LA overview

Question 1

where is LA deposited in infiltration technique and what can it anaesthatise

Answer 1

deposited at terminal end branches

anaesthatises soft tissues and pulp where bone is thin e.g maxilla and mandible at lower anteriors

Question 2

where is LA deposited in block technique and what can it anaesthatise

Answer 2

deposited beside nerve trunk

can anaesthitise everything that nerve supplies both pulp and soft tissues

Question 3

what techniques would you use to anaesthitise the pulp, buccal gingivae and palatal gingivae in the upper arch

Answer 3

pulp - buccal infiltration
buccal gingiva - buccal infiltration
palatal gingiva - palatal infiltration

Question 4

how do you anaesthitise dental pulp in the mandibular arch

Answer 4

IDB, mental nerve block or buccal infiltration

Question 5

how do you anaesthitise buccal gingiva in the mandibular arch

Answer 5

molars - long buccal infiltration
premolars - buccal infiltration or mental nerve block
anteriors - buccal infiltration

Question 6

how do you anaesthitise lingual gingivae in the mandibular arch

Answer 6

2nd part of IDB will anaesthitse lingual nerve

lingual infiltration

Question 7

bevel

Answer 7

tip of needle

Question 8

hub

Answer 8

base of needle - most prone to fracture

Question 9

how to gauge numbers work

Answer 9

smaller the gauge number the larger the diameter

i.e 25 gauge needle has larger lumen than 30 gauge

Question 10

is a larger or smaller gauge number better and why

Answer 10

larger i.e smaller lumen size as this results in less deflection therefore increased accuracy , decreased breakage risk and easier aspiration

Question 11

buccal infiltration technique

Answer 11

injection site = into sulcus just below tooth apex slightly distally
advance till needle over apex
if hit bone withdraw slightly

Question 12

palatal infiltration site of injection

Answer 12

5-10mm palatal to crown centre , insert needle at 45 degree angle to injection site
advance until needle contacts bone the withdraw slightly

Question 13

mental nerve block injection site

Answer 13

inject between apices of lower pre molars

Question 14

where are we aiming to inject LA in a IANB

Answer 14

in region of mandibular foreamen

Question 15

what are the important landmarks when giving an IDB

Answer 15

coronoid notch - place thumb of non working hand
pterygomandibular raphe - stringy bit
contralateral pre molars - where LA barrel should be

Question 16

injection site of IDB

Answer 16

6-10mm above occlusal plane in between coronoid notch and raphe - about 2/3 in raphe direction
advance until contacts bone then withdraw slightly

Question 17

what should be done if you don’t contact bone when giving an IDB

Answer 17

move the barrel of LA more distally in relation to pre molars

Question 18

what should be done if you contact bone straight away when giving an IDB

Answer 18

move the barrel of LA more mesially in relation to pre molars

Question 19

how is the lingual nerve block achieved

Answer 19

done as a second part of the IDB
deposit 2/3 - 3/4 of LA in the IDB area
then as you withdraw release the remaining solution to achieve lingual nerve block

Question 20

what waste stream are LA bungs disposed of in

Answer 20

clinical waste - orange

Question 21

akinosi technique

Answer 21

alternative IANB
closed mouth injection e.g if ptx has trismus
injection given in line with maxillary margins

Question 22

gow gates tecnique

Answer 22

alternative IANB

injection given towards neck of coronoid process