This dental care case involves a patient who was in the process of undergoing an inferior alveolar block when the needle used for local anesthesia broke off in the patient’s mouth. The needle is two-inches long and has been stuck in place for close to a month now. Numerous oral surgeons have attempted to remove the needle without any success.
I perform inferior alveolar blocks on half of my restorative patients. I also teach the procedure to dental students. It is rare for the needle to break. The needle usually breaks at the hub. If the needle breaks and the fragment is protruding from the tissue, it should quickly be grasped and removed with a curved hemostat. If the needle was inserted up to the hub and no portion of the broken needle is visible above the surface of the tissues, no attempt should be made by the operator to retrieve it. Any attempts may drive the needle deeper. Surgical removal under general anesthesia is recommended. To locate the fragment, imaging modalities such as multi-plane X-rays or fluoroscopy with two reference needles in place or three-dimensional CT scanning are typically necessary.
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