An Audit of the Use of Intra-Septal Local Anaesthesia in a Dental Practice in the South of England

Aim The aim of this audit was to evaluate the efficacy, when used by the author, of the intra-septal local anaesthetic technique for cavity preparation in mandibular molar and premolar teeth. Methods One hundred and thirteen consecutive patients who required local anaesthesia (LA) for cavity preparation in lower molar and premolar teeth in a general dental practice took part in the audit sample. Articaine 4%, with1:100,000 adrenaline (epinephrine), was administered using the intra-septal technique. Visual analogue scales (VAS) were used to record pain experienced on injection and the quality of anaesthesia obtained. Any side-effects reported were recorded. The standards set were that at least 70% should find the administration of the LA pain-free and that at least 80% should experience no pain during cavity preparation. Results Sixty-nine (62%) patients reported the injection technique to be completely pain-free and a further 23 (20%) reported very minor pain on injection. Eighty (71%) patients reported pain-free treatment and 18 (16%) experienced very minor pain during treatment. No side-effects were reported. Patients aged under 40 years and those who had cavities prepared in first premolar teeth appeared more likely to experience pain during cavity preparation. Conclusion The intra-septal injection technique requires no specialist equipment, is easily administered, rapid in onset and provides a level of anaesthesia equivalent to that produced by an inferior dental nerve block and with fewer side-effects. The injection is relatively painless to administer.