In doing a PDL injection, everything feels and looks right. No anesthetic is
leaking into the patient’s mouth. However, there is no blanching, and when I
remove the needle from the patient’s tissue a lot of anesthetic flows into the
patient’s mouth. How can I correct this?

What is happening is improper technique. If the bevel is facing against the
bone, it is likely that the needle will become obstructed by the bone, preventing
the blanching from occurring and preventing the anesthetic from flowing
out. When you remove the needle, the pressure inside the tubing will force tl”e
anesthetic into the patient’s mouth.

This can be corrected by keeping the bevel of the needle facing the tooth, and
advancing the needle with the bevel in contact with the tooth until resistance
is met. This will prevent the needle from becoming obstructed with bone.

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