Palatal anaesthesia for the removal of maxillary third molars as practised by oral and maxillofacial surgeons in Australia and New Zealand

Abstract

Injections of local anaesthetic to the palate are well known to be poorly tolerated. The absolute requirement of a palatal injection for the removal of maxillary third molars has never been investigated. The aim of this study was to document the current practice of palatal anaesthesia for extraction of these teeth with local anaesthesia as practised by oral and maxillofacial surgeons. A postal survey was sent via the ANZAOMS office to all oral and maxillofacial surgeons who were members of the Australian and New Zealand Association, a total of 131. A response rate of 64 per cent (n = 84) was achieved. The frequency of administration and the factors that determined the decision to administer a palatal injection were assessed, as well as the methods employed for reducing the injection discomfort. The majority (77 of the 84) "always" gave a palatal injection for the removal of maxillary third molars, four respondents administered an injection "most of the time", and two respondents "occasionally". Significantly, one respondent "never" gave a palatal injection. The majority (76 per cent) utilized at least one adjunct in order to reduce the discomfort of the injection. The results of this survey suggest that for removal of maxillary third molars the requirement of the poorly tolerated palatal injection may not be absolute as conventionally taught and demonstrates the need for further investigation.