Jet Injector Applications:
A 12 Year Report on the Use of Jet Injection Technique in Dental Practice
History
In 1960 I had the opportunity to use and observe a jet injection instrument manufactured in
Great Britain. My experience with this instrument illustrated quite clearly that such an instrument
did have merit; however the extensive amount of repairs and downtime finally discouraged its
use. We again started to use jet injection with the announcement of an American-made Jet
Injector in 1969. Our results have been most encouraging and I have often remarked, “I don’t
see how any dentist could practice without this instrument”. It is true that on occasion we require
minor service on the instrument but, in most cases, our office staff has been able to clear the jet
washer when it became occluded and, as long as we follow the simple general cleaning and
maintenance procedures in our office, we have experienced very few problems.
My general practice is fairly substantial, mostly dealing with reconstruction techniques and some
surgical procedures. Although my practice has varied over the past 26 years, I still have
approximately a 25% pedodontic practice.
We are strong proponents of the Jet Injector as a pre-injection procedure. We have four (4)
operatories and keep a Jet Injector in each operatory area. Interestingly we had the
manufacturer of the Jet Injector prepare one instrument with approximately two times the normal
dental pressure and found this most satisfactory for use strictly in the mandibular region for preinjection prior to deep needle insertion for mandibular blocks. Our technique is to use the other
Jet Injectors for pre-maxillary or other mandibular anesthetic injections. These Jet Injectors
provide relatively pain free injections after their use.
Technique
The following is a description of use with the special mandibular Jet Injector for pre-injection prior
to mandibular blocks. After considerable efforts and testing we had the manufacturer provide
several Jet Injectors with various increasing levels of pressure and subsequent depths of
penetration. The final instrument was 6.5 ounces per foot pound pressure and our technique with
this instrument is:
1. Palpate with left hand the occlusal table of where the third molar should be and place
finger alongside the occlusal table.
2. Bisect left finger and place the Jet Injector so that the distance cone is perpendicular to
that site.
3. Hold instrument firmly against the oral mucosal tissue and inject.
The problem we ran into initially with the Jet Injector was an occasional slight edema of the tissue
adjacent to the site of the injection; however, this edema resolved itself in one or two days.
Occasionally we experienced some capillary oozing which we also experienced with the needle
and syringe. Since the slight popping sound was a new experience to some of my patients, we
frequently discharge the instrument into the air[from a minimum distance of two feet from the
patient], to familiarize the patient with the sound. This procedure is often employed most
successfully in those patients who appear overly apprehensive.
Applications
The following is a list of some of the clinical uses employed with the Jet Injector:
A.
B.
C.
D.
E.
F.
G.
Extraction of deciduous teeth
Curettage and scaling
Minor gingivectomies
Exposed pulp anesthesia
Removal of residual spicules
Pre-injection anesthesia in maxillary and mandibular areas
Pre-injection in palatal area
We fully realize that as with any piece of equipment, the dentist must develop his own technique.
This was especially true when we first started to use the Jet Injector and we use it now almost
automatically. We find that by following the instructions as recommended by the manufacturer,
such as keeping the Jet Injector in a vertical position, nose down when cocking it, placing the
distance cone gently but firmly on the tissue, injection towards bony underlying structure and
following the simple cleaning and maintenance procedures, we have experienced very few
problems. Of course, the normal pre-injection tissue prepping is always observed as well as
holding the Jet Injector steady while injecting.
Most patients are completely unaware that they have been anesthetized by the Jet Injector and
almost every patient is amazed that when deep needle insertion takes place they literally feel
nothing. We use 2% Lidocaine with or without epinephrine, depending on the clinical history pf
the patient. Concentrations of less than 2% Lidocaine will not provide adequate levels of
anesthesia.
Additional Techniques
We employ the Jet Injector in root canal procedures and do this by removing the distance cone
(plastic tip) position the tip of the nozzle over the canal and firing anesthesia directly into the
canal. We have found that anesthesia provided by the Jet Injector is most sufficient in the
removal of deciduous roots and loose teeth. The technique employed is to inject at the interapical areas from the lingual and buccal aspects.
Special Injection Technique with The Jet Injector
Perhaps one of the most important advantages of this instrument is its ability to produce good
anesthesia in the palate. By injecting on either side and adjacent to the papillae at the
nasopalatine foramen, unusually good anesthesia can be obtained. Since this can be done in
almost all cases without pain, the technique deserves the interest of every dentist who has to
infiltrate this tissue with a needle and syringe.
Special Notes on My Pedo Practice
I have few if any problems with children using the Jet Injector. It is accepted readily. We explain
to the child that we are going to spray his tissues and demonstrate this by showing the spray
when the instrument is fired into the air.
Conclusion
1. As with other equipment the operator should first become familiar with the written
instructions and technically written information provided by the company.
2. The care of this instrument is very simple but necessary to minimize downtime.
3. Our experience over these past 12 years has clearly indicated the value of the Jet Injector
we believe our success with it directly relates to the patience and techniques we developed
early in its use.
4. The results with our patients, especially those who are overly apprehensive, have been
very worthwhile and clearly justifies the several instruments used in our practice every day.
5. The special Mandibular Jet Injector is an excellent tool and even though the company does
not provide such a product routinely, we believe that there is a definite need for it.
William Frost, DDS
Rutherford, New Jersey
October 1, 1980
© AMI, Inc. and Mada Medical, Inc.