Nasal Spray alternative to Needle?

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2TheApex: Yes!

Last June the FDA approved an anesthetic nasal spray (Kovanaze) for use in restorative procedures on teeth #4 through #13.  It takes two squirts 5 minutes apart (a third squirt may be needed sometimes).  One big advantage, in addition to calming patients with a needle phobia, could be pulpal anesthesia without lip numbness for esthetic cases.  Use for root canal treatment or biopsy has not been studied yet.  Kovanaze is reported to be available sometime this fall.  Recent Study  Manufacturer Press Release

Explanation with diagrams from Spear Education

What percentage of crown-prepped teeth become necrotic?

Kelly, M Tooth #30 Pre Op 8-22-16

2TheApex:  Roughly 10%

One statistic you may want to share with patients is that 1 in 10 teeth with crowns end up requiring root canal therapy. Here is the Study.  Not a bad statistic for patients to know prior to a crown prep.  There is always a risk.  The more highly the tooth is restored increases the chances.

http://endolit.com/betaadmin/uploads/A_Prospective_Study_of_the_Incidence_of_Asymptomatic_Pulp_Necrosis_Following_Crown_Preparation.pdf

Kelly, M Tooth #30 Post Op 8-22-16