Conversation Opener: What are the key issues in intraosseous anesthesia?
If doing an intraosseous injection, practitioners should inject LA slowly in order to limit the increase in heart rate.
Intraosseous anesthesia steps:
- Take a bitewing radiograph to ensure sufficient bony space between the roots.
- Apply topical anesthetic.
- Do a preparatory infiltration so the perforation is painless.
- Do the perforation over attached gingiva. The perforation should remain perpendicular to the buccal cortex. The perforation should be done in a pecking motion for less than 5 seconds.
- Slowly inject 1/2 a cartridge of local anesthetic over 30 seconds to 1 minute.
- Use a maximum of 1 cartridge of local anesthetic per appointment.
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Dr. Isen completed a Bachelor of Science degree in neuroscience from the University of Toronto and graduated in dentistry from the University of Western Ontario. Following his graduation, Dr. Isen underwent advanced training in intravenous sedation at the Montefiore Medical Center in New York which has focused his dental practice on patients requiring special care for their treatment. Dr. Isen lectures widely on topics related to local anesthesia and medical emergencies. He is past president of the Ontario Dental Society of Anaesthesiology and has acted as a reviewer for dental journals and published a number of his own articles.