Few, if any, crown and bridge procedures do not begin with a local anesthetic injection. In patient surveys, fear of local anesthetic injections is typically either the #1 or #2 reason given for why people have avoided the dentist. In addition to the stress that the patient feels about the injection, published literature states that dentists miss inferior alveolar blocks 15-20% on the first attempt, which can result in a dentist attempting to work on a partially anesthetized tooth. Furthermore, most dental schools still only teach the traditional Halstead approach to lower blocks, essentially guaranteeing some degree of frustration.

This class demonstrates an injection for inferior alveolar block anesthesia which had a nearly 95% success rate in the literature—the Gow-Gates technique. Also demonstrated is an innovative injection for esthetic cases allow dentists to anesthetize the maxillary anterior teeth, as well as all palatal tissue and most facial tissue, without affecting the patient’s ability to smile utilizing the Anterior Middle Superior Alveolar nerve block. Also discussed is the enhanced action of buffered local anesthetic solutions.