Learning to give injections

[mg777]

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While I was at my interviews, I heard that dental students learn to give injections by first trying them out on each other. Ouch. I was wondering how this has worked out for you all? This probly varies by school, but when did you start learning to do injections?

 

[aphistis]

While I was at my interviews, I heard that dental students learn to give injections by first trying them out on each other. Ouch. I was wondering how this has worked out for you all? This probly varies by school, but when did you start learning to do injections?

Oh...8 weeks ago, maybe? The learning curve can take some time, but the technical exercise is pretty simple.

 

[DrTacoElf]

While I was at my interviews, I heard that dental students learn to give injections by first trying them out on each other. Ouch. I was wondering how this has worked out for you all? This probly varies by school, but when did you start learning to do injections?

Oh Joy 🙁

 

[Rezdawg]

I hate the fact that some amateur is going to slam a needle into my gums. And Vice Versa.

I think I may be so nervous that I'll miss and poke the poor bastard in the eye. Or throat.

 

[DrTacoElf]

the worst partner you could get would be some big ex football player thats dead set on oral surgery 😛 . Ever been on dental town and read a thread about painless injections (oral surgeons by and large are like it doesn't matter just slam it in there)

or conversely someone who is so squeemish that they keep missing the block and have to do it like 30X

 

[mg777]

I'm hoping they have fleet of instructors carefully looking on when we start doing injections making sure something doesnt go terribly wrong . I'll make friends real quick with the student learning to give me an injection.

the worst partner you could get would be some big ex football player thats dead set on oral surgery 😛 . Ever been on dental town and read a thread about painless injections (oral surgeons by and large are like it doesn't matter just slam it in there)

or conversely someone who is so squeemish that they keep missing the block and have to do it like 30X

 

[Rezdawg]

the worst partner you could get would be some big ex football player thats dead set on oral surgery 😛 . Ever been on dental town and read a thread about painless injections (oral surgeons by and large are like it doesn't matter just slam it in there)

Yeah, haha, I have read about oral surgeons not giving a crap about the injections. The GP's and OMFS people get into that debate. Pretty funny.

 

[Dr.SpongeBobDDS]

I hate the fact that some amateur is going to slam a needle into my gums.

... and into your palate, and through your incisive papilla, and up to your infraorbital foramen, and along the ramus of your mandible. And then a Gow Gates on the other side just for good measure.

I was the first in my group to get the needle and I remember just sitting there in the chair with my mouth open while the professor helped my classmates move the needle around feeling different landmarks on and around my condyle. Good times, good times.

 

[lnn2]

Fun but scarry times! The next injection will be on a real patient 😱 I would shadow a 4th yr and ask them if you can give their patients the block (IA)

 

[dinesh]

I hope they use lots of topical anaesthetic.

 

[Dentalhopeful]

what year do most dental schools begin to teach local anesthesia. I hope not first year.

 

[DrTacoElf]

I'm pretty sure mcg is first year during the summer.

 

[rocknightmare]

my mouth aches just thinking about the needle on the palate

 

[hokiedds]

Do dental students have to use a regular syringe to give palatal injections or can you use a pressure syringe?

 

[DrJeff]

The first person I injected(OK lets be honest, STABBED 😱 ) happened to be my wife (Girlfriend at the time), she went first (we were paired together in that lab), and then I got to return the favor via a inferior alveolar, PSA, infra orbital and a mental infiltration. I got her good on the PSA as I had the bevel of the needle scraping periosteum all the way up 😱

Even after all that she still married me 😉

One of my current favorite lines I use on patients all the time, is when they as me if the injection will hurt, my reply........ "Not me!" 😉 😱 😀

 

[lnn2]

One of my current favorite lines I use on patients all the time, is when they as me if the injection will hurt, my reply........ "Not me!" 😉 😱 😀

My lines:
After drilling for a few seconds, I ask them "you're not in any discomfort/pain, are you?" -No? good, I can change that real quick! I love to see their facial expression! "you're sick!" is usually a common response from my patients! 😀

Sometimes in OS, when I'm elevating a tooth, I ask them the same question "Are you experiencing discomfort/pain?" No? Good, Me neither!" 😀

 

[DrTacoElf]

Awesome lines 😀

 

[ItsGavinC]

We learned this prior to entering clinic (of course), and it wasn't nearly as bad as I thought it would be. The palatal didn't even hurt much, and neither did the IA.

 

[kato999]

I was really nervous as I had never had an injection from a dentist, let alone a dental student. The topical was money (pina colada flavored) so I closed my eyes and tried to pretend I was at a Jimmy Buffett concert.

I didn't feel a thing for the infiltrations. The IA and the palatal hurt a little, but not any more than a pinch and some pressure. Some advice is to wiggle the cheek while injecting and try to pull the tissue onto the needle rather than stabbing the needle onto the tissue. This helped me for sure on the infiltrations.

 

[eight143]

The first time I gave the Infraorbital, my partner showed up the next day with a hematoma (ouch)...it looked like her husband gave her a black eye the night before. I felt soooo bad!!! Word of advice....ASPIRATE!

 

[ikwu_Dental2006]

I hope they use lots of topical anaesthetic.

Hey Dinesh,
How is the dental school over their in the west indies? Do you still have to enroll in a school in United states to be licensed after graduation. How did your application process go? Is the tuition over their expense? Please let me know. I am thinking of applying to your school.

 

[ikwu_Dental2006]

I hope they use lots of topical anaesthetic.

Hey Dinesh,
How is the dental school over their in the west indies? Do you still have to enroll in a school in United states to be licensed after graduation. How did your application process go? Is the tuition over their expensive? Please let me know. I am thinking of applying to your school.

 

[Biogirl361]

okay you all are scaring me big time...i just hope i get a gunner for my partner and not one of those kids than never come to class unless they have to... 😱

 

[DDS2BE]

okay you all are scaring me big time...i just hope i get a gunner for my partner and not one of those kids than never come to class unless they have to... 😱

LOL

 

[fishindr]

I was really nervous as I had never had an injection from a dentist, let alone a dental student. The topical was money (pina colada flavored) so I closed my eyes and tried to pretend I was at a Jimmy Buffett concert.

I didn't feel a thing for the infiltrations. The IA and the palatal hurt a little, but not any more than a pinch and some pressure. Some advice is to wiggle the cheek while injecting and try to pull the tissue onto the needle rather than stabbing the needle onto the tissue. This helped me for sure on the infiltrations.

So how often ARE you giving injections leading up to clinic. Should I plan on getting a shot or two a week for my whole 2nd year or what? 1st year?

 

[USUaggie]

I practiced on chickens! Ok not really, they don't have teeth. But last year I worked with the county mosquito abatement and one of my jobs was to draw blood from the sentinal chicken flocks - that was a PAIN until I got the hang of it. It was like drawing blood from someone's arm except the vein was a lot smaller.

 

[DrJeff]

okay you all are scaring me big time...i just hope i get a gunner for my partner and not one of those kids than never come to class unless they have to... 😱

Half the time the clinical instructor is right behind you and grabs your shaking hand and "guides" you on in 😱 😀 Or as my instructor put it, "99.9% of dental students live through this, but if you're that 0.1%,...........sucks to be you!" 😀 😱 😉

 

[Biogirl361]

Half the time the clinical instructor is right behind you and grabs your shaking hand and "guides" you on in 😱 😀 Or as my instructor put it, "99.9% of dental students live through this, but if you're that 0.1%,...........sucks to be you!" 😀 😱 😉

i'm gonna insist on an army of instructors behind whoevers working on me!!

 

[unlvdmd]

We did it TODAY! I LIVED!!!

 

[ItsGavinC]

We did it TODAY! I LIVED!!!

We told you so!

I did an IA on a patient today and it was fine. See, it always turns out fine.
😀

 

[drhobie7]

Anyone else tried the external approach for the IA block? You come from behind the Pt. insert the needle 2 cm anteromedially through the tail of the parotid and deposit about a cartridge. Just kidding. To my knowledge that doesn't exist. I don't know who it would freak out more -- me or the Pt.

 

[booshwa]

My first intraoral injection I ever recieved was from my classmate giving a PSA. Followed by an infraorbital, a supraperiosteal and then an AMSA. Later we were given a IA w/ l. buccal, a Gow-Gates and a mental.

Of these I only felt slight pain on the Gow-Gates.

Really people, if these injections are done as they are supposed to, there shouldn't be that much pain. My partner didn't feel any pain when I injected her either.

The only really bad thing about the whole ordeal was the anticipation of pain (as it is for most patients), and the fear of hurting my partner or doing something wrong and given them permanent paresthesia. My hands were really shaking, and they did continue to shake the next few times I gave injections, but then all of a sudden I realized that this wasn't such a bad thing.

One thing I would really recommend for everyone with the opportunity, is to do dental work outside of school (in a controlled and supervised environment). I was down in Central America over my spring break working, and it was not only a great opportunity to help people who might not get the opportunity for good dental work, but also a great opportunity for me to pick up some skills, get some practice, but more importantly become more confident and comfortable with my abilities without the presence of an instructor breathing down my neck in clinic.

 

[TucsonDDS]

My partner didn't feel any pain when I injected her either.

It must not have been her first time.

jk


I agree with the extra clinical time. It is pretty cool that you were able to go and help in a place like that. I hope that I am able to do the same in a couple of years.

Take care

 

[Dr.Millisevert]

btw.. Dr. George Gow-Gates was a Sydney University Prof. He just passed away in 2001.

 

[ItsGavinC]

Anyone else tried the external approach for the IA block?

No, but we do the external infraorbital all of the time.

 

[Biogirl361]

My first intraoral injection I ever recieved was from my classmate giving a PSA. Followed by an infraorbital, a supraperiosteal and then an AMSA. Later we were given a IA w/ l. buccal, a Gow-Gates and a mental.

Of these I only felt slight pain on the Gow-Gates.

Really people, if these injections are done as they are supposed to, there shouldn't be that much pain. My partner didn't feel any pain when I injected her either.

the key words here are "if they are done as they are supposed to", the definition of first time is that it is usually not done as it is supposed to lol. until injections are over i will continue to live in mortal fear of being permanently damaged! did you get to choose your partners?

 

[unlvdmd]

We got to choose. It was kind of funny how all the hygienists clumped together. But can you blame them? They've already been through it once. I guess its only fair they get eachother.

 

[toofache32]

No, but we do the external infraorbital all of the time.

This reminds me...I've started using a complete V2 block via the greater palatine foramen for patients with abscesses or hot maxillary anteriors. If you just inject around the infraorbital, it usually won't work because of the acidity of the infections (which I'm sure you've already heard/read).

Just do a regular greater palatine block, wait 30 seconds, then go in again and probe around until you find the foramen. Then slowly bury the needle to the hub and inject.

This is great for ER patients with abscesses which you will probably see when you get into practice.

 

[aphistis]

This reminds me...I've started using a complete V2 block via the greater palatine foramen for patients with abscesses or hot maxillary anteriors. If you just inject around the infraorbital, it usually won't work because of the acidity of the infections (which I'm sure you've already heard/read).

Just do a regular greater palatine block, wait 30 seconds, then go in again and probe around until you find the foramen. Then slowly bury the needle to the hub and inject.

This is great for ER patients with abscesses which you will probably see when you get into practice.

Clinically, do you get the high incidence of hematomas? Our anesthesia guy harped on that quite a bit as a reason not to do a V2 without a fairly compelling indication.

 

[toofache32]

Clinically, do you get the high incidence of hematomas? Our anesthesia guy harped on that quite a bit as a reason not to do a V2 without a fairly compelling indication.

I havent seen one yet after maybe 15-20 of these injections. But then again, our patients often don't return for followup.

 

[DDS2BE]

I havent seen one yet after maybe 15-20 of these injections. But then again, our patients often don't return for followup.

why won't the patients return??? You must be giving them hell of a good discount 🙂

 

[Comet208]

I have been thinking .... if I know my partner in advance, I'll take them out for dinner the night before!

 

[toofache32]

why won't the patients return??? You must be giving them hell of a good discount 🙂

Yep...it's called FREE. These are patients at the county hospital where I work. Patients who come to the ER for a toothache or for a tooth that "got all swoll up" are not what you call reliable or compliant with post-op instructions, including coming back to clinic so we can take that drain out of their head.

 

[Rezdawg]

My hands were really shaking, and they did continue to shake the next few times I gave injections, but then all of a sudden I realized that this wasn't such a bad thing.

Does everyone's hands shake? I think I will definitely be a victim of this. I'd be shocked if I could even get the needle into the oral cavity. I'll probably miss and hit the neck. Or eyeball.

 

[drhobie7]

Are you serious? You do external infraorbital blocks all the time? Why? To scare the patient?

No, but we do the external infraorbital all of the time.

 

[lnn2]

Yep...it's called FREE. These are patients at the county hospital where I work. Patients who come to the ER for a toothache or for a tooth that "got all swoll up" are not what you call reliable or compliant with post-op instructions, including coming back to clinic so we can take that drain out of their head.

True dat! and they are the worst type of patients that you've ever treated! They want EVERYTHING for NOTHING! The thing is they usually are not appreciative of what you've done. The words "thank you" don't exist to most of them. They really made a skeptic out of me.

 

[USUaggie]

Does everyone's hands shake? I think I will definitely be a victim of this. I'd be shocked if I could even get the needle into the oral cavity. I'll probably miss and hit the neck. Or eyeball.

I expect they teach us stabalizing techniques, like if you brace the needle with your other hand which is braced against the patients head or something like that.

 

[lnn2]

I expect they teach us stabalizing techniques, like if you brace the needle with your other hand which is braced against the patients head or something like that.

Always finger rest for drilling, the pinky finger on the teeth so that when the patient moves, your drilling/injection hand will move in sync with it. Use a mouth prop/rest if there's chance of patient's close her mouth while you're drilling! For injections, I guess it depends whether or not your hand is shaky, use finger rest until you feel comfortable with it.

 

[12YearOldKid]

No, but we do the external infraorbital all of the time.

Why?!!!!! That is crazy. Sure, it is the most direct route but I would think you would have patients run screaming out of the clinic on a regular basis. It sure wouldn't be much of a practice builder in the real world. All the patient is going to see is that needle coming straight at their eye. 😱 It's not like the intraoral route is difficult.

And unless you are prepping a whole quadrant or doing surgery/multiple extractions there is rarely an indication for anything other than infiltration and an occasional incisive foramen block on the maxilla. Crowns and restorative all get infiltration on the maxillary arch when I'm doing it. Quick, relatively painless, and effective.