How do you guys manage extractions with periapical infection?
I’ve been running into a recurring issue and wanted to hear how others handle it in practice.
In cases with clear periapical infection, even after multiple local anesthesia injections, patients still report pain during extraction. Achieving profound anesthesia becomes really unpredictable, especially in hot teeth.
For those with more clinical experience:
- What’s your go-to anesthesia technique in these cases?
-Do you rely more on nerve blocks, supplemental injections (PDL, intraosseous, intrapulpal), or something else?
- Any tips for improving patient comfort and cooperation when anesthesia isn’t fully effective?
- Do you ever defer extraction and manage infection first, or proceed anyway?
Would really appreciate practical, chairside tips that have worked for you.
Thanks in advance!