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Dr. Gasteier brings up many valid points. The type of reaction written about in the article is rare. That was the point of the article. It is very fortunate that Dr. Gasteier has never experienced this type of reaction, but other practitioners have. Dr. Spyro Spyratos in his March JADA letter to the editor experienced two such anesthetic injection reactions in less than five years of practice experience.

Dr. Gasteier is absolutely correct that inferior alveolar nerve block injections should be given with proper positioning of the head and syringe. Injections should be given slowly with aspirations. Even with the utmost care that I believe all practitioners give to their patients, untoward reactions do occur.

Patients move heads, the anesthetic needle may have been placed at a higher level that intended, blood vessels are entered, and so forth. There was even an October 2001 JADA article in which a dental student ended up with temporary hearing loss from an inferior alveolar injection.¹

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TOP REFERENCES

1. Brodsky CD, Dower JS Jr. Middle ear problems after a Gow-Gates injection. JADA 2001;132(10):1420–4.
   
   

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Webber, B. Search for Related Content PubMed Articles by Webber, B.