Dental blocks are an elaborate science. A dental nerve block is a technical term used for local dental anesthesia. General dentists and dental specialists study years to become licensed to administer dental blocks.
When you are under the course of significant dental treatment, dentists most likely suggest a dental block before the procedure.
Dental blocks temporarily desensitize the teeth and make the entire dental procedure painless and more comfortable.
Depending on the area to be treated, dentists administer different nerve blocks. Each block varies in its dosage, site of administration and action.
For example, the lower eyelid region and the upper lip is desensitized by the infraorbital nerve block. The lingual nerve block desensitizes the tongue.
Most people have no problems getting numb though certain complications may arise due to varied reasons.
But, overall, administering dental nerve blocks proves to be a smoother way to carry out the entire dental treatment.
This article highlights the indications, methods of administration, uses, and alternate ways of performing the commonly used oral nerve blocks.
What is a dental nerve block?
An oral nerve block is an effective way to manage orofacial pain (1) without distorting the anatomy of a wound and to carry out painful dental treatments easily and comfortably.
Dentist injects a medicine, called local anesthesia, into gums or the inner region of the cheek which causes a tingling sensation and numbs the area.
A block injection numbs an entire region of your mouth, such as the tongue, or the cheek region or one part of the lower jaw.
Most widely used local anesthetic is lidocaine (also known as xylocaine or lignocaine).
Other currently used local anesthetic agents include articaine, bupivacaine, Prilocaine, and mepivacaine. (2)
A combination of these may be administered depending on the requirement (with or without epinephrine).
Why is a dental nerve block used?
Our oral cavity is innervated by a large number of nerves which make it extremely sensitive towards pain stimulus. Dental nerve blocks are used to desensitize the nerves of the oral cavity to create numbness of the desired region.
It also diminishes the pain and thus makes any dental procedure smooth. Indications of nerve block include –
- Toothache, cases of pulpitis
- Root impaction cases
- Orofacial laceration (e.g., tongue, lip, mucosal)
- Post-extraction and post-surgical pain, including dry socket
- Dentoalveolar abscess drainage
- Dentoalveolar trauma
- Mandibular, maxillary and Dentoalveolar fractures
- Root canal treatment
How is a nerve block administered?
Depending on the landmark positioning of various hard and soft tissues of the oral cavity, the dentist locates the nerves that need to be desensitized. The procedure is as follows –
- Locating the anatomical landmarks – The dentist feels various landmarks to access the desired nerves in the vicinity of the region that needs to be treated.
- Preparation – A topical numbing agent is either sprayed or applied in a gel form at the injection site with a cotton swab.
- Injection – The nerve block is then slowly injected into the desired site. For most people the experience is painless, and they do not feel the needle sting. Some people may describe it as a pinch or a minor burning sensation when the solution goes into the tissue.
- Time of action – A tingling sensation is felt in the desired and the adjacent regions. Effect of the block lasts for several hours.
Action time and recovery time
Acting time – It varies to about a few minutes during the block acts and causes numbness of the nerves and a tingling sensation.
Recovery time – Depending on the concentration of the anesthetic solution and tolerance of the patient, a block can last for 1-2 hours, after which, it wears away on its own.
Eat cautiously when the dental nerve block is wearing off as you may end up biting your numb tongue or cheek. However, the block does not interfere with regular actions such as brushing and flossing.
Factors affecting dental blocks
- Anatomical factors – Limitation in accessing anatomical landmarks can reduce the action of nerve block.
- Pathological factors – Infection, abscess, swelling, and some medical reasons can make nerve desensitizing a challenge for the dentist.
- Pharmacological factors – chronic alcohol abuse and drug abuse diminish the action of anesthetic agents.
- Psychological factors – Fear, anxiety, and phobia can also hamper the action of anesthetic agents.
- Poor Technique – Improper approach by the dentist also hampers the effect of a dental block.
What are the other available Options?
The other available options for sedation include –
- Anti-anxiety agents- such as nitrous oxide
- Enteral sedation- Sedation by oral intake of a pill
- Intravenous sedation- the sedative is injected to a vein
- General Anesthesia- inhalation of a gaseous anesthetic (3)
Take home message
Dental blocks are the easiest and the most precise method to desensitize the nerves for a dental procedure. They only make your dental procedure painless, more comfortable and smooth.
Before the administration of dental block, always inform your dentist about your allergies, past medical history, and medicine regime.
If you are anxious about getting a dental block, discuss with your dentist about your fears and ask all the questions that you have in your mind.