Was I wrong? Needle question

New stick = new needle!

You shouldn't feel nervous.

This is something he should know. If he fusses, just tell him you'd hate to have him dealing with a nice little, say...abcess... that gets into the sinus/bone... and that pesky thing called the brain. Dentists sometimes like to hark back at how they used to never use gloves etc., etc., thing is they do have education in all of this, but since they don't deal with the medicine side of things, but for just the periphery, they can get this "that never happens" way of practice. It probably won't but then again that patient can end up in the ER, with everybody wondering how he got so sick.

I agree with 2ndwind.

The normal bacterial flora of the skin is likely to be very different than the normal bacterial flora of the mouth. I would imagine that the bacteria from the skin that contaminates the needle could cause a serious infection when introduced into the deep tissues of the mouth.

His practice is unsound and unsafe. If he argues, perhaps he would agree to have the Department of Health Infectious Disease Specialist settle the argument.

I agree with the alternate flora concept. That was actually my first thought and the main basis for my speaking up. Yes, it's the same patient. But a totally different part of the body and a new stick!

I just have this really bad situation with us being married and all...

He is very well versed with the sedation protocol and safety, etc., but IV's are a bit newer to him (used to do just oral sedation). I'm hoping we can talk about this civilly in the next few days while the office is closed for holiday.

As an infusion nurse, i can tell you this is a really bad idea. The needle isn't even sharp after using it once, therefor doing more damage to the lumen of the vein. All IV needles are designed for one "poke" and designed to pierce the epidermis/dermis. not the fragile oral mucosa. Osteomyelitis, bacteremia and sepsis can result from what you have described. Not to mention lawsuits and the risk of losing ability to practice (for all involved). it's worth the extra money in the short-run to avoid millions of dollars and infections in the long run. Ask him to take this all into advisement, stat!

Maybe I didn't clarify myself on one point--he is NOT using an IV needle in the mouth! I am referring to the syringe needle (28 or 30 gauge) for the local anesthetic.

But a needle nonethless...

It's wrong, very wrong. Draw up one syringe with a small amount of lidocaine for the IV start and a seprate syringe with the amount of lidocaine anticipated to be used to deaden the area to be worked on.

It's not only wrong, it's dangerous, lazy and cheap. Husband or no, make him stop, it will be cheaper than paying legal fees.

Maybe I didn't clarify myself on one point--he is NOT using an IV needle in the mouth! I am referring to the syringe needle (28 or 30 gauge) for the local anesthetic.

But a needle nonethless...

Doesnt matter, I wouldnt use the same needle to for lidocaine to prep for needle cannulation in dialysis then use it on the same pt for the second needle prep. One stick then toss and get a new one. If I was his pt I would be running the other direction!!! I agree with previous posters in regards to setting up a pt for abscess, mrsa, etc this way. EEEKK is all I can say, by the way I was responsible for infection control standards in my unit and this would horrify me.

I agree. On a related note, IIRC, our policy on regitine use after dopamine infiltration calls for a new needle for each individual SQ injection - and those injections are all going into the same site!

Good luck convincing the hubby.

:paw:

Needles should never ever be reused. i dont care where it was.

just dont do it.

mouth is very very dirty place meaning that needle is very very contaminated.

I thought I've seen multiple dentists using the same needle for multiple injections in my mouth. I'm just saying maybe dental standards are different. I can conceive that a dentist would be comfortable taking a sterile needle, sticking it under the skin, then taking this unclean needle and injecting a super dirty area that is the mouth. They do not use a sterile needle for each poke into your gum and they are pulling out from a filthy area and re-injecting over and over and over (I've had way too much dental work).

Having said that I have a nasty ulcers every time I've ever had local in my mouth and there's no doubt why. But maybe the standards for injections into the mouth are different. If you are going to inject my gums multiple times with the same needle, it's going to be much much cleaner if it just came out of my intradermal space than from anywhere in my mouth. If I were an RN working in a dental office I would need to become familiar with the standards for injections for local dental anesthesia. Having said that, though I believe the practice described in the OP is not harmful, I doubt any dental organization would approve and would probably insist on separate needles for each part of the body.

Dental anesthesia injections are in no way sterile. I believe the only reason they sterilize them is to prevent transmission of disease from the previous patient.

By the way, all my knowledge of dental anesthesia comes from personal experience having it. All but 2 of my non-incisor teeth have crowns and at least half of those were root canals.