7 Local Anesthesia Complications Every Dentist Must Know | IANB, PSA & LAST

Local anesthesia is one of the safest procedures in dentistry, but do you know what to do when things go wrong? We cover 7 complications by injection site and fix the most common mistakes. ⏱️ Chapters 0:00 Intro 0:16 IANB anatomy 0:42 1. Trismus 1:23 2. Transient facial paralysis 2:04 3. Needle breakage 2:42 4. Paresthesia 3:21 5. Hematoma (PSA block) 4:03 6. Soft tissue injury 4:32 7. Local anesthetic systemic toxicity (LAST) 5:13 Keep in mind: syncope, allergy, methemoglobinemia 5:39 Summary ✅ Key points Trismus after IANB: medial pterygoid, not lateral Facial palsy: never deposit without bone contact Needle breakage: mostly 30G short needles at the hub → use long 25/27G for IANB Paresthesia: lingual nerve in 89% of reports Hematoma: highest risk with PSA; aspiration does NOT prevent it LAST: stop, call for help, airway, 100% O₂, benzodiazepine, 20% lipid emulsion 📚 References Malamed SF. Handbook of Local Anesthesia, 7th ed. Elsevier; 2020. Malamed SF, Reed K, Poorsattar S. Needle breakage. Dent Clin North Am. 2010;54:745–756. Garisto GA et al. Paresthesia after local anesthetic administration. JADA. 2010;141:836–844. Hersh EV et al. Phentolamine mesylate for soft tissue anesthesia reversal. JADA. 2008;139:1080–1093. Neal JM, Neal EJ, Weinberg GL. ASRA LAST Checklist 2020. Reg Anesth Pain Med. 2021;46:81–82. ⚠️ Educational content for dentists and dental students. Clinical decisions belong to the treating clinician, based on current guidelines and individual patient assessment. #dentistry #localanesthesia #dentalstudent #IANB #oralsurgery #dentaldet