Experience with septocaine/articaine?

[tenfeetz]

hey
i would like to try to use septocaine for my upcoming NERB...i have never used it before, it is essentially like administering an inflitration at the apex of the tooth? is the onset similar to a maxillary inflitration (nice and fast?)? for the tooth i am clamping for the rubber dam, should i inflitrate with septocaine at the apex as well or inject into the papilla like i usually do? thanks

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[reapply2007]

Don't change anything the day of NERB. You will already be nervous enough. Stick with Lidocaine/epi.

 

[tenfeetz]

i am asking for a reason. i have worked on a lesion on this pt before, even the faculty had a difficult time numbing this pt up. this pt has a nice lesion on #29, this is all i have unfortunately, and i would like to try articaine. please, if anyone can answer my questions i would appreciate a response immensely

 

[Daurang]

If it's allowed y the board, then go for it.

 

[omaralt]

i am asking for a reason. i have worked on a lesion on this pt before, even the faculty had a difficult time numbing this pt up. this pt has a nice lesion on #29, this is all i have unfortunately, and i would like to try articaine. please, if anyone can answer my questions i would appreciate a response immensely

Ya do it the same way you would do a maxillary infiltration. Make sure you give it in addition to the IANB, not instead of. I don't see why it wouldn't be allowed, but I would double check. Good luck

 

[tenfeetz]

ok, but why couldnt you substitute the IANB for this, isn't that the point? plus on the progress form, is it even possible to fill out infiltration and block, and then 2% lidocaine and septocaine? i just thought it had to be one or the other

 

[OceanDMD]

MY experience on lower infiltration w/septo:

1- Poor success with 2nd/3rd molars. I dont even try now.
2- 1st molars, infiltrate at mucogingival junction, usually 1/2-3/4 carpule. WAIT TEN MINUTES. Even if the patient says their lip is numb,wait. That first time you start too early and they feel pain, on some patients you are done.Their brain will continue to tell them they are feeling something. Often I will give a few drops delivered via PDL injection before I start as insurance.
3- Usually anything anterior of 6 year molars has no problem getting anesthesia with septo. Again, the key IMHO is waiting. I almost always wait 10 minutes for septo, and even my blocks with lido.

Now for the OP, if you have had problems in the past anesthetizing this patient, block her/him with Lido, give about 1/2 carp of septo infiltration, and for shats and giggles you can give a few drops PDL right before you start. 99% of the time if the patient still says they feel it its mental (as long as its not that dreaded 2nd mandibular molar).
Good luck on the NERB.

 

[Streetwolf]

MY experience on lower infiltration w/septo:

1- Poor success with 2nd/3rd molars. I dont even try now.
2- 1st molars, infiltrate at mucogingival junction, usually 1/2-3/4 carpule. WAIT TEN MINUTES. Even if the patient says their lip is numb,wait. That first time you start too early and they feel pain, on some patients you are done.Their brain will continue to tell them they are feeling something. Often I will give a few drops delivered via PDL injection before I start as insurance.
3- Usually anything anterior of 6 year molars has no problem getting anesthesia with septo. Again, the key IMHO is waiting. I almost always wait 10 minutes for septo, and even my blocks with lido.

Now for the OP, if you have had problems in the past anesthetizing this patient, block her/him with Lido, give about 1/2 carp of septo infiltration, and for shats and giggles you can give a few drops PDL right before you start. 99% of the time if the patient still says they feel it its mental (as long as its not that dreaded 2nd mandibular molar).
Good luck on the NERB.

I needed a crown put on my own tooth, #19. I've had operative work done (recently) on #18 and 20 and I was fine with an IANB. But that one tooth #19 has *always* given me problems. I've had fillings on it and felt pain, I've had an onlay put on it and felt pain, etc. And the crown was no exception.

They tried the IANB. The instructor even tried it, hit my lingual nerve (I felt the shock go through my tongue), and still didn't achieve anesthesia on that tooth. They tried septo and it provided slight relief but it didn't last long and it wasn't complete.

The OS chief resident was called over and gave me some PDL injections. I didn't feel a single one of them since the tissue was anesthetized. It worked beautifully. Didn't feel a thing.

Try the PDL if all else fails.

 

[tinman831]

Again, the key IMHO is waiting. I almost always wait 10 minutes for septo, and even my blocks with lido.

The only problem is on the NERB you really don't have the luxury of time. For my class 3 patient, I used to have a horrible time trying to get her anesthetized in the past. It'd take at least 10-15 minutes before she was completely comfortable. Our school recommended that we use Septocaine since it was supposedly more predictable as far as performance is concerned. I tried it during the exam, and sure enough, she was numb in less than 5 minutes. I used only one carpule and she was happy as a clam through the entire procedure.

 

[OceanDMD]

The only problem is on the NERB you really don't have the luxury of time. For my class 3 patient, I used to have a horrible time trying to get her anesthetized in the past. It'd take at least 10-15 minutes before she was completely comfortable. Our school recommended that we use Septocaine since it was supposedly more predictable as far as performance is concerned. I tried it during the exam, and sure enough, she was numb in less than 5 minutes. I used only one carpule and she was happy as a clam through the entire procedure.

Upper or lower tooth? Upper your ready to rock in 3 to 5 minutes. My post above was with respect to mandibular infiltration.

 

[tinman831]

Upper or lower tooth? Upper your ready to rock in 3 to 5 minutes. My post above was with respect to mandibular infiltration.

Infiltration around mandibular anterior and maxillary PM.

 

[tenfeetz]

hey thanks so much for your responses! i am working on #29, however i actually spoke to a friend recently who says that it is an almost instantaneous affect and just make sure to rub the bone in the area to distribute it. i think i'm going to try it, he always advised to penetrate maybe 2mm juste nough to see the bubble bc you dont want to risk penetrating the mental foramen
any other last minute tips?
thanks so much for eveythhing

 

[HupHolland]

agree with the others: block with 2% lido, infiltrate with 4% septo. if that fails, PDL it up....

Hup