PDF Version - Glidewell Dental Labs

Dr. Michael DiTolla: Let me start off by saying that ever since
you taught me local anesthesia when I was a dental student,
it has been a really important focus in dentistry for me.
I vividly remember giving my first injection in dental school;
it was an infiltration over tooth #9, and I remember the sweat
pouring down my forehead. That first injection is one of the
more stressful moments in dental school, and we get slightly
more used to it; but as we continue to practice, the administration
of local anesthesia has the potential to be one of the
more stressful things we do. What are your thoughts on that?
Dr. James Dower: It’s funny you bring that up because
we just finished our first week of the local anesthesia
block. We started this method of practicing injections during
the spring quarter, and as you mentioned it creates
a lot of stress for the students. Many have never had a
dental injection in their life, so getting an injection for
the first time from their lab partners who can’t mix alginate,
well, it creates stress on both sides. But stress is a
huge component for practitioners who are having trouble
in their block injections. Of the courses I teach, that is
probably the group of dentists with the most emotion
because many of them have such difficulties they are
actually thinking of getting out of practice, as hard as that
is to believe.
MD: Wow, yeah, it’s never been quite to that extreme for me.
About three years ago I purchased the STA System (Milestone
Scientific; Livingston, NJ), and I purchased it because I love
the idea of single-tooth anesthesia on lower molars for crown
preparation, for example. I loved the idea of not having to potentially
miss a lower block, especially because patients don’t
like lower blocks. I didn’t want to give a lower block to do a
single crown on a lower molar, and I’ve had really good luck
giving injections with the STA System. But the funny thing is,
the biggest difference the STA System has made in my life has
been for the esthetic cases where we’re giving multiple maxillary
infiltrations. The ability to set this device on its lowest
speed and to give injections with the carpule being changed
at the device itself removes so much stress from my life. More
than 20 years into practice, I realized how stressful it was for
me to give maxillary infiltrations, for example, in that sensitive
area under the nose. But with the STA System, a computer
controls the device at a very slow speed, so I can give
nearly painless injections. I didn’t realize how stressed I was
until I got the STA System and all of my anxiety disappeared.
JD: The knowledge of doing the PDL injection to give
anesthesia is really a good thing for a person to have. Had
I not learned the PDL injection and the mylohyoid injection
early in practice, I would’ve had a real tough time
because I can’t work on a patient who is in pain.
The term I really like for PDL, which I read in a study
from Israel, is the trans-ligamentary injection. It describes
the process of the needle in the periodontal ligament
30 chairsidemagazine.com