Question: I have been looking into the possibility of using injectable fillers to smooth out my face. I have been reading about the procedure online, and I read that a “dental block” is often used during the injection session. What is a dental block, and why would it be used during a dermal filler injection?
Answer: A “dental block” is the injection of anesthetic in and around nerves that exit the facial skeleton and provide sensation to large areas of the face. The most common areas to inject are in the cheek, near the infraorbital nerve that supplies sensation to the upper lip and cheek. Injections below the lower lip can anesthetize the mental nerve that provides sensation to the chin and lower lip. This anesthetic block then allows the injection or treatment to that area in a pain-free way. The downside is that the injections to perform the block are often rather uncomfortable. The good news is that if you are going to undergo filler injections, I have found that there is simply no need for a dental block in the far majority of patients with the newer hyaluronic acid fillers that have lidocaine in them. What I personally do is provide some extremely cold spray to the skin that allows for a painless initial injection. This injection then starts to numb that area due to the fact that there is lidocaine in the filler material, and subsequent injections then are also pain free. I have treated many patients in very sensitive areas, such as their lips, in an essentially painless fashion with this newer injection technique. I can therefore avoid the dental block that, as I have said before, can be rather uncomfortable. The numbness in the area lasts for about an hour to an hour and a half, and by the time it wears off, there is really no discomfort, and only a small amount of redness and mild swelling remain. This is why I recommended that they ice the area for the first 30 to 60 minutes after the injection, as this will minimize any sort of a visible abnormality due to the injection.