Dental Flashcards

1
Q

How is an inferior alveolar nerve block performed?

A

Indication: Unilateral mandibular teeth procedures (covers all teeth unilaterally)

Technique
- 25g needle, lignocaine +/- adrenaline
- Apply topical xylocaine viscous prior to injecting
- Retract cheek and palpate coronoid notch with thumb
- Approach at an angle from the contralateral incisor
- Insert needle 1-2cm deep just posterior to thumb (coronoid notch)
- 1-3mls anaesthetic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How is a supraperiosteal block performed?

A

Indication: Any singular tooth causing pain or needing a procedure

Technique
- 1% lignocaine with small needle
- Inject at the mucobuccal fold around the apex of the affected tooth
- Numbs the tooth itself +/- teeth either side and the lip

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How is an inferior orbital nerve block performed?

A

Indication: Unilateral Maxillary anterior teeth procedures (goes back as far as the 1st molar)
Also for lip and lower face procedures (ie vermillion border crossing laceration repair)

Technique
- 25g needle, lignocaine +/- adrenaline
- Apply topical xylocaine viscous prior to injecting
- Infraorbital foramen located (can be palpated) in line with the pupil at the infraorbital rim
- Insert needle through the mucosa of the 2nd premolar (5th tooth) aiming superiorly at the notch
- Aim approx 2cm and inject 2-3mls of anaesthetic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How is the traditional TMJ relocation technique performed?

A

Traditional
- May require relaxation/sedation
- Patient lying with head up or seated with head supported posteriorly
- Physician stands in front with elbows flexed, mandible held with thumbs intraorally lateral to lower molars
- Pull down and push backward, should feel immediate

Modified Traditional
- Stand behind the patient instead
- Same maneuvres

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How is the TMJ relocation syringe method performed?

A
  • Place 10ml syringe between the posterior upper and lower teeth on one side
  • Patient bites down while syringe is rolled back and forth
  • Typically the opposite reduces
  • Then move syringe to other side and do it again
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How is Calcium hydroxide paste applied to fractured teeth?

A

Indication: Ellis type 2/3 fractures

Technique
- Ideally perform a sub-periosteal or other dental block to numb the teeth
- Mix the catalyst and the base on a mixing pad in equal amounts using a dental spatula or cotton applicator
- Dry the tooth using 02 via nasal cannula, open mouth breathing or biting on gauze
- Apply the paste to the expose area, keep mouth open to dry over a few minutes
- Soft diet, see dentist in 24-36hrs

** If unlikely to get to a dentist within 36hrs then apply dental foil over the top to protect the CaOH seal**

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How is dental splint paste (ie COE-PAK etc) applied to luxated teeth?

A

Indications: subluxed teeth, avulsed teeth that have been re-implanted, complex gingival lacerations with not otherwise controlled bleeding

Technique
- Consider dental block for analgesia
- Mix equal parts catalyst and base on mixing pad with spatula/cotton applicator
- Wear gloves, apply lubricating jelly to fingers to prevent paste sticking to fingers
- Dry the teeth/gingiva, apply paste to affected teeth and to at least one tooth either side (if applicable)
- Ensure paste covers both front and back of the teeth for maximum stability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How are avulsed teeth re-inserted?

A

Indication: Intact teeth avulsion

Contraindications: Fracture tooth/socket, any significant maxillofacial/head trauma, altered conscious state

Considerations
- Handle the tooth by the crown, touching the tooth can damage the peridontal ligament cells
- Gently rinse the tooth to remove debris
- If delay to re-implantation then place in transport medium ASAP, milk will keep the tooth for 4-8hrs, dedicated mediums (ie Save-A-Tooth) 12-24hrs

Technique
- Gently suction the socket to remove any debris or clot, gently irritgate post
- Re-insert the tooth with slow, gentle pressure
- patient to bite down gently on gauze to help realign the tooth
- Splint the tooth
- ADT, liquid diet, urgent dental/Max Facs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly