The commonly used anesthesia methods for tooth extraction include inferior alveolar nerve block anesthesia, lingual nerve block anesthesia and buccal nerve block anesthesia.
Oral injection is often used for inferior alveolar nerve block anesthesia. When the patient opens his mouth wide, there is a longitudinal cord-like mucosal fold behind the molar and in front of the pharyngeal arch, that is, pterygomandibular ligament. Its intersection with the midline of maxillary and mandibular alveolar ridge 3~4mm away is the injection mark. When injecting, ask the patient to open his mouth and put the needle between the first pair and the second pair of fangs, making an angle of 45 with the midline. The injection needle should be higher than the occlusal surface of mandibular teeth 1cm and parallel to it, and the depth of the needle should be about 2.5cm from the injection mark to the bone surface. If there is no blood, you can inject an appropriate amount of anesthetic to anesthetize the alveolar nerve. Because the lingual nerve is located at about 1cm in front of the inferior alveolar nerve, the injection needle is pulled out from 1cm and injected with 0.5 ~ 1 ml anesthetic, so that the lingual nerve can be anesthetized. If 0.5 ~ 1 ml anesthetic is injected when the needle retracts to the muscularis and submucosa, the buccal nerve can be anesthetized. When extracting mandibular teeth, it is necessary to anesthetize the inferior alveolar nerve and lingual buccal nerve at the same time to achieve the purpose of painless extraction. Five minutes after the above operation, the patient felt numbness and swelling in the corners of the mouth, lower lip and tongue tip on the same side, suggesting that anesthesia is effective and teeth can be extracted.
Posterior alveolar nerve block anesthesia, anterior palatine nerve block anesthesia and nasopalatine nerve block anesthesia are commonly used in tooth extraction. In addition to the buccal proximal root of the first molar, the posterior superior alveolar nerve innervates the ipsilateral molar, alveolar process and its corresponding buccal mucoperiosteum and periodontal ligament. The anterior palatal nerve innervates the palatal alveolar bone and gum of the ipsilateral bicuspids and molars. The nasopalatine nerve innervates the gum, palatal mucoperiosteum and alveolar bone in front of the canine tooth palatine line on both sides. When extracting bicuspids, front teeth and first molars, infiltration anesthesia must be performed at the corresponding gingival sulcus.