septocaine...last time. I swear.

Before I get started...all you non dentist people might get lost on this blog (and might not make it to the end). But one thing I would like you to do is check out the AGD's non-dentist site. It is Knowyourteeth.com . Please check it out and let me know what you think.

Hi all,

Hope you had a good weekend.

Oh, my gosh the weather here in Florida is so beautiful. Today it is 65 degrees and breezy.

It is the kind of day you go to the outside shops and just walk around enjoying the day.

A day you just sit outside and read. A day you just open all the windows and watch a movie.

This time of year the azaleas are blooming. The tababuia trees are blooming. Soon the jasmine will be blooming and all will be well with my soul.

It is a Monday and I am off work so I will get right to it. I don't like to be on the computer when I am at home. It sends a wrong message to the kids.

But I have been thinking about this subject too long.

I told you that I was able to talk to all the dentists during Dentistry from the Heart.

I did my own little survey on Septocaine.

Most of the dentists were using Septocaine and most of them were using it for everything.

You know as a dentist that WAS using it for everything, it makes you feel okay. All dentist want to feel like they are a part of a group. Standing alone is tough. So if you are doing something that a lot of people are doing...it is okay.

When I read Reality, I just want to use the most popular brand.

And when I heard everyone was doing it...I felt okay.

And they all reported No Problems.

I have told you I am not giving blocks with Septocaine anymore.

So, I know you are wondering what AM I doing.

Well one of the things I did was at Dentistry from the Heart was I pinned down the oral surgeon and asked him how to give a block.

I know what you are thinking. A dentist 13 years out of school wondering how to give a block.

I know this looks bad. I was a little embarrassed but I know it was for the greater good.

I also know I am not the only one missing blocks because then Septocaine would not be so popular.

But I pinned him down and asked him to show me. So we went into the room and did it together on a patient (with lidocaine). He said most people go too high on their blocks.

He showed me what anatomical things to look for and told me exactly where to put the needle.

I have done a handful of blocks since then and I have to be honest with you....I still am about 70%.

One thing though, I have had an aversion to giving blocks. If I am doing a tooth that is premolar forward I use local. So really I only need a block if I am doing anything on the molars. Well what if I am doing an MO on #30 only. This is a filling that will take me about 10 minutes. If I do a block they will be numb for 2-4 hours.

So I starting using this...

.
This is the Paraject system by Septodont. I love, love, love it.

I have been using it for a month or two. It takes about 3 minutes to numb a tooth and it WORKS. I have used it about 60 times and it has only not worked once (and I am now thinking that might have been a fluke).

Basically this is a interligamental injection system. The needle is tiny. You give a little in the tissue around the tooth before starting and then push the tip at the MB line angle and squeeze the trigger. It is hard to do because you are forcing anaesthetic in a small space.

Then I put the needle in the furca space and maybe in the DB line angle.

It works so good that I have done 3 root canals with just this type of injections.

Patients love it.

They leave with out ever feeling numb.

Now I am using it for multiple teeth. Say if I have to do fillings on #18 and 19. Well it takes a little time but very effective.

So now, even though it was aggravating my assistance for awhile. I use Septocaine on the upper with the regular set-up (30 short), I use Septocaine with the regular set up from lower premolars forward.

If I am doing more than two teeth on the lower it is Lidocaine in the regular set up (for a block). And if I am doing 2 or less molars it is the Paraject with Septocaine.

I know it seems like a lot of work but...at least I am not sweating that once a year call from a patient that says his lip is still numb the next morning.

But that leads me to my last point.

I think it is becoming official that the side effect to giving a lower block with Septocaine MAY lead to more instances of parasthesia.

When does the memo come out?

Remember I was ticked off about the poor information chain when it came to the antibiotic premed thing. No one knew for about a year whether to change our protocol. And the physicians still aren't with it.

So who is going to come out and say something.

I don't think the dentists want to stop using it because it is so effective.

Septodont doesn't want to come out with it because it is selling like hot cakes.

Who is going to tell the dentist?

Or is <1%>

But if it is bad someone needs to stand up and say something.

If Septodont knows there is a problem then they need to take it off the market.

If there is a way to give the injection that will make it less of an issue...like if you give the injection slower or if you chill the solution it needs to be researched because a lot of people want to know.

I mean almost every dentist has an email address (and as the older guys retire the percentage of email-able dentists goes up). The information can travel very fast.

We need to figure out a way to make this happen.

What do you think?

Am I just talking crazy or am I making sense here?

Have a great start of your week.

john