Failed Dental Anesthetic Procedure Results In Severe Injury

Case Overview

This dental care case involves a patient who was in the process of undergoing an inferior alveolar block when the needle used for local anesthesia broke off in the patient’s mouth. The needle is two-inches long and has been stuck in place for close to a month now. Numerous oral surgeons have attempted to remove the needle without any success.

Questions to the Dentistry expert and their responses

Do you perform inferior alveolar blocks?

I perform inferior alveolar blocks on half of my restorative patients. I also teach the procedure to dental students.

How common is it for the needle used to deliver local anesthesia to break?

It is rare for the needle to break.

If a needle were to break, how should you recover it and what steps must be taken?

If the needle breaks and the fragment is protruding from the tissue, it should quickly be grasped and removed with a curved hemostat. If the needle was inserted up to the hub and no portion of the broken needle is visible above the surface of the tissues, no attempt should be made by the operator to retrieve it. Any attempts may drive the needle deeper. Surgical removal under general anesthesia is recommended. To locate the fragment, imaging modalities such as multi-plane X-rays or fluoroscopy with two reference needles in place or three-dimensional CT scanning are typically necessary.

About the expert

This highly qualified Pediatric Dentistry expert received her D.D.S. from the University of Iowa and went on to receive a Doctorate in Medical Dentistry. She is board certified in Pediatric Dentistry and is a Fellow of the American Academy of Pediatric Dentistry. She is a member of numerous professional societies including the American Dental Association. This expert serves as an editor of the Journal of the American Academy of Pediatric Dentistry and has published several peer-reviewed journal articles.