top of page


Updated: Sep 12, 2022

Hit Your Best Shot With These 5 Simple Strategies.

So many times, I hear clinicians say, “Tina, I wish I could be as confident as you, when giving injections.” If you’re reading this and find that you hold your breath and pray it all goes well, welcome. You are in the right place. Over the years I have coached countless dental hygiene students and clinicians on the techniques of local anesthesia and found these five items helped them overcome their anxiety and gain the confidence to hit their best shot.


Yep, you get to dig up the valuable information from the first part of school. All that anatomical education is something we apply to our skills, not just the hurdle of a class we had to jump to graduate. This is more than understanding the names of the nerves and what tissues they innervate, which is SUPER important. It's vital to review the nerve flow so you can identify if you are injecting in the correct region. Also understanding the boney features of the skull and how these create roadblocks for our needle helps guide your syringe. Not to mention the ability to identify surface anatomy to use them as landmarks and guideposts. All of this makes the syringe slingin' life so much easier. While this isn’t always an easy topic to learn or even the most glamourous, it will help you gain confidence in knowing where your needle is going.


This is more than just asking if there are any changes to your patient’s health history. That is not enough. Understanding your patient’s health history is more than assessing if their medications are giving them xerostomia or if they need premedication for that heart valve replacement. It will help you understand which anesthetic you can give them and how much. Because HELLOOOO…. this is for their safety! There are certain medications which don’t play nice with the anesthetic solution. Plus, different health conditions can impact anesthetic selection and dosage. You don’t want to give someone with Cirrhosis of the Liver a bunch of lidocaine because they can't metabolize it effectively. Or a patient with a history of severe cardiac issues anesthetic with higher concentrations of vasoconstrictors.

Speaking of cardiac issues. Make sure you evaluate your patients blood pressure. Did you know that an elevated B.P. can impact your patients ASA status? As a reminder the ASA status helps us determine the risk of a medical emergency and the patient’s capability to tolerate anesthesia.


How often do you give the Vazirani-Akinosi injection? My guess is not very often, but wouldn’t it be nice to have the confidence to give it when the occasion calls for it? Or if you have been struggling with getting a painless GP injection, reviewing the process can really help you out. So, take some time and review them. As a reminder, you can snag up your free placement guide here. Just click the link at the end of this blog.

Speaking of painless, don’t forget to place that topical and really retract the oral tissues so you can see where you are going. This will create a perfect environment for the needle to penetrate the tissue.


Of course, you must understand needle safety too. There is a safe process of uncapping and recapping your needle. Poking yourself with a needle is not fun. Besides, who really wants more paperwork to do. Those incident forms are full of details. Along with needle safety, creating great stabilization points for yourself helps. Whether your arm is snug by your side or you have a finger/thumb resting on the barrel of the syringe, this can help keep you shooting straight and steady. Doing that and breathing too! Don’t forget to breathe. Sometimes I even say it out loud. Usually, the patient thinks it’s for their benefit but sometimes it’s for mine too!


Last but certainly not least is practice. Yes friends, you just have to start doing them. Trust me you wont always be perfect. You’ll have moments when you weren’t on target, or the patient’s tongue was so big you couldn’t see any landmarks, but those are the best learning times. You can learn just as much sometimes even more when those challenging situations arise. You need to allow yourself to overcome your own uncertainty and just go for it. As I tell my students, trust the process.

But let's take this practice one step further. Incorporate your practice sessions with someone you trust. Perhaps it's a coworker, who is great at injections, but can also be the encouraging voice over your shoulder while you give a few injections. Take a hands-on course or bring in a coach to conduct a hands-on review for you and your entire office. Not only will you have detailed and personalized review, it can be a great bonding moment for the entire clinical office.

All five of these steps can truly make an impact on your skill set. I know it has helped me in my career and thousands of other clinicians. It takes time and it won’t happen overnight but, I know when you embrace these you will confidently Hit Your Best Shot!



If you are ready to begin your journey to confidently Hit Your Best Shot head to and sign up for the on demand anesthesia CE course.

Recent Posts

See All


bottom of page