Article: Volume 46 Number 3 Page 204 - March 2019

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  Dent Update 2019; 46: 204-218

Oral surgery:  Inferior Dental Blocks Versus Infiltration Dentistry: Is it time for change?

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Abstract: Dentistry is unique in that high volume surgery is undertaken efficiently on conscious patients, an anathema to most other surgical specialties who predominantly operate on unconscious patients. Local anaesthesia provides an efficient block to nociceptive pain (the first stage of the pain pathway) but only addresses one small part of the pain experience. Currently the inferior dental block (IDB) is the ‘go to’ standard for dental LA for mandibular dentistry despite its significant shortcomings. Unfortunately, as creatures of habit clinicians continue to practise what is taught at dental school, namely IDBs, when evolving more patient-safe practice takes time to be taken up by the workforce.

Clinical relevance: Dentistry is a profession predicated upon causing and/or managing pain in patients. Providing effective pain control during surgery is essential but using techniques with the minimum risks is imperative.

Author notes: Tara Renton, BDS, MDSc, PhD, Professor Oral Surgery, Kings’ College London, Bessemer Road, Denmark Hill, London SE5 9RS, UK. Email:

Objective: To compare ways of providing effective pain control during surgery using techniques with the minimum risks.


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