I wish to congratulate Drs. Chiappelli and Cajulis for their helpful commentary and more completely detailed explanation of the anatomy of the face. Their explanation clarifies and enhances my article.
While Drs. Chiappelli and Cajulis find intra-arterial injection from an inferior nerve block to be relatively common in the daily routine of their dental practice, many other dentists do not. In his June JADA letter to the editor, Dr. Laurence Stein indicates he has never encountered the reaction described in the article in over 28 years of dental practice. In personally speaking to numerous dentists, I found that many had no experience with this reaction, while some did. Some recent dental graduates had no idea what the article was about, having had no experience with this reaction.
The main purpose of the article was to educate other practicing dentists about this type of anesthetic injection reaction. With all the attention this article is generating, I think it is achieving that goal.