Anaesthetics

Question 1

how do you anaesthetise the upper incisors?

Answer 1

buccal, +- palatal

Question 2

how do you anaesthetise the upper molars?

Answer 2

buccal and palatal

Question 3

how do you anaesthetise the lower canine?

Answer 3

mental +- lingual

Question 4

how do you anaesthetise the lower molars?

Answer 4

ID (inferior alveolar nerve block), long buccal, lingual

Question 5

why may anaesthesia not work?

Answer 5

hyperaemic pulp
infection
patient factors
inadequate anaesthesia

Question 6

what is hyperaemic pulp

Answer 6

large number of dilated congested blood vessels
- washes anaesthetic away

Question 7

why can infection not make anaesthetic work? specifically for acute pulpal inflammation

Answer 7

in acute pulpal inflam
- c fibres are hyperexitable
- anaesthetic may not be able to block the conduction

Question 8

What Patient factors may reduce the effect of anaesthetic?

Answer 8

• increased vascularity - remove solution rapidly
• individual response
• high pain threshold
• high anxiety levels

Question 9

what are the 3 superior alveolar blocks? what do they anaesthetise?

Answer 9

anterior - upper central, lateral and canine

middle - upper premolars

posterior - upper molars

Question 10

What are 3 alternative types of topical anaesthetic?

Answer 10

1. Lidocaine 4% Ointment Cream
2. Lidocaine 10% Spray
3. Oraqix 2.5%

Question 11

What is the most common topical anaesthetic? (numbing cream)

Answer 11

xylonor gel

Question 12

Who should not use xylonor gel and why?

Answer 12

athletes
- can cause positive test on doping test

Question 13

what are 3 possible complications of local anaesthetic administration?

Answer 13

• soft tissue trauma
• nerve trauma = electric sensation in lower jaw or tongue
• intravascular injection

Question 14

how do you anaesthetise the mucosa of the maxillary plate?

Answer 14

greater palatine block

Question 15

what can you anaesthetise with an infraorbital block?

Answer 15

maxillary incisors, canines, premolars and MB cups of first molar and palatal/buccal mucosa

Question 16

10 steps of anaesthetic administration

Answer 16

1. check medical history
2. explain procedure
3. gain consent
4. apply topical anaesthetic
5. set up safety plus syringe and cartridge
6. locate area of placement
7. administer slowly after aspirating
8. dispose of needle
9. record the procedure in notes

Question 17

what do you need to check for on the anaesthetic cartridge?

Answer 17

batch number
expiry date
if it is intact

Question 18

what do you put in your records after administration?

Answer 18

target area
type of anaesthetic
any complications
post-care instructions

Question 19

how can you improve patient comfort? (5)

Answer 19

• communication
• stretch tissues
• topical
• room temp cartridge
• slow injection

Question 20

what does a nasopalatine block anaesthetise?

Answer 20

maxillary mucosa surrounding incisive foramen from the canines medially