Subjective signs of efficacious inferior alveolar nerve block in children

This study is designed to examine the clinical signs relating to profound anesthesia of the primary dentition using the inferior alveolar nerve block (IANB) injection. The IANB injection has been used for many years for both adults and children to anesthetize the mandibular teeth. Most dentists are quite familiar with the signs of profound intraoral anesthesia in the adult. Because of infrequent exposure, they might not be as aware of the signs of adequate anesthesia on the child patient. Additionally, the dentist may not be able to differentiate apprehensive behavior from behavior elicited with inadequate pulpal anesthesia. The study consisted of forty male and female children. The subjects who ranged in age from 3 years to 12 years, with a mean age of 7 years, were scheduled for routine restorative care of mandibular primary teeth. Each subject was injected with 1.8 ml of 2 percent xylocaine, 1:100,000 epinephrine using the mandibular-block technique. Anesthesia was evaluated using direct ice placement, lip reaction, tongue reaction and gingival reaction at intervals of 0, 1, 2, and 5 minutes. The results showed a correlation of lip and tongue anesthesia and pulpal anesthesia over time. A stronger correlation existed with gingival anesthesia and pulpal anesthesia over time. There was no statistical relationship between the subject response to ice and pulpal anesthesia.