Dental Nerve Block: Types, What to expect and its consequences 

1. Introduction

Usually, most dental procedures are painful, so the region that requires treatment in the oral cavity needs to go numb to perform the procedure. To anaesthetize a particular region in the oral cavity, administer local anaesthesia in the form of topical gels, topical sprays and even infiltration. But these anaesthetics are less effective in anaesthetizing a region in the oral cavity when compared to giving a nerve block.

Nerve blocks are very effective in anaesthetizing a region or tooth as they greatly help in performing pain-free procedures, thereby enhancing patient comfort during treatment procedures.

2. What to Expect During a Dental Nerve Block?

What patients should be instructed before the treatment?

The dentist should explain the treatment procedure and its possible consequences before starting the treatment.

How to administer anaesthesia for a nerve block?

Usually, to anaesthetize a particular tooth, insert the syringe needle into the adjacent buccal sulcus of the respective tooth and ensure that the syringe tip hits the periosteum around the tooth to anaesthetize the nerve supply of the tooth. 

How long does a nerve block lasts?

Usually, after administering local anaesthesia, the anaesthetized site gets numb within 5 minutes and lasts for an hour. The effect of anaesthesia wears off only after 24 hours.

3. Types of Dental Nerve Blocks

There are many types of nerve blocks in dentistry, but the most common nerve block given in the lower jaw is the inferior alveolar nerve block, and for the upper jaw, it is posterior superior alveolar nerve block Some minor nerve blocks include mental and incisive nerve blocks.

Inferior Alveolar nerve block (IANB)

Administer IANB in the lower jaw on either right or left side, to anaesthetize one side of the mandible. Parts of the mandible get anaesthetized by the inferior alveolar nerve block such as periosteum (outer covering of the bone), buccal soft tissues from the midline of the mandible till the last teeth present in the lower jaw, mandibular teeth, chin and lower lips. The inferior alveolar nerve block success rate is found to be more than 70% in recent research.

Posterior Superior alveolar nerve block 

The Posterior superior alveolar nerve block anaesthetize maxillary molars, buccal soft tissues, periodontium, and ipsilateral maxillary molars etc. 

Mental and Incisive nerve block

These types of nerve blocks are given when both sides of the mandible need to undergo inferior alveolar nerve block for treatment procedures that require the entire lower jaw to get anaesthetized. This mental and incisive nerve block anaesthetizes the chin, lower lip, buccal soft tissues around the incisors and their periodontium, and the lower incisors and canine. 

4. What to Expect after a Dental Nerve Block?

Some reasons for soreness after dental nerve block

After giving Dental nerve blocks patients may get soreness due to the following reasons:

  1. Needle injection might cause trauma at the injection site.
  2. The anaesthetic solution might cause soreness due to its neurotoxic effect as it produces chemical changes causing inflammation and discomfort at the site of injection.
  3. Multiple injections given at the same site might cause soreness at the site of injection.

Risks of dental nerve block

Some of the risks associated while giving nerve blocks include 

  1. Ischemia occurs when the anaesthetic solution is accidentally administered into a blood vessel while giving a nerve block.
  2. Local complications such as soft tissue injury, pain at the site of injection, difficulty in mouth opening, infection, hematoma etc may occur while giving nerve block.
  3. General risks of getting dental nerve blocks include ocular and neurological complications, tissue necrosis, atrial fibrillation etc.

What to eat after a nerve block ?

Patients are usually advised to wait for an hour before eating after the treatment procedure that includes dental nerve blocks as the effect of anaesthesia will get withdrawn within an hour.

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