3. Local Anesthesia for Dental Child
Patient
Introduction
Preparation of the child patient
Application of the topical anesthetics
Injection the local anesthetic solution
Nerve block anesthesia in the
mandible.
4. Local Anesthesia for Children
- Local anesthesia is the most common method
of pain control
- Effective local anesthesia allows dental
procedures to be carried out painlessly
- Most cavity preparations, vital pulp therapy,
extraction of teeth and surgical procedures
requiere administration of local anesthetics
5. - This method of eliminating pain is painful
itself and can be very distressing to the
child
6. Local Anesthesia for Children
1. Preparation of the child dental patient.
•The child will be told that to treat his tooth
properly and comfortably, this tooth is going
to be “put to sleep”
• At first a paste “will be applied to put the
gum to sleep”
• The parents should be informed not to
interfere or comment
7. Local Anesthesia for Children
2. Application of the topical anesthetics
• To act effectively, topical anesthetic paste
has to be applied to dried mucous membrane
• Use one end of cotton roll to dry the site of
insertion and the other end being used to
apply the topical anesthetic
• Topical anesthetic are available in gel, liquid,
spray, and ointment
11. Local Anesthesia for Children
3. Injection the local anesthetic solution
• Stretch the tissues
prior to insertion of
the needle, will result
in easier penetration
12. Local Anesthesia for Children
3. Injection the local anesthetic solution
•The bevel of the
syringe should be
against the bone
• The concealment of
the syringe from the
child is
recommended
13. Local Anesthesia for Children
3. Injection the local anesthetic solution
• All maxillary and lower anterior teeth can be
anesthetized by filtration anesthesia using
short or extra-short needle
• Lower primary molars can be anesthetized
by infiltration anesthesia or inferior dental
nerve block
14. Local Anesthesia for Children
3. Injection the local anesthetic solution
• wait for the buccal
infiltration to have its
effect
• inject the palatal of the
interdental papillae from
the buccal side distal and
mesial to the tooth
15. Local Anesthesia for Children
3. Injection the local anesthetic solution
When the buccal infiltration anesthesia is
used in the lower jaw, lingual anesthesia
will be necessary for any extraction
An intrapapillary injection as mentioned
with maxillary teeth will be sufficent
16. Local Anesthesia for Children
3. Injection the local anesthetic solution
Nerve block anesthesia in the mandible:
• Is used for all procedure in the
mandibular molars (primary and
permanent) in the children, except for the
very young
• Is preferred when localized infection
exists in the area of the infiltration site.
17. Local Anesthesia for Children
3. Injection the local anesthetic solution
Nerve block anesthesia in the mandible:
• The size of the mandible is also smaller
than that of the adult
• The mandibular foramen is situated at a
lower level
18. The injection must be made slightly
lower and more poteriorly than for the
adult
20. Introduction
Indications for extraction of primary
teeth
Contraindications to extraction of
primary teeth
Indications for extraction of
permanent first molars
Preoperative preparation
Techniques for the removal of primary
teeth
Postoperative instructions
21. PRINCIPLES
Avoid injury to soft tissues such as the
tongue, lips, gingiva and cheeks.
Avoid injury to underlying developing
permanent teeth and other hard tissues
such as bone and adjacent or opposing
teeth.
Use radiograph to determine
Size and shape of roots.
Amount and directions of root
resorption.
Position and stage of developing of
underlying permanent tooth.
Any pathology
22. PRINCIPLES
1. The oral cavity is small and there is
greater difficulty in gaining access to
the field of operation.
2. The jaws are in process of growth and
development
23. 3. The dentition is in continuous state of
change with eruption and resorption of
primary teeth and eruption of
permanent teeth taking place at the
same time.
4. The bone structure more liable than
adult bone.
30. PRE - OPERATIVE PREPARATION OF
THE PARENT AND CHILD
PARENT-
1 PARENTAL CONSENT BEFORE
THE PROCEDURE.
2 INSTRUCT THE PARENT NOT TO
DICUSS WITH THE CHILD WHAT
THE DENTIST WILL DO.
31. CHILD-
1 ARMAMENTARIUM SHOULD BE KEPT
BEHIND THE CHAIR.
1. NEVER HOLD THE NEEDLE IN FRONT OF
CHILD ALWAYS HIDDEN BY FINGERS.
32. 2 BEFORE GIVING THE LA, EXPLAIN TO
THE CHILD THAT SENSATION OF
PINCHING OR AN ANT BITING MAY BE
FELT.
3 CHILD REALIZES THE DIFFERENCE
BETWEEN PRESSURE AND PAIN.
4 EXPLAIN THE SENSATION OF
NUMBNESS TO CHILD.
