The mandibular nerve of the fifth cranial or trigeminal nerve and its branches can be anesthetized in a number of ways by the dental hygienist for patient pain management with hemostatic control depending on the extent of procedure anticipated and the structures needing to be anesthetized (see
Table 10-4).
1 In addition, the dental hygienist must also understand that administering mandibular anesthesia has its own considerations as compared with administering maxillary anesthesia.
2First, a supraperiosteal injection of the mandible is not as clinically effective as that of the maxillae because overall the mandible is denser and less porous than the maxillae over
similar teeth, especially within the mandibular posterior sextant (see discussion in
Chapter 12).
1,3 This increase in density of the mandible compared to the maxillae can be demonstrated with a panoramic radiograph (see
Figures 10-2 and
10-8). For this reason, nerve blocks are preferred to supraperiosteal injections in most parts of the mandible, unlike the maxillae.
1,4Second, substantial variation exists in the anatomy of local anesthetic landmarks of the mandible as well as the associated nerves, compared with similar structures in the maxillae, complicating mandibular anesthesia for the clinician.
1,2 Thus the need for troubleshooting of cases may arise with a lack of clinical effectiveness of anesthetic administered for the mandible (see
Chapter 10).
1,4 This chapter covers some of the most common anatomic variations of the mandible.