Long buccal nerve block injection pain in patients with irreversible pulpitis.

OBJECTIVES The purpose of this study was to determine the pain associated with needle insertion (with or without topical anesthetic) and solution deposition for the long buccal nerve block injection in patients with irreversible pulpitis. Initial pain and any differences by age and gender were also studied. STUDY DESIGN One hundred twelve emergency patients with irreversible pulpitis received long buccal nerve block injections using 2% lidocaine with 1:100,000 epinephrine. The patients recorded pain of needle insertion and solution deposition on a Heft-Parker visual analog scale (VAS). RESULTS Moderate-to-severe pain occurred from 41% to 46% of the time with the long buccal nerve block. The use of topical anesthetic did not statistically decrease the pain of needle insertion. CONCLUSIONS In conclusion, 41% to 46% of patients presenting with irreversible pulpitis have the potential for moderate-to-severe pain with the long buccal nerve block.