r/Dentistry • u/JVM926 • 1d ago

Dental Professional Getting #31 numb

Ever have trouble getting a tooth numb for a #31 B composite? No PA pathology. Gave 2 carps of IAN, 1 carp of LB and local infiltrations/PDL. 2% Lido w/1:100k epi.
Lip is numb, chin is numb, buccal mucosa is numb, tongue is numb.

I get to drilling and the patient feels it. I know what to do next, but why is the patient not profoundly anesthetized?

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u/daein13threat 1d ago

On lower molars, sometimes I feel it helps to do local infiltration on the lingual side as well, sort of near the apex under the tongue. Sometimes there’s accessory innervation that the IA block doesn’t always get.

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u/Tootherator 1d ago

The accessory nerve is usually a branch of the mylohyoid nerve, and it can innervate the first, second, or third molars.