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BDS2 LA Symposium > LA Overview > Flashcards

LA Overview Flashcards

1
Q

why do dentists need to use Local Anaesthetic?

A

in order to be able to undertake a range of dental procedures pain free

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2
Q

what are common adverse effects of local anaesthetics?

A
  • systemic toxicity
  • allergy
  • trismus
  • ocular complications
  • non-surgical paraesthesia
  • interactions
  • methemoglobinemia
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3
Q

what is trismus?

A

uncontrolled inability to open mouth or jaw

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4
Q

what is the simple definition of pain?

A

an unpleasant sensory and emotional experience associated with, or resembling that associated with actual or potential tissue damage

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5
Q

what are the six additional definitions of pain?

A
  • pain is a personal experience
  • pain and nociception are different phenomena
  • individuals learn the concept of pain throughout life
  • a persons report of pain should be respected
  • pain may have adverse effects on function and social and psychological well-being
  • there are several behaviours used to express pain
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6
Q

what are the divisions of the TYPES of local anaesthetic solutions?

A
  • ester

- amides

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7
Q

what is the more commonly used TYPE of local anaesthetic used?

A
  • amides

- safer in relation to allergy

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8
Q

what is interesting about articaines structure?

A

it has an ester ring on its surface (however not a true ester)

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9
Q

what is an example of an amide local anaesthetic?

A

lignocaine

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10
Q

in addition to the local anaesthetic itself, what else is usually found in the solution and why?

A
  • a vasoconstrictor!
  • local anaesthetics are vasodilators, without a vasoconstrictor the LA is washed away very quickly and working time is short
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11
Q

what are common vasoconstrictors typically used in local anaesthetics?

A
  • adrenaline

- felypressin

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12
Q

who can you NOT give Felypressin to?

A
  • pregnant people!

- induces labour

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13
Q

what three things make up a local anaesthetic solution?

A
  • local anaesthetic
  • vasoconstrictor
  • preservatives
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14
Q

when LA allergic reactions are seen, what is usually the primary cause of this?

A

the PRESERVATIVES! true LA allergy is very rare

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15
Q

what are examples of preservatives used in LA solutions?

A
  • bisulphite

- propylparaben

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16
Q

what are the 2 types of local anaesthetic techniques used?

A
  • infiltration techniques

- block techniques

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17
Q

explain where, in relation to the nerve, the local anaesthetic is deposited when using the infiltration technique?

A
  • LA deposited around terminal branches of nerves
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18
Q

explain where, in relation to nerves, the LA is deposited when using the block technique?

A
  • LA deposited beside the nerve trunk
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19
Q

what is the LA infiltration technique used for?

A
  • used to anaesthetise soft tissues

- used to produce pulpal anaesthesia where alveolar bone is thin

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20
Q

where is the infiltration technique commonly used?

A
  • maxilla

- lower anteriors

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21
Q

when is the block technique used?

A
  • used where bone is too thick to allow infiltration
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22
Q

what is the block technique used for?

A
  • used to produce soft tissue anaesthesia

- abolished sensation distal to site administered

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23
Q

where is the block technique commonly used in the mouth?

A
  • the mandible
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24
Q

if you were restoring a tooth, what tissues would you want to anaesthetise?

A
  • dental pulp

- soft tissues (matrix band/rubber dam placement)

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25
Q

if you were extracting or performing a surgical procedure on a tooth/teeth, what tissues would you want to anaesthetise?

A
  • dental pulp
  • gingiva
  • surrounding soft tissues
26
Q

if you were scaling teeth, what tissues might you want to anaesthetise?

A
  • gingivae

- perhaps pulp

27
Q

if you want to achieve anaesthesia of the dental pulp on the maxillary arch, where do you inject LA?

A
  • buccal infiltration (adjacent to tooth you want anaesthetised)
28
Q

if you were wishing to achieve anaesthesia of the buccal gingivae of the maxillary arch, where would you inject LA?

A
  • buccal infiltration
29
Q

if you were wishing to achieve anaesthesia of the palatal gingivae of the maxillary arch, where would you inject LA?

A
  • palatal injection
30
Q

anaesthesia of the DENTAL PULP of the mandibular molars and second premolar?

A

inferior alveolar nerve block

31
Q

anaesthesia of the DENTAL PULP of the mandibular premolars and canine?

A
  • mental nerve block
32
Q

anaesthesia of the DENTAL PULP of the mandibular canine and incisors?

A
  • buccal/labial infiltration
33
Q

anaesthesia of the BUCCAL GINGIVAE of the mandibular molars and second premolar?

A

(long) buccal infiltration

34
Q

anaesthesia of the BUCCAL GINGIVAE of the mandibular first premolar and canine?

A
  • buccal infiltration
  • mental nerve block
  • long buccal infiltration
35
Q

anaesthesia of the BUCCAL GINGIVAE of the mandibular incisors and canine?

A

buccal/labial infiltration

36
Q

anaesthesia of the LINGUAL GINGIVAE of the mandibular arch?

A
  • lingual nerve block

- lingual infiltration

37
Q

what are some examples of different types of LA syringes?

A
  • SAFETY SYRINGE
  • metallic (self-aspirating) syringe
  • metallic (aspirating) syringe
  • pressure syringe
  • jet injector
  • disposable syringe
38
Q

what are the different areas of the safety syringe needle called?

A
  • bevel
  • shaft
  • hub
  • cartridge and penetration end
39
Q

what is interesting about the hub?

A
  • most fragile part of the needle
  • never insert the needle this far
  • IT CAN SNAP
40
Q

what is the bevel of the needle?

A
  • the point or tip of the needle
41
Q

what occurs with an increased bevel angle to the long axis of the needle?

A

increased deflection ( = less accurate)

42
Q

what is the gauge of a needle?

A
  • diameter of the lumen of the needle
43
Q

what does a lower gauge number result in?

A

a larger diameter of needle lumen

  • > gauge needles = increased accuracy
  • > gauge reduces risk of breakage
  • > gauge = easier aspiration
44
Q

what are the types of syringe barrels?

A
  • short

- long

45
Q

what length is the short syringe barrel?

A

25mm

46
Q

what length is the long syringe barrel?

A

35mm

47
Q

why is it important to stretch the mucosa before giving LA?

A
  • easier to penetrate & see

- prevents ‘tearing’

48
Q

why is it important to aspirate before injecting the LA?

A

to ensure you are not injecting a blood vessel

49
Q

what would you do if blood entered the cartridge upon aspiration?

A
  • remove the needle from the mucosa

- change to a new cartridge

50
Q

with infiltration anaesthesia, what area is affected?

A
  • pulpal anaesthesia (limited to one or two teeth)

- soft tissue anaesthesia

51
Q

why is infiltration anaesthesia done supra-periosteal?

A

very sore if you go below

52
Q

what are some limitations of infiltration anaesthesia?

A
  • infection may limit effect (pH cause)

- dense bone may limit effect

53
Q

when doing a palatal infiltration, what needle is used?

A

short needle

54
Q

when performing palatal infiltration, where is the area of needle penetration>

A

5-10mm palatal to the centre of the crown

55
Q

when performing an inferior alveolar nerve block, what needle is used?

A

35mm needle (long needle)

56
Q

what are the important landmarks to identify when performing an inferior alveolar nerve block?

A
  • coronoid notch of the mandibular ramus
  • posterior border of mandible
  • pterygomandibular raphe
  • lower premolar teeth of the opposite site
57
Q

what are the limitations of IDB?

A
  • increased onset time
  • increased lingual nerve palsy
  • no change in intravascular injection
58
Q

go through the steps of performing an inferior alveolar nerve block:

A
  • thumb placed at coronoid notch
  • needle entry junction of buccal pad of fat/pterygomandibular raphe
  • syringe lies over contra lateral 5-6
  • advance to bony contact (1cm of needle visible)
  • withdraw 1mm
59
Q

what would you do if you contact bone too soon when performing an inferior alveolar nerve block?

A

reposition syringe barrel mesially

60
Q

when confirming anaesthesia, how might the patients describe how LA feels?

A
  • rubbery
  • numb
  • tingly
  • swollen/fat

BDS2 LA Symposium (5 decks)

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