Re: Wooohoo! I'm buying made in USA again

Dr. V OMFS, DMD via MedKB.com <forum@xxxxxxxxx> wrote:

> Only on kids (up to 13) do I not have to do the block, also use nitrous.
> Have to do the blocks on adults (use lidocaine for the block) but buccal
> infiltration with Septo.(too afraid of prolonged anesth with a Septo block.)
> Otherwise if the tooth isn't a third molar, can use the buccal
> infiltration, but have to wait a good 10min for good anesthesia.
>
We use Septocaine N (1/200 000) for mandibular blocks and we haven't had
problems. It is the only anesth I use on 'adults'. I use Lido with epi
or even Citanest Plain on the kids (higher quantity of product usable
over the course of the Tx). If I miss a block with 1.7cc Septo N on a 6
year old, I'm basically knackered for the treatment on him/her for that
day. If I miss it with Lido, I can give another two.
> Wired together a 20 something young man who had a dentoalveolar fx, entire
> anterolateral alveolus fractured from #6-9, teeth all in place.

Barroom Blitz?

Lemmee see: for me that's 2-1, 1-1, 1-2 and 1-3. !!!! 1-3 ?!?!!? Broke
the whole maxilla up to the apex of the UR canine?!?!?!?. That musta
been a chair leg or a baseball bat what hit 'im sqare whilst a buddy was
holdin' 'im down... Or W_B hit 'im... He kinda gets upset over missed
appointments....
>. Gave one
> carpule of Septo, patient stated that even his palate was numb! No other
> anesthesia/sedation used, went great.

Could it be that you actually went through to the palatal side inside
the broken osseous crack? If you're injecting slowly and advancing
slowly, that could be possible.
>
_I_ would have taken a 27 guage long, bent it to 45deg, and headed for
the greater palatal foramen (I'd aim just distal to the UR 2nd Molar, or
your #2, in the ditch between horizontal and vertical palate). If I
could get a good second division block, he would've been fine for the
procedure. We do this in perio when we can.
> IMHO it seems to work better with a little longer waiting time.

That's probably part of the problem 'chez-nous'. We only have two
treatment rooms; mine and the hygienist's room, so we can't just let 'em
freeze up for 1/2 hour whilst we do something else. So we tend to do
allot of intraosseous where and when we can, if the block is taking
time. I use X-Tip in the posterior hard to get at places(HATE it), and
the original Stabident everywhere else(LOVE it). We use articaine there,
as well. You're not supposed to inject a 4% sol'n that contains
vasoconstrictor with intraosseous, I know. In my experience,if you
in...ject..... slow....ly and never more that about 1/3 carpule, it goes
OK, and I've never had any problems like osteonecrosis or circulatory
complications. We never do this if there is bone loss or severe cardio
problems.

I would be interested in any comments to the above that you would have,
and also what size and make of needles you use for blocks and
infiltrations.
Thanks
SP
--
Finally: take out the TRASHH
.

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