What Is a Dental Nerve Block?

Have you been to the dentist and received local freezing? If so, then you have had a dental nerve block. Most dental procedures produce strong sensory stimuli to the point that it affects the amount of general anesthetic required and a painful recovery. Dental nerve blocks interrupt these sensory stimuli locally and should be a component of overall pain management. Dental nerve blocks can decrease the amount of gas anesthetic required- this helps decrease the possible negative side effects such as hypotension (low blood pressure), bradycardia (slow heartbeat) and hypoventilation (low respiratory rate).

Dental Nerve blocks also ease a patient’s recovery from anesthesia because adverse side effects such as hypertension (high blood pressure), tachycardia (fast heartbeat) and tachypnea (high respiratory rate) are minimized because of decreased oral pain.

Local anesthetics (nerve blocks) completely block sensory nerve transmission and prevent secondary (central) pain sensitization. Local blocks are often used in conjunction with other injectable and oral pain medications. The benefits of using multiple pain medications for dental and oral surgery, specifically dental nerve blocks, include:

• Owners expect effective pain management
• Pets are often discharged the same day after dental procedures, and owners want their pets to be as alert and pain-free as possible
• Pets recover faster and with fewer complications
• The amount and inhalant anesthetic required is decreased
• They eliminate pain perception, which results in a smoother anesthesia experience
• Local blocks continue to give pain management after the dental procedure is over, keeping the pet more comfortable
• Signs of pain after dental procedures, such as rough recoveries, vocalization, restlessness, pawing at the mouth, behaviour changes, decreased appetite and depression, are minimized when dental blocks are used

Common dental and oral surgical procedures where dental nerve blocks are indicated include:

• Surgical and non-surgical extractions
• Advanced periodontal treatments, such as root planning, periodontal debridement and periodontal flap surgery
• Oral trauma that involves lacerations of the lips, gums and tongue
• Foreign body removal and jaw fractures that require hard and soft tissue surgical repair
• Biopsies of masses
• Corrective hard and soft tissue oral surgery (i.e. palate surgery and reconstruction surgery)

We use four main dental nerve blocks. The Infraorbital Nerve Block affects the upper incisors, canines and the first, second and third premolars as well as the soft and hard tissues in front of the upper fourth premolars. The Maxillary Nerve Block affects the upper fourth premolar, upper molars and the soft and hard tissue behind the fourth premolars, including the hard and soft palate. The Middle Mental Nerve Block primarily affects the bottom incisors and the soft tissue around them. The Inferior Alveolar Nerve Block or the Mandibular Block affects all the teeth in the lower jaw, including the soft and hard tissues.

Dental nerve blocks are relatively safe when used correctly. Complications resulting from oral nerve blocks have been described in human dentistry. However, the incidence is extremely low. Complications are uncommon in pets. Dental nerve blocks significantly improve pet care and are a valuable addition to pain management for dental and oral surgical procedures here at Kingston Veterinary Clinic.

Written by Kristine Hanson, RVT