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OPERATOR PREFERENCE OF RETRACTION METHOD DURING ANESTHESIA DELIVERY

The participants were then asked about their preference of the retraction method ; 22 responded they prefered the mirror to be used for the delivery of the anesthesia , 29 preferred the device , and 3 preferred their finger as retraction ( Table 3 ). Due to the small number in the last group , it was not possible to conduct a formal statistical analysis .

Table 3 . Preference of retraction method

However , when asked to choose the method that was easier , 30 chose the mirror , 18 the device , and 10 said using their finger for retraction was easier ( Table 4 ). This resulted in a p-value of 0.005 , which indicates that there is a significant difference in the proportions of participants choosing the three different methods .

Table 4 . Retraction Method that was easier

4 . Discussion

The results from this study relate with the conclusion from Haskell et . al , that novice practicioners can become comfortable with a learned technique using mirror retraction to deliver anesthesia 19 . From the results , the porportion of participants who felt comfortable and confident , was significantly greater than that of the other porportion feeling uncomfortable and anxious ( p-value < 0.001 ). In some cases , as with learning how to use a new device , 27 % of the DCP ’ s expressed anxiousness and discomfort . Limited evidence exists assessing anxiousness and discomfort of the DCP when “ trying out ” novel devices . 20 Our results coincide with studies stating possible nervousness or fear may exist in some people as there is an introduction

19 , 21-23 of a new stiumuli . The results indicate 94 % of the DCPs prefer to use a method of retraction other than their finger for delivery of dental anesthesia . The use of a finger for retraction during anesthesia guides the operator with palpating necessary landmarks prior to the injection , 24 in addition to the retraction of the mucosa . As mentioned earlier , leaving the finger intraorally during anesthesia delivery puts the retracting hand of the DCP at risk for an NSI . 8 , 9 Regarding which retraction was easier for the DCP , 83 % of the DCPs stated that the alternative retraction ( mirror or device ) was easier than using the finger lending to a p value less than 0.005 among the three methods . With the many advances and innovations created for the delivery of dental anesthesia , there is a necessity to consider alternative methods of retraction while providing dental anesthesia . 9 There are reports discouraging DCPs from using their finger for retraction and encouraging DCPs to

13 , 25 , 26

use a safer method to deliver local anesthesia . When changing technique , or working with a new device , DCPs need to review the clinical evaluations to gauge safety 27 and appropriateness of the innovative devices . Our hypothesis and clinical implication were confirmed . Comfort and confidence with use of an alternative retraction method ( mirror and device ) was found to be a constructive perception . The results reassure the profession , not just within a university clinical setting , but also in practice , that there are techniques and armamentarium available to the DCP to assist in retraction during dental anesthesia . Practitioners should consider the value of additional training to get comfortable with an easier and safer technique of delivering anesthesia , 28 , 29 especially if their learned technique was the use of a finger retraction . Clinicians may find other devices or armamentarium ( tongue depressor , or alternative retractor ) that may provide the same retraction method similar to the methods used in this study . This study provides preliminary data to showcase benefits of using alternative retraction methods . The DCPs participating in this study are considered novice and show preferences and opinions different from DCPs practicing for over 10 years . More studies need to be conducted to further investigate the benefits of using a fingerless retraction method , its relation to NSIs , and its effectiveness in dental anesthesia .

5 . Conclusion

As with providing any dental care , the dental practitioner should be comfortable and confident with the delivery of dental anesthesia . This study explored other techniques for retraction when delivering local anesthesia ; an area that needs further exploration . Our results show that noninvasive techniques and armamentarium can be useful when delivering local anesthesia . Retraction techniques help in reducing the risk of NSIs , which is a benefit to the dental providers .

Conflict of interest and financial disclosure The authors declare that they have no conflict of interest and there was no external source of funding for the present study . We would like to acknowledge Bing Innovations , LLC for their support in providing supplies for use with device .