Prevalence and risk factors of failed mandibular anesthesia following simple tooth extraction: an epidemiological study
Background: Though mandibular nerve block is frequently used in dentistry; it can fail even in the hands of experienced surgeons and this can cause distress for patients. While the prevalence of failed mandibular nerve block is known in Caucasians and Asians, there appears to be no study to determine the prevalence in Africans.
Objective: To determine the prevalence and risk factors of failed mandibular nerve blocks among dental patients that had simple tooth extraction at a teaching hospital in Nigeria.
Methodology: In this retrospective study, the case notes of all the patients that presented for teeth extraction from July 2010 to August 2020 were retrieved. Collected data were age, gender, religion, place of residence, level of education, marital status, occupation, operator experience, side of operation, teeth removed, failed mandibular anesthesia and type of alternative method. Chi-square test and binary logistic regression was used for data analysis. A P-Value less than 0.05 was considered statistically significant.
Result: One hundred and seven patients were studied with age range of 19-63 years. The mean age and standard deviation were 47.2 ± 4.78 years respectively. There were more females than males with a sex ratio of 1:1.5(M: F).The prevalence of mandibular nerve block failure was 39.3% in both gender. The age (P=0.00) and operator experience (P=0.03) was significantly associated with the prevalence of mandibular nerve block failure. In the multivariate analysis, both age (P = 0.02) and operator experience (P = 0.00) had significant predictive power on the rate of prevalence of mandibular nerve block failure.
Conclusion: Prevalence of mandibular nerve block failure of 39.3% was recorded. The risk factors for the prevalence were age of patients and operator experience. There is a global variation of prevalence of mandibular nerve block failure with higher prevalence among the Africans.