The TNN Technique

TNN Tools

There is no need for a special handpiece, perforators, port or sleeves. All you need to practice TuttleNumbNow (TNN) is the presently preferred materials, which include:
  • A standard dental syringe
  • A recommended 30 gauge needle designed to penetrate bone
  • Articaine 4% 1:100K epi. [Septocaine]
  • TNN Needle guide
  • Proper TNN Steps

Why These Tools?

  • A conventional needle on the left, double bevel scalpel tip on the right, designed to penetrate bone.
  • This is essential to optimal TNN technique due to its unique scalpel design.
  • According to recent studies, it requires 29% less force to penetrate.
  • Upon purchase of the TNN technique, further information about the needle will be provided. The TNN needle guide is an invented hub extension which aids in the TNN technique. It facilitates the proper bending and control during the TNN injection. It is manufactured to custom fit the recommended needle. When you order the TNN technique, you will receive a sample of these guides within the starter kit. They're available for purchase to anyone who has been properly trained.

The Goals

  • To facilitate a predictable experience for the dentist and patient by an established local anesthesia protocol
  • Eliminating the most common frustration for the patient, "I can never get numb"
  • Eliminate the most common frustration for the dentist, "I can't get him numb"
  • Reduce the use of IA nerve block except for lengthy procedures
  • To never wait for anesthetic onset... "Set down the syringe and pick up the drill!"
  • Let us consider TNN as the primary modality of anesthesia over all other modalities
    • TNN is faster acting (immediate)
    • TNN involves intraosseous injection into bone
    • TNN is less painful on injection
    • TNN is less toxic (locally and systemically)
    • TNN has the fastest reversal times than any other modality
    • TNN is the least expensive by far

Simple Efficiency

  • Shorter appointments
  • Opens up the appointment book
  • Turns hygiene room into a treatment room
  • Fewer ops needed (I work out of 2)
  • Fewer patients waiting in the reception area
  • Fewer follow-up appointments
  • Same day treatment
  • Can work in all 4 quadrants in one appointment
  • Easier to stay on schedule

Instant Numbness

  • Effective on patients who could never get numb
  • Predictable and definitive start time
  • No buffering preparations
  • Good for those with limited opening
  • Better for handicapped or children
  • Rubber dam put on instantly /painlessly
  • “Set down the syringe and pick up the drill”

Less Risk

  • Eliminates all risks, difficulties, and side effects of IA nerve block
  • The average IAN lawsuit in the US is nearly $100,000
  • There can be anatomic variations, more than one nerve, mylohyoid, etc
  • No access problem if tongue and cheek are big
  • No electric shock zing when hitting the nerve
  • No gag reflex
  • Never a hematoma
  • Never injection trauma parenthesia
  • No risk to the joint capsule
  • No risk of IA causing blindness (remote)
  • No drilling into the bone with a port or perforator, less risk of root damage
  • No chance of biting the dentist or needle
  • Shorter appointments for oxygen dependent, diabetic, incontinent, pregnant
  • Safeguard during mandibular implant surgery, as the lip and tongue are not numb when drilling so you will know if you hit something you shouldn’t or if you are too deep instead of a second surgery to correct the mistake
  • Simultaneous sounding of bone during injection
  • Valuable and effective for stage 1 single tooth implant surgery
  • Patients with TMJ or limited opening don’t even have to open their mouth to get numb
  • The needle is always visible and never buried to the hub or bent at the hub
  • Better bite equilibrations and fewer adjustments with fillings
  • More accurate bite registrations and triple tray impressions
  • Minimizes the need for nitrous or sedation, which has negative effects such as:
    • Theft of tanks
    • Takes lots of chair time
    • Limited on who you can work on (kids or elderly)
    • Risk to assistants
    • Cost and clutter
    • Bulky to work around
    • Malpractice insurance costs
    • Abused (in two cases, doctor’s children died)
    • Less Medico-legal claims
    • Inability to perform optimum treatment because mid-course corrections or modifications to treatment cannot be made because they are unavailable to discuss new treatment options and give consent
    • They don’t get to see how hard you work

 

Eliminates Excess

  • Uses a standard syringe and single needle found in every dental office
  • Eliminates the need for Onset or sodium bicarbonate buffering, Stabident, X-Tip, Vibraject, The Wand, Electronic anesthesia, Ligajet, Oraverse, and many other novelties
  • Blanches pericoronal gingiva= less bleeding for better restorative in a dry, blood reduced field
  • Reduces and often eliminates the need for retraction cord, chemical, electric or laser cautery or troughing
  • Less post-op pain from the injection site
  • Greatly reduces the need for and use of sedation or nitrous
  • Uses 1/3 carpule or .5cc per site, as opposed to multiple carpules