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IAN Block
A Townie asks for advice to perfect their technique when it comes to numbing patients before a procedure

Intrigue
Member Since: 09/28/15
Post: 1 of 129

I just wanted to reach out to the dental community and ask if anyone else has the same issues
as I do with IAN block. Once in a while I will get a patient who will not get numb fully for
lower molars. I have tried Septocaine 4% block and lidocaine 2%. I use the same technique for
all patients. I even check pano to try to get location of the IAN.
90% of the patients will be OK, but that 10% do not get fully anesthetized. Is that a normal
ratio? Could I be doing something wrong with my block technique? Any advice? ■
2/10/2021

the Judge
Member Since: 09/16/04
Post: 2 of 129

I switched to this years ago and have 99% success rate. I did not do a double-blind study,
just trial and error: I give 1 carp lido in the normal IA location. Then I give ½ carp Septo high.
Like almost trying to give a Gow-Gates. Then I give the last ½ carp Septo below my initial lido
injection a few mm. Have never had problems since. ■
2/10/2021

tricuspid
Member Since: 08/09/07
Post: 6 of 129

You are fine. This is common. There are other threads on Dentaltown about this same issue.
If I do a block and the patient is showing all other signs of anesthesia, but is still sensitive
on the molar when prepping, I'll follow with articaine in the buccal vestibule beside the molar.
Basically, I am aiming for the root apices. That almost always finishes the job. Very seldom, I
will hit it in the PDL also, but this is not usually necessary. ■
2/10/2021

dalmacija
Member Since: 04/14/15
Post: 19 of 129

Here is my routine. My blocks work at a very high rate. The max carps I'll give for a block
is two. If the patient isn't numb enough, I will give an intrapapillary injection with Septocaine.
This will do the trick 99.9% of the time. I don't do PDLs because they are not predictable for
me. In the rare case those two don't work, then it's x-tip intraosseous.
I never have had a case where I couldn't get the patient numb and had to refer out. Now if the
patient is very fearful and a pain, they get a referral to someone who can do sedation. Sedation
is a good option for the patients who complain they can never be numb. ■
2/11/2021

cschoe04
Member Since: 08/19/16
Post: 25 of 129

I think I read this in DT, but after I inject the IAN with 2 carps (1 carbo, 1 lido), I immediately sit the patient up to 45 degrees for three to five minutes while the anesthesia sets in. Along
with incorporating carbocaine into my IANB protocol, this has increased my success rate. ■
2/12/2021

drillher
Member Since: 04/22/02
Post: 30 of 129

I have had cases recently where the side of the tongue is numb, but not the lower lip and
therefore no IAN block. What is going wrong? ■
2/13/2021

MAY 2021 // dentaltown.com

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