If you have ever been to the dentist to have a tooth removed, you are likely familiar with the local anesthetic (or freezing) that is done prior to extraction. Despite being under general anesthetic, we use a similar practice in veterinary medicine, commonly referred to as a dental nerve block.
Dental nerve blocks are part of a multi-modal pain control approach that we use when doing a tooth extraction. Multi-modal means using multiple forms of analgesia, before, during and after the procedure. Typically for dental extractions, an opioid is given prior to anesthetic induction, followed by a local anesthetic and lastly an injection of pain relief upon wakeup. Of course, no two patients are the same, and the drugs we choose and the category of drugs do vary on a patient to patient basis.
There are multiple benefits to performing a dental nerve block, one of which is being able to maintain the patient on a lower dose of inhalant anesthetic. A lower dose is better for their cardiac output and heart rate, respiratory rate, blood pressure and more. Not only does the dental nerve block make for a safer anesthetic, but it also provides pain control when the pet wakes up from the anesthetic. The drug we use for the block is called Bupivacaine (0.5%), while it does have a delayed onset (4-8 minutes), it can last up to 10 hours after injection. This means the pain control is still on board long after the patient wakes up.
There are a few different injection locations when it comes to the nerve blocks, choosing which one to perform is dependent on which teeth the veterinarian is going to extract. The block is done by injecting a small volume of Bupivacaine with a small gauge needle to the area in question. This procedure is to be done by a veterinarian or technician as it does require a great deal of precision. There are four main blocks that are performed in veterinary dentistry:
Maxillary Infraorbital Block – blocks the upper canines and incisors
Rostral Maxillary Nerve Block – blocks the upper molars and premolars
Middle Mental Nerve Block – blocks the lower canines and incisors
Mandibular Nerve Block – blocks all lower teeth, this is typically the best
block for the lower teeth in cats and small dogs
If you have any questions regarding your pet’s teeth, West Hill Animal Clinic is offering complimentary dental examinations with our technicians until March 31st!
Written by: Zoe, RVT