Failure rate of inferior alveolar nerve block among dental students and interns

Abstract

Objectives:To report the failure rate of inferior alveolar nerve block (IANB) among dental students and interns, causes of failure, investigate awareness of different IANB techniques, and to report IANB-associated complications.Methods:A 3-page questionnaire containing 13 questions was distributed to a random sample of 350 third to fifth years students and interns at the College of Dentistry, King Saud University, Riyadh, Saudi Arabia on January 2011. It included demographic questions (age, gender, and academic level) and questions on IANB failure frequency and reasons, actions taken to overcome the failure, and awareness of different anesthetic techniques, supplementary techniques, and complications.Results:Of the 250 distributed questionnaires, 238 were returned (68% response rate). Most (85.7%) of surveyed sample had experienced IANB failure once or twice. The participants attributed the failures most commonly (66.45%) to anatomical variations. The most common alternative technique used was intraligamentary injection (57.1%), although 42.8% of the sample never attempted any alternatives. Large portion of the samples stated that they either lacked both knowledge of and training for other techniques (44.9%), or that they had knowledge of them but not enough training to perform them (45.8%).Conclusion:To decrease IANB failure rates for dental students and interns, knowledge of landmarks, anatomical variation and their training in alternatives to IANB, such as the Gow-Gates and Akinosi techniques, both theoretically and clinically in the dental curriculum should be enhanced.

Experiences of Students and Interns with Success Rate of Inferior Alveolar Nerve Block during Surgical and Endodontic Procedures

“…These results are similar to the findings of the previous study wherein the majority of students reported the same. 13 These findings of the present study are similar to those mentioned in a previous study wherein the variation in the morphology of the ramus of mandible and that of mandibular foramen location were being cited as the causes for failure of the IANB. Nevertheless, the most common cause is found to be the wrong procedure of injection.…”

“…These findings fairly match with the results of the previous study conducted on interns and students in Riyadh. 13 In the present study, the majority of interns (70%) and dental students (71.9%) believe that anatomical variation is the common cause for IANB failure, while 22.9% interns and 20.2% dental students said that IANB failure was due to wrong technique. These results are similar to the findings of the previous study wherein the majority of students reported the same.…”

“…12 It might have been due to the inadequate training with respect to alternative techniques as found in the earlier study. 13 It has been recorded earlier that the Gow-Gates technique provides a much better anesthetic effect when compared with that of the conventional IANB technique, 14 notwithstanding the fact that onset of anesthesia takes a little longer time (around 5-7 minutes). 15 A closed-mouth mandibular nerve block technique was introduced by Akinosi.…”

Understanding neurophobia: Reasons behind impaired understanding and learning of neuroanatomy in cross‐disciplinary healthcare students

“…Poor understanding of neuroanatomy has been documented as a major hindrance in the successful translation of basic neuroscience knowledge to clinical situations. For example, the incorrect administration of inferior alveolar nerve block by dental students and interns due to their lack of understanding of the possible neuroanatomical variations has led to major complications (AlHindi et al, ). Insufficient neuroanatomical understanding and a resulting lack of confidence when treating neurology patients has been identified among general practitioners (Schon et al, ; McCarron et al, ) and medical students across various countries including the United States (Zinchuk et al, ), Ireland (Flanagan et al, ), the United Kingdom (Schon et al, ; Ridsdale et al, ; Pakpoor et al, ), Australia (Hudson, ), Singapore (Lim and Seet, ; Kam et al, ), Caribbean countries (Youssef, ), Nigeria (Sanya et al, ), Sri Lanka (Matthias et al, ), and India (Gupta et al, ).…”

Application of Mandibular Nerve Blocks by Dental Practitioners in Bulgaria with a Working Experience of More than 10 Years – Survey

“…Only 0.89% (n=5) and 0.18% (n=1) claimed that they prefer the Gow-Gates and the Akinosi-Vazirani techniques accordingly. In a study, done by Maryam AlHindi [1], 10.3% from all the surveyed claimed that they are well versed in the Gow-Gates mandibular nerve block and only 2.9% claim that they are familiar with the Akinosi-Vazirani closed-mouth nerve block. In the same study 22 of all the 238 surveyed dentists indicated that they have eno/ugh theoretical knowledge and practical skills to use alternative to the classical Halsted approach to inferior alveolar nerve block.…”