgeon and professor emeritus from Virginia, dives into the world of local anesthesia. He shares essential tips for anesthetizing full maxillary extractions and discusses the complexities of using local anesthetics on pregnant patients. Dr. DeLuke emphasizes the importance of allergy testing and understanding maximum dosages. Plus, insights on managing patients who don't respond to anesthesia, the benefits of buffering, and pain minimization techniques make this conversation a must-listen for dental professionals.
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Effective Maxillary Anesthesia Techniques
- Use infraorbital and PSA blocks plus greater palatine or anterior palate injections for full maxillary extractions.
- Slow down injections to minimize pain, especially for local-only cases without sedation.
Topical Anesthetic and Palate Injection
- Use topical anesthetics on the labial mucosa as they help, but they're ineffective on the palate.
- Employ pressure anesthesia, like pressing with a mirror, for palatal injections to reduce pain.
Articaine Risks and Usage
- Articaine and prilocaine have higher risks for post-injection persistent paresthesia compared to lidocaine and bupivacaine.
- Many dental schools avoid articaine for nerve blocks due to medico-legal concerns, despite some disagreement.
