I am a practicing general dentist. I do a lot of extractions. I have frequently heard the "10 carpules" rule for full mouth extraction case. However, by the time I numb the upper arch, I already used 7-8 carpules of lidocaine.
Does anyone know how to and where to properly numb the patient with 10 carpules or no more than 10 carpules of lidocaine 2% 1 in 100k epi?
Is it safe to use more than 10 caupules?
Please advise.
Thanks
This does require some skill cause frankly, if you miss a block, then you've wasted a carp.
For a full mouth extraction, I would usually do the following:
Right PSA: 3/4 carp
#4 Infil: 1/2 carp
#6 Infil: 1/2 carp
#8 Infil: 1/2 carp
Greater Palatine: 1/4 carp
Nasopalatine: 1/4 carp
Same for the left
Total for upper arch: 5-6 carps
Right IA/Lingual: 1 carp
Right long buccal: 1/4 carp
same for the left
Total for lower arch: 2.5 carps
Total carps: about 8, giving you a couple carps to use as adjunctives for hot teeth.
But in all honesty, most full mouth extractions are already missing some teeth, and not every one of these is always needed, like if they are missing all the left lower molars, don't do a long buccal, or if 1-3 are gone, don't do a PSA. It's very patient dependent, some tend to have more tolerance than others to anesthetics too.
Anyway, the other trick is to wait...a lot of people rush in after injections, but often a tooth that hurts to elevate 10 minutes after an injection will not hurt at all if you just wait another 5 minutes.