Anesthesia and

extraction in children
Dr. Masar Mohammed
LOCAL ANESTHESIA IN
CHILDREN
Local Anesthesia for Dental Child
Patient

Introduction

Preparation of the child patient

Application of the topical anesthetics

Injection the local anesthetic solution

Nerve block anesthesia in the

mandible.
Local Anesthesia for Children
- Local anesthesia is the most common method
of pain control
- Effectie local anesthesia allo!s dental
proced"res to #e carried o"t painlessl$
- Most cait$ preparations% ital p"lp therap$%
e&traction of teeth and s"r'ical proced"res
re("iere administration of local anesthetics
- This method of eliminatin' pain is painf"l
itself and can #e er$ distressin' to the
child
Local Anesthesia for Children
1. Preparation of the child dental patient.
)
The child !ill #e told that to treat his tooth
properl$ and comforta#l$% this tooth is 'oin'
to #e *p"t to sleep+
)
At first a paste *!ill #e applied to p"t the
'"m to sleep+
)
The parents sho"ld #e informed not to
interfere or comment

Local Anesthesia for Children
2. Application of the topical anesthetics
)
To act effectiel$% topical anesthetic paste
has to #e applied to dried m"co"s mem#rane
)
,se one end of cotton roll to dr$ the site of
insertion and the other end #ein' "sed to
appl$ the topical anesthetic
)
Topical anesthetic are aaila#le in 'el% li("id%
spra$% and ointment

Don!t do it
Local Anesthesia for Children
". Injection the local anesthetic solution
)
#tretch the tissues
prior to insertion of
the needle$ %ill result
in easier penetration
Local Anesthesia for Children
". Injection the local anesthetic solution
)
&he bevel of the
s'rin(e should be
a(ainst the bone
)
&he concealment of
the s'rin(e from the
child is
recommended
Local Anesthesia for Children
". Injection the local anesthetic solution
)
All ma)illar' and lo%er anterior teeth can be
anestheti*ed b' filtration anesthesia usin(
short or e)tra+short needle
)
Lo%er primar' molars can be anestheti*ed
b' infiltration anesthesia or inferior dental
nerve block
Local Anesthesia for Children
". Injection the local anesthetic solution
)
%ait for the buccal
infiltration to have its
effect
)
inject the palatal of the
interdental papillae from
the buccal side distal and
mesial to the tooth
Local Anesthesia for Children
". Injection the local anesthetic solution
,hen the buccal infiltration anesthesia is
used in the lo%er ja%$ lin(ual anesthesia
%ill be necessar' for an' e)traction

An intrapapillar' injection as mentioned
%ith ma)illar' teeth %ill be sufficent
Local Anesthesia for Children
". Injection the local anesthetic solution
)
Is used for all procedure in the
mandibular molars -primar' and
permanent. in the children$ e)cept for the
ver' 'oun(
)
Is preferred %hen locali*ed infection
e)ists in the area of the infiltration site.
Nerve block anesthesia in the mandible/
Local Anesthesia for Children
". Injection the local anesthetic solution
Nerve block anesthesia in the mandible/
)
&he si*e of the mandible is also smaller
than that of the adult
)
&he mandibular foramen is situated at a
lo%er level

&he injection must be made sli(htl'

lo%er and more poteriorl' than for the
adult
0)traction of teeth in
Children

Introduction

Indications for e)traction of primar'

teeth

Contraindications to e)traction of
primar' teeth

Indications for e)traction of

permanent first molars

Preoperative preparation

&echni1ues for the removal of primar'

teeth

Postoperative instructions
-RINCI-LES

Avoid injur' to soft tissues such as the

ton(ue$ lips$ (in(iva and cheeks.

Avoid injur' to underl'in( developin(

permanent teeth and other hard tissues
such as bone and adjacent or opposin(
teeth.

2se radio(raph to determine

#i*e and shape of roots.

Amount and directions of root

resorption.

Position and sta(e of developin( of

underl'in( permanent tooth.

An' patholo('
-RINCI-LES
1. &he oral cavit' is small and there is
(reater difficult' in (ainin( access to
the field of operation.
2. &he ja%s are in process of (ro%th and
development
". &he dentition is in continuous state of
chan(e %ith eruption and resorption of
primar' teeth and eruption of permanent
teeth takin( place at the same time.
3. &he bone structure more liable than
adult bone.
INDICA&I4N 546 07&6A&I4N 45
D0CID242#
&00&8

.adl$ cario"s can not #e restored.

Acute patholo(ic involvement

Chronic patholo(ic
involvement

for orthodontic purpose.

Oer retained primar$ teeth preentin'

er"ption of permanent s"ccessor.

S"pern"merar$ teeth

The an/$losed decid"o"s tooth.

The impacted tooth.

In tra"matic in0"r$ to teeth if ertical

fract"re occ"r.
C4N&6AINDICA&I4N# 546
07&6AC&I4N# 45 &00&8 IN
C8ILD60N#

Acute oral infection

9lood diseases

2ncontrolled diabetes mellitus.

Acute s'stemic infections.

&eeth in irradiated bone.

P60 + 4P06A&I:0 P60PA6A&I4N 45
&80 PA60N& AND C8ILD

-ARENT-
1 -ARENTAL CONSENT .E2ORE THE
-ROCED,RE.
3 INSTR,CT THE -ARENT NOT TO
DIC,SS 4ITH THE CHILD 4HAT
THE DENTIST 4ILL DO.

C8ILD+
1 ARMAMENTARI,M SHO,LD .E 5E-T
.EHIND THE CHAIR.
1. NE6ER HOLD THE NEEDLE IN 2RONT O2
CHILD AL4A7S HIDDEN .7 2IN8ERS.
3 .E2ORE 8I6IN8 THE LA% E9-LAIN TO
THE CHILD THAT SENSATION O2
-INCHIN8 OR AN ANT .ITIN8 MA7 .E
2ELT.
: CHILD REALI;ES THE DI22ERENCE
.ET4EEN -RESS,RE AND -AIN.
< E9-LAIN THE SENSATION O2
N,M.NESS TO CHILD.
E9TRACTION TECHNI=,E
-OSITION O2 THE -ATIENT AND THE
O-ERATOR
&echni1ues for the removal of primar'
teeth
2pper forceps
6otation
;a)illar' Incisors

%l
Deliver' to labial
;a)illar' Incisors
6i(ht
Left
;a)illar' ;olars
5irst
Counter clock %ise
;a)illar' ;olars
-
&echni1ues for the removal of primar'
teeth
Lo%er forceps
;andibular incisors
Contraindicated in Primar' &eeth
&he child is instructed to hold bet%een
his lips a small
cotton roll until his lips <%ake up <

&he children should reminded not to

bite lips after mandibular block
anesthesia

Li(ht meal %ith no hard food is

recommended.