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Figure 8: Correctly selecting the closest shade
is half the battle. No shade matches a tooth
perfectly, so it is incredibly helpful to the dental
technician if you take and include a digital
photograph of the selected shade tab next to
the tooth you are matching. There is no easier
way to immediately improve your esthetic results
than to e-mail some digital shade pictures with
your case. Technicians simply try harder when
you give them a road map to follow.
Figure 9: Now I am placing the PFG gel (Steven’s
Pharmacy; Costa Mesa, Calif.), an important first
step in giving a pain-free injection. Placing the
gel with an Ultradent syringe makes it easier to
“sneak” some of the anesthetic into the sulcus,
so that the patient does not feel the insertion
of the needle through the attachment. After 60
seconds, we wash the PFG gel off tooth #8 and
#9 and begin the injection.
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Figure 10: Part of the advantage of using the
STA Single Tooth Anesthesia System ® device
(Milestone Scientific; Livingston, N.J.) is being
able to give painful infiltrations right under a
patient’s nose. The STA device allows me to
predictably get pulpal anesthesia with a painfree
PDL injection. I slide the 30 gauge extra
short needle into the sulcus without going
through the attachment. I step on the STA
foot pedal and give a few drops of Septocaine
into the sulcus prior to going through the
attachment. I honestly don’t know if this helps
in any way, but I know it doesn’t hurt, and it
makes me feel better. Once I give a few drops,
I continue to express the Septocaine while the
needle tip is advanced through the attachment
until it reaches the crest of the bone.
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