Problem
A patient is in the office for a 1-hour nonsurgical periodontal treatment of the mandibular left quadrant. The dental hygienist administers two cartridges of lidocaine 2% 1:100,000 epinephrine. The patient informs the dental hygienist that he feels very numb. The procedure is much more difficult than the dental hygienist expected, and the entire quadrant is not completed after the hour elapsed. The dental hygienist asks the patient if he is able to stay longer to complete the procedure because there is an opening in the schedule. After approximately a half hour into the continued treatment, the patient complains that he is feeling pain and asks for some more anesthetic. The dental hygienist administers another cartridge of anesthetic, but the patient does not get numb.
Critical Thinking Questions
a) Why did the patient not get numb the second time the anesthetic was admin- istered?
b) What could the dental hygienist have done to prevent this from occurring?
c) How should the dental hygienist handle the situation?