X-Tip FAQ’s (Frequently Asked Questions)

Q: What is the best way to become proficient with the X-tip intraosseous anesthesia system?
A: The most difficult aspect of learning to use the X-tip is drilling a hole in the bone the very first time. It is normal to be apprehensive at first, but after one or two successful uses, you will begin to look forward to predictable, instant and profound anesthesia.It is very important to use a gentle "pecking" motion while running the slow-speed handpiece to efficiently penetrate the cortical plate of bone.

Q: Will patients experience rapid heart rate from X-tip injections?
A: Use the X-tip system as recommended. Slowly and gently inject 1/3 to ½ cartridge of anesthetic through the guide sleeve and into cancellous bone. Rapid injection may cause discomfort to the patient. Practice will determine the optimal rate of injection. The recommended concentration of epinephrine is 1:100,000 or less. When using vasoconstrictor anesthetics, inform patients that they may have a temporary rapid heartbeat, which is normal and will quickly pass. A plain solution of local anesthetic can be used to avoid any heart rate effects or in patients who have contraindications to the use of a vasoconstrictor.

Q: Can I leave the X-tip in place during long procedures?
A: It is perfectly acceptable to leave the X-Tip in place until completing treatment. Be sure to remember to remove it prior to dismissing the patient. You may find it easiest to insert the X-tip prior to placing the rubber dam. Lifting the edge of the dental dam allows for access to the X-Tip guide sleeve should re-injecting be necessary.

Q: What post-op instructions should I give the patient?
A: No special post-op instructions are necessary. The majority of patients will have little or no postoperative pain.  In such cases, the patient will usually experience immediate discomfort, and a new perforation site should immediately be selected. The other source of post-op pain is overheating the bone during perforation. In rare cases (less than 5%) the patient may experience a localized swelling with or without infection. These situations usually heal uneventfully but in some cases may require antibiotic therapy.

Q: How can I be sure I won't perforate the root?
A: Always take a pre-op radiograph to make certain there is adequate room between the roots. If the roots have been closed together orthodontically, for example, you may have to inject one or two teeth mesial or distal to the tooth you will be treating.

Q: How do I remove the guide sleeve from the bone and dispose of the used X-tips?
A: The guide sleeve is easily removed by gripping it with a hemostat or needle holder. The guide sleeve, drill and 27-gauge needle are then placed in a standard sharps container for safe disposal.

More X-Tip FAQ’s