A December JADA case report by Dr. Brian Webber and colleagues ("Complications of an Intra-Arterial Injection From an Inferior Alveolar Nerve Block") was recently brought to my attention. This article was of interest to me because I lecture on the anatomy of local anesthesia to dental students.
However, I was very disappointed after reading the report. I found several problems with the logical analyses and discussion of this case, not the least of which was the assumption that an injection of anesthetic will flow backward against a significant arterial pressure and be distributed primarily to one artery in the orbit.
No other potential explanations are given for the patient’s responses, such as the potential involvement of the facial artery, which would explain why there was blanching that occurred along the lip, side of the nose and the lower eyelid (the course of the facial artery).
Although the article’s conclusion concerning patient care is a very important one, the point I wish to make is that dentists are a very well-educated group of professionals and to print an article of such poor scholarship is, I feel, effectively insulting the dental community, not to mention a poor reflection on JADA.
I would encourage JADA in the future to enlist a basic science peer review where appropriate. This will only enhance JADA’s professional profile. I hope that as Dr. Jeffcoat’s tenure begins, JADA will see a move in this direction.
