The dental hygienist must understand how the maxillary nerve of the fifth cranial or trigeminal nerve and its branches can be anesthetized in various ways for patient pain management with clinically effective hemostatic control depending on the extent of procedure anticipated and the structures requiring local anesthesia (see
Table 10-4).
1 In addition, the dental hygienist must also understand that administering maxillary anesthesia has its own considerations compared with administering mandibular anesthesia.
2First, most local anesthesia of the maxilla is more clinically effective than that of the mandible because the facial cortical plate of the maxillae is less dense and more porous than that of the mandible over similar teeth; anesthesia from the palatal surface is also possible (see
Chapters 10 and
13).
1,2 This decrease in density of the maxillae compared to the mandible can be demonstrated with a panoramic radiograph (see
Figures 10-2 and
10-8).
Second, there is less anatomic variation of both the maxillae and palatine bones as well as the associated nerves with respect to local anesthetic landmarks than there is in similar mandibular structures, making the maxillary injections more routine, and usually without the need for troubleshooting if there is lack of clinical effectiveness of anesthetic administered (see
Chapter 10).
1,2 However, this does not mean that maxillary injections do not have any complications that can occur (see later discussion and related tables).
3 But unlike mandibular arch anesthesia, the entire maxillary arch can usually undergo anesthesia within one appointment without serious complications.