1. MAXILLARY ANESTHESIA

2. Basic Injection Technique Check flow of local anesthetic Position the patient Prepare the tissue Communicate with the patient Establish hand rest

3. Basic Injection Technique Make the tissue taut Keep the syringe out of patient sight Bevel the needle toward the bone Insert the needle Deposit while advancing the needle

4. Basic Injection Technique Aspirate Slowly inject Communicate with the patient Withdraw the needle Cap the needle Watch the patient Record the injection in the patient chart

5. Infiltration - Palate Nerves Terminal branches - Greater Palatine nerve Terminal branches - Greater Palatine nerve Nasopalatine nerve Nasopalatine nerveArea Palatal soft tissue in area of injection Palatal soft tissue in area of injection

6. Infiltration - Palate Indications Limited area Limited area Hemostasis HemostasisContraindications More than 2 teeth More than 2 teeth Inflammation/infection at site Inflammation/infection at site

7. Infiltration - Palate Advantages Hemostasis Hemostasis Minimal area affected Minimal area affectedDisadvantages Potentially traumatic Potentially traumatic

8. Infiltration - Palate Technique Apply topical, pressure Apply topical, pressure Insert into gingiva in center of area Insert into gingiva in center of area - 5-10 mm from gingival margin - 5-10 mm from gingival margin Aspirate (positive results are rare) Aspirate (positive results are rare) Inject 0.2-.3 ml, slowly Inject 0.2-.3 ml, slowly

10. Signs and Symptoms Numbness, blanching of palatal soft tissue No pain during dental therapy

11. Failures of Anesthesia Quite rare Failure of hemostasis Inflammation Inflammation Lack of vasoconstrictor Lack of vasoconstrictor

12. Complications Necrosis of soft tissue (due to excess vasoconstriction) (due to excess vasoconstriction)