Exam II Lecture 9

Question 1

___ is a frequent reason why patients avoid medical and dental treatment

Answer 1

injection phobia (trypanophobia) or sharp object phobia (aichmophobia)

• 20% of the general population has some degree of fear of needles and injections
• 10% have true phobias
• can be learned or inherited
• past traumatic experiences

Question 2

what are the advantages of injectable anesthetics?

Answer 2

• good working time
• predictable response
• very cost effective
• readily available
• easily delivered
• hemostatis - containing vasoconstrictors
• minimal side effects

Question 3

what are the disadvantages of injectable anesthetics?

Answer 3

• fear of the needle
• long lasting effects
• prolonged numbness of adjacent tissues such as lips, cheek, and tongue
• pharmacologic/sensitivity response
  
  • anesthetic agent, epinephrine, and/or preservative

Question 4

___ anesthesia is the gold standard for most dental procedures

Answer 4

block injection (with or without topical anesthetic)

Question 5

what periodontal procedures is anesthesia needed to control pain and discomfort?

Answer 5

• periodontal probing (initial and re-evaluation examination) - frequently needed
• periodontal maintenance - frequently needed
• subgingival scaling and root planing - usually needed
• periodontal surgical and implant procedures - always needed

Question 6

whta are the advantages of an A-MSA block (anterior and middle superior alveolar)?

Answer 6

• used alone can provide good anesthesia for cosmetic dentistry
  
  • anesthesia to 6 anterior teeth without effecting lips and facial tissues
• combined with facial and buccal block or infiltration injections require (usually) only one palatal injection

Question 7

what are the disadvantages of an A-MSA block?

Answer 7

• can be difficult to administer sufficient volume using mechanical syringe without sufficient hand strength and good technique
• when injection is done too quickly can result in adverse reactions of palatal soft tissue (e.g. tissue necrosis)

Question 8

what is the approximate duration of an A-MSA block injection?

Answer 8

60-90 minutes

Question 9

what are the dose approximations for an A-MSA block injection?

Answer 9

• 2% drugs: 0.75-1 cartridge
• 4% drugs: 0.5 cartridge
  
  • rx: articaine 1:200,000

Question 10

the A-MSA block injection involves a ___ approach

Answer 10

palatal

Question 11

what are the landmarks for an A-MSA block injection?

Answer 11

• midway between free gingival margin and mid-palatine suture
• bisects premolars

Question 12

studies have shown that topical anesthesia does not necessarily compromise ___ and may offer similar pain management as ___

Answer 12

• treatment
• injectable anesthesia

Question 13

what are the disadvantages of topical anesthesia?

Answer 13

• cost
• additional inventory management
• short lasting requiring frequent reapplication
• may effect areas of mouth not directly applied to
• variable results
• profoundness of anesthesia highly variable
• does not easy to predict
• soft tissue irritation/sensitivity/low pH

Question 14

what are the best studied topical anesthetics used for periodontal therapy? what are the active ingredients?

Answer 14

• oraqix gel and ELMA cream
• active ingredients are eutectic mixture of 2.5% lidocaine and 2.5% prilocaine

Question 15

oraqix is a ___-free anesthetic gel that is ___ approved

Answer 15

• needle
• FDA

Question 16

what is the onset of oraqix?

Answer 16

30 seconds

Question 17

describe how oraqix works

Answer 17

eutectic mixture (2.5% lidocaine:2.5% prilocaine) that dispenses as a liquid and then sets as a gel in the periodontal pocket

Question 18

what is an acceptable retraction technique?

Answer 18

gauze and a retractor (like a minnesota)