A child with Duchenne muscular dystrophy and mucopolysaccharidosis needs caries removal. Which anesthesia technique is most appropriate?

Correct answer: B. PDL (periodontal ligament) infiltration

• A. ❌ Mental nerve block covers only the anterior mandible — insufficient for posterior caries.
• B. ✅ Correct. PDL (intraligamentary) infiltration delivers anesthetic directly to the periodontal ligament with minimal systemic absorption. Ideal for medically complex children — avoids systemic loading, works without patient cooperation, and can be administered quickly.
• C. ❌ IAN block requires patient cooperation, has systemic drug considerations, and may be technically challenging in a DMD patient.
• D. ❌ Nitrous oxide requires nasal breathing and cooperation — compromised in mucopolysaccharidosis (airway involvement).