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ADEX exam

ADEX Local Anesthesia OSCE – Techniques & Safety Steps

A focused guide on the injections, safety sequence, and common errors ADEX evaluates during the local anesthesia OSCE.

Quick Answers

What does the ADEX LA OSCE test?

Your understanding of injection steps, anatomical landmarks, safety checks, and complication prevention.

What are the most tested injections?

IAN block, long buccal, PSA, MSA (if present), infiltration, and mental nerve block.

What must you ALWAYS state?

Aspiration before deposition and slow delivery of anesthetic.

What common errors fail candidates?

Poor landmark identification, skipping aspiration, fast injection, and injecting in the wrong plane.

How long should you inject?

At least 1 minute for a full carpule to avoid tissue damage and complications.

1. What the ADEX LA station is assessing

The goal is not to test hand skills with a real patient but to evaluate whether you understand safe, predictable injection protocols. Clear steps, correct landmarks, and prevention of complications matter most.

2. The essential safety sequence

Every ADEX OSCE expects you to state these steps:

  • Review medical history and confirm no contraindications.
  • Check the anesthetic type, expiry date, and concentration.
  • Apply topical for at least one minute.
  • Stretch tissues appropriately for the injection.
  • Insert the needle slowly following anatomical landmarks.
  • Aspirate before depositing solution.
  • Inject slowly to minimize discomfort and complications.
  • Withdraw the needle gently and recap safely.
  • Monitor patient for delayed reactions.

3. High-yield injections ADEX loves to test

IAN block (most common)

Target the area just above the mandibular foramen. Approach from the contralateral premolar area and keep the barrel over the premolars. Aspiration is critical.

Long buccal

Inject into the mucosa distal and buccal to the last molar. A small volume is typically enough.

PSA block

Aim upward, inward, and backward behind the maxillary tuberosity. Avoid over-insertion to reduce hematoma risk.

Infiltration (simple and reliable)

Used frequently for maxillary teeth. Inject near the apex with the bevel toward the bone and deposit slowly.

Mental nerve block

Target the mental foramen area between the premolars. Avoid deep penetration.

4. Key exam expectations

  • Identify landmarks clearly.
  • Explain needle angulation and depth without confusion.
  • Always mention aspiration.
  • Inject slowly and safely.
  • Recognize contraindications such as recent heart event or allergy.
  • Know possible complications (hematoma, trismus, paresthesia).

5. Common exam traps

  • Skipping topical anesthesia or ignoring medical history.
  • Incorrect barrel positioning during IAN block.
  • Injecting too fast.
  • Failing to aspirate or not mentioning aspiration.
  • Mixing up PSA vs infiltration landmarks.

6. Fast memory points

  • Topical → stretch tissue → insert → aspirate → slow injection.
  • IAN: barrel over opposite premolars.
  • PSA: upward, inward, backward.
  • Infiltration: bevel toward bone.
  • Always consider medical contraindications.

How DentAIstudy helps

Use Study Builder to generate:

  • Local anesthesia OSCE scenarios.
  • Step-by-step injection descriptions.
  • Checklists for safety sequences.
  • Flashcards for indications, complications, and landmarks.

Try Study Builder →

References

  • CDCA-WREB-CITA Local Anesthesia OSCE expectations.
  • Standard dental anesthesia techniques and safety guidelines.
  • Common clinical protocols for IAN, PSA, and infiltration injections.