Anesthetics Clinical Correlations Flashcards
what can influence the patients reaction to anesthetics?
Anxiety Sleeplessness Traumatic dental history Severe inflammation
Explain the topical anesthetic Benzocaine
- 18-20% concentration
- rapid onset (15-20 sec)
- duration (10-15 min)
- relatively inexpensive
Explain the topical anesthetic Cetacaine
- rapid onset (15-20 sec)
- duration (60 min)
- liquid or spray
- more costly
Explain the topical anesthetic Oraquix (dentsply)
- less rapid onset (30 sec)
- duration (20 min)
- topical for scaling and root planning
- gels at body temperature
Injectable anesthetics
LIDOCAINE (Xylocaine)
SEPTOCAINE (Articaine, Carticaine)
MEPIVOCAINE (Polocaine, Carbocaine)
MARCAINE (Bupivacaine)
types and duration of LIDOCAINE (Xylocaine)
2% LIDOCAINE, 1:100,000 EPINEPHRINE
2% LIDOCAINE, 1: 50,000 EPINEPHRINE
duration: 55-90 min
types and duration of SEPTOCAINE (Articaine, Carticaine)
4%SEPTOCAINE, 1:100,000 EPINEPHRINE
4%SEPTOCAINE, 1:200,000 EPINEPHRINE
duration: 60-120 min
types and duration of MEPIVOCAINE (Polocaine, Carbocaine)
3% MEPIVOCAINE, (no epi)
2% MEPIVOCAINE, 1:20,000 LEVONORDEFRIN
duration: 20-45 min
types and duration of MARCAINE (Bupivacaine)
.5% MARCAINE, 1:200,000 EPINEPHRINE
duration: 90-120 min
what are the max number of carpules you can give per injectable anesthetic?
2% LIDOCAINE, 1:100,000 EPINEPHRINE: 13
.5% MARCAINE, 1:200,000 EPINEPHRINE: 10
4%SEPTOCAINE: 7
3% MEPIVOCAINE: 7
2% LIDOCAINE, 1: 50,000 EPINEPHRINE: 7
what are the types of nerve blocks?
- Inferior Alveolar Nerve Block (Mandibular Block)
- Gow-Gates Block
- Incisive Block (Mental Nerve Block)
- Posterior Superior Nerve Block
- Nasopalatine Nerve Block
- Greater Palatine Nerve Block
nasopalatine nerve block
- inject at incisive foramen
- six maxillary anterior teeth anesthetized
greater palatine nerve block
- inject greater palatine foramen (distal to second maxillary molar)
- palatal of posterior maxillary teeth anesthetized
posterior superior nerve block
- inject above and distal to apex of maxillary second molar
- maxillary molars except mesiobuccal of 1st molar anesthetized
incisive block (mental nerve block)
- inject the mental foramen
- mandibular premolars and anterior teeth anesthetized
- could cause hematoma
inferior alveolar nerve block
- inject into the mandibular foramen (ptergomandibular space)
- the entire mandible on side of inject except some buccal gingiva of molars are anesthetized
- 75-90% success in normal teeth
- 14-57% success in irreversible pulpitis
Gow Gates Block
- inject at the neck of the condyle
- entire mandibular arch anesthetized
intrapapillary injection
- used for short duration of anesthesia (15-20min)
- used in peds for primary teeth
intrapulpal injection
- painful, pressure gives anesthesia, use short needle, short duration
intraligamental injection
- Supplemental anesthesia
- Localized anesthesia
- small volumes of anesthesia from standard dental cartridges at high hydrostatic pressure
- Short needle
- bevel toward root surface at 30° angle
- Duration: 23 min
intraosseous injection
- Supplemental Injection
- Injection site distal to tooth to be anesthetized (except second molars)
- Drill hole through cortical plate
- Anesthesia into cancellous bone adjacent to tooth (usually mandibular posterior teeth)
- Faster onset but shorter duration ( 15-30 min) than infiltration injection
painless dental injection
- More comfort, less anxiety, increased patient satisfaction
- Flow rate and pressure of anesthesia controlled during injection
what is Hot Tooth?
Severely inflamed Vital tooth with spontaneous, moderate to severe pain and a low response to local anesthesia or even fail
what are the hypothesized reasons for local anesthesia failure in Hot Tooth?
- Accessory innervation
- Effect of inflammation on local tissue pH, blood flow, nociceptors and central sensitization
- Central core theory (molar teeth outer nerve bundle)
