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Full mouth anesthesia for SRP

Can I perform full mouth SRP with anesthesia in a day? Will it be okay with the patient?



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1 Answer

Some hygienists do prefer to do full mouth anesthesia and complete SRP in one day. Personally, I am not one of those hygienists for a few reasons. Dr. Stanley Malamed (who literally wrote the book on local anesthesia) does not recommend it either. Research has shown, when comparing healing after one session or multiple sessions, the difference in healing rates aren’t clinically significant. When administering local anesthesia, one must remember the maximum recommended dose (MRD); because when anesthetizing the entire mouth, a lot of anesthetic is used. This is especially important in medically compromised patients. Further, anesthetizing the whole mandible has risks to the patient. There is greater risk of the patient injuring themselves by biting their tongue and buccal mucosa. On these same lines, patients feel “swollen” when anesthetized and patients can panic because they feel like they can’t breathe or swallow.
 
I prefer to do no more than two quads at one time. Upper right and lower right then upper left and lower left. This method lowers the risks mentioned above. It also gives me the chance to assess and review homecare over multiple appointments.

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