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BDS2 CDS LA symposium > LA overview > Flashcards

LA overview Flashcards

1
Q

what is an additional benefit of LA?

A

vasoconstrictos in LA aid for haemostatic control for both restorative and surgical procedures

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2
Q

what adverse events can happen when using LA?

A 
systemic toxicity
allergy
trismus
occular complications
non-surgical parasthesia
interactions
methemoglobinemia
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3
Q

what is the 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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4
Q

what can cause dental anxiety?

A

perception of pain/noxious stimulus
needles
wider societal, environmental and media related pressures

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5
Q

what are the 2 types of LA

A

ester

amide

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6
Q

which type is safer?

A

amide

  • less reactions
  • more predictable
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7
Q

is articain ester or amide?

A

ester ring

not true ester

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8
Q

what vasoconstrictors are used?

A

none
adrenaline
felypressin

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9
Q

which vasoconstrictor is most common?

A

adrenaline

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10
Q

which vasoconstrictor cannot be given to pregnant women?

A

felypressin

induces labour

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11
Q

which preservatives are used?

A

bisulphite

propylparaben

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12
Q

what is an infiltration technique?

A

solution deposited around terminal branches of nerves
used for soft tissues
used to produce pulpal anaesthesia where alveolar bone is thin
maxilla
lower anterior teeth

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13
Q

what is a block technique?

A 
deposited beside nerve trunk
abolishes sensation distal to site
soft tissue anaesthesia
where bone too thick to allow infiltration
mandible
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14
Q

what tissues are anaesthetised when restoring?

A

pulp
soft tissue- matrix/dam
haemostatic management in fixed prosthodontic work -soft tissue

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15
Q

what is anaesthetised when doing extraction/surgical procedures?

A

pulp, gingiva, surrounding soft tissue

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16
Q

what is anaesthetised when scaling?

A

gingivae
or
pulp and gingivae

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17
Q

what types of anaesthesia are used in the maxilla?

A

pulp = buccal infiltration
buccal gingivae= buccal infiltration
palatal gingivae = palatal injection

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18
Q

how is pulp numbed in the mandible?

A 
lower molars & 2nd premolar
-ID block
lower premolars & canine
-mental (incisive) nerve block
canines & incisors
-buccal/labial infiltration
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19
Q

how is buccal gingivae numbed in the mandible?

A 
molars & 2nd premolar
-long buccal infiltration
1st premolar & canine
-infiltration/ long buccal/mental block
incisors & canines
-buccal/labial infiltration
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20
Q

how is lingual gingivae numbed in the mandible?

A

lingual infiltration

2nd part of IDB

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21
Q

what is the most fragile part of a needle?

A

the hub

-never insert needle up to hub can cause fracture

22
Q

what is a bevel?

A

point of needle

cutting surface to penetrate w/ as little resistance as possible

23
Q

what is a guage?

A 
diameter of lumen of needle
< guage number = > diameter of lumen
> guage is better
-more accurate
-less breakage
-easier aspiration
24
Q

what are the components of a cartridge?

A 
glass tube
stopper- punger bung
cap
diaphragm
solution
25
Q

what do you need for LA?

A

syringe handle and bung
syringe barrel
cartridge
expiry date & batch

26
Q

which needle is used for infiltration and which for IDB?

A

infiltration- short 25mm

block - long 35mm

27
Q

how should you prepare the equipment for LA?

A 
collect syringe handle and needle
collect selected LA cartridge
unpack everything
record details for decontamination
make up syringe handle
attach rubber bung
-broader end toward handle
load cartridge in needle barrel
connect syringe handle and LA needle with cartridge
-bung end into needle
click in place, pull to check
prepare needle for use
-pull back safety sheath, point away, click sheath into place
remove disposable cap by pulling away from needle
make needle safe by re-sheathing
-1 click re-use, 2 clicks lock
28
Q

how do you prepare the patient for LA?

A 
check medical history
position in chair
dry mucosa- guaze/cotton wool
apply topical for 1-2 mins
-pea size on cotton wool
29
Q

what is relaxation breathing used for?

A

reduction of tension

30
Q

how do you prevent needle anxiety in the px?

A

keep needle out of view

31
Q

describe injection technique?

A 
stretch mucosa
puncture quickly
position needle tip at target point
bevel towards bone
aspirate
inject slowly >30s
32
Q

what are myths about LA?

A

needle length influences discomfort
needle diameter influences discomfort
temperature influences discomfort

33
Q

where is the injection site for buccal infiltration?

A

reflection of mucosa below apex of tooth

34
Q

describe infiltration anaesthesia

A

pulpal anaesthesia limited to 1 or 2 teeth
soft tissue
supra-periosteal

35
Q

what are limitations of infiltration anaesthesia?

A

infection may limit effect

dense bone may limit effect

36
Q

what are positives of infiltration?

A

high success rate
technically easy
atraumatic

37
Q

describe buccal infiltration technique?

A 
stretch cheek
puncture mucosa with correct bevel of needle - open towards bone
advance needle until over apex of tooth
if contact bone, withdraw slightly
aspirate
38
Q

what do you do once completed buccal infiltration?

A 
remove syringe from mouth
slide sheath down to 1st click
replace cartridge if need further injections
massage local into tissues
wait 2 mins
test by sticking probe down PDL
39
Q

describe palatal infiltration

A

short needle
penetrate 5-10mm palatal to centre of crown
apply pressure behind injection site
insert needle at 45 angle to injection site w/ bevel angled toward soft tissue
advance needle, slowly deposit as soft tissue is penetrated
advance needle until contact bone
depth of penetration few mm
0.2-0.4ml needed
blanching tissue immediately

40
Q

describe greater palatine block

A

posterior portion of hard palate and overlying soft tissues as far as 1st premolar and medially to midline

41
Q

describe nasopalatine block

A

anterior portion of hard palate (soft & hard)

bilaterally from mesial of right 1st premolar to mesial of left 1st premolar

42
Q

how should you dispose of sharps?

A 
take handle off 
2 clicks 
orange box
cartridge blue
lock bin after use
handle sterilised
bung clinical waste
43
Q

what do you avoid in mental nerve block?

A

foramen

should be between apices of lower premolars

44
Q

what are the important landmarks for IDB?

A 
coronoid notch of mandibular ramus
posterior border of mandible
pterygomandibular raphe
lower premolar teeth of opposite side
site = region of mandibular formamen
45
Q

where is the thumb placed in IDB?

A

coronoid notch

46
Q

where are fingers placed in IDB?

A

posterior border of mandible

47
Q

what are the limitations of inferior position?

A

increased onset time
increased lingual nerve injury
no change in intravascular injection

48
Q

how many mm above occlusal plane should needle be in IDB?

A

6-10mm

49
Q

where is the injection site in IDB?

A

halfway between coronoid notch and raphe

50
Q

describe IDB technique

A

thumb placed at anterior notch
needle entry junction of buccal pad of fat/pterygomandibular raphe
syringe lies over contra lateral 5-6
advance to bony contact, withdraw 1mm
-1mm needle visible
if no bony contact reposition distally
if bony contact too soon, reposition mesially
when in correct position withdraw from bony contact
aspirate
inject slowly
-for lingual anaesthesia withdraw when last 1/3 solution

51
Q

how do you confirm anaesthesia?

A 
ask px how it feels
-rubbery
-numb
-tingly
-swollen/fat
IDB
tongue & lower lip to midline should feel different
ability to sense pressure will remain
test mucosa with probe

BDS2 CDS LA symposium (7 decks)

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