Tatyana Fortune

There are so many benefits to being a provider that can give painless injections. Patients have a better experience, it builds trust, and they are more likely to give good referrals.

The first mistake that is commonly made is not leaving the topical anesthetic in place on dry mucosa for the full 2 minutes. This can reduce the effectiveness. Most dentists use Benzocaine, but a compounded topical (usually a mix of Lidocaine, Prilocaine, and Tetracaine) can be more effective at eliminating injection pain.

One method of reducing pain is by giving a plain anesthetic first (ex., Prilocaine) then following with Lidocaine or Septocaine. Giving plain anesthetic is less painful because the solution is less anesthetic.

Another method (and a cheaper alternative to the method mentioned above) is to buffer the first carpule of anesthetic before injection. This type of injection has a rapid onset and had higher effectiveness around sites that are harder to numb due to infection. It is recommended to use about 0.2 mL of 8.4% sodium sodium bicarbonate for each patient. A downside to this technique is that the pH of sodium bicarbonate can very, and the solution must be used quickly once it is mixed.

Other techniques include warming the anesthetic to 37 degrees Centigrade (temperature can be regulated using a Calset or C-Warmer unit).

Having a good hand technique for injection can also make a world of difference. It is crucial that the provider has a good finger-rest. The beveled tip should be inserted just under the mucosa, an a few drops should be deposited. After waiting a few seconds, the needle can be advanced further while gently pressing the plunger. The injection site should be aspirated in two different planes.