Sometimes when we give a nerve block for an extraction , tooth doesn't anesthetize , why?

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Multifactorial.. 1) site of injection is not exact 2) presence of chronic infection.. pus will affect effeciency of LA. 3) absence or low vasoconstrictior that will allow easier absorption of LA resulting in low LA available at that site for the procedures. 4) Dosage of LA.
Following reasons: Anatomical location /depth of injection is not reached. Low dose of L.a injected Varied results of l.a noticed in chronic smokers and tobacco chewers. Delayed action of l.a in case of abscess(20 mins.)
There could be many reasons.Firstly,if we are not injecting at a right place and with right dose.The other probably could be because of infection ,the area gets acidified and reduces the efficiency of local anaesthesia.
Can be due to various reasons:- •Infection at extraction site,take antibiotic •Patient has consumed alcohol or is chronic alcoholic •
Bcs of varied Anatomy...and lack of knowledge of the same on the part of clinician...for example if you supplement a IANB with mylohyoid block better success rate will be achieved.... clinically tested and works for me.
Nice Doctor

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