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Children's Dentistry > Local Anesthesia > Flashcards

Local Anesthesia Flashcards

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1
Q

When can we skip local anesthesia? (3)

A
  1. Preparation into enamel (PRR)
  2. Slow speed hand excavation
  3. Very careful supra-gingival rubber dam clamp
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2
Q

What type of anesthetic is benzocaine (amine or ester) and when do you use it?

A

Ester-type

Used for temporary relief in pain associated with:

  • toothache
  • minor sore throat pain
  • canker sore
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3
Q

How much benzocaine does the topical unit contain?

A

0.40gm of 20% benzocaine gel

Generally the concentration of benzocaine ranges from 10%-20%

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4
Q

Where should the patients head and doctor position be for each quadrant injection?

A

UL: head to the right. 11:00
UA: head straight or right. 7:00 or 11:00
UR: head straight or right. 7:00 or 11:00

LL: straight. 11:00
LA: straight 11:00
LR: to the right. 7:00 or 11:00

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5
Q

What is 2% lidocaine with 1:100,000 epi used for

A

Infiltration and block for any age group

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6
Q

What is 4% septa canine with 1:100,000 epi used for?

A

Prudent infections only – advantage for mandibular infiltration when there is concern for post visit self-injury

It is approved for children >=4yrs old

Superior alveolar penetrate - advantage for infiltration technique for exodontia with PAP

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7
Q

Infant needs extractions of D,E,F,G and weights 22 pounds. Calculate the lidocaine and septocaine dosage

A

Lidocaine = 2mg/lb
Max dose = 2x22 = 44mg
Carouse contains 34mg
Thus, safe to use 1.3 carpules

Septocaine = 3.2mg/lb
Max dose = 3.2x22 = 70.4mg
Carpules contain 68mg
Thus, safe to use 1 carpule

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8
Q

What is the 27G, 30G, and 30G X-short needles used for

A

27G - mandibular block
30G - maxillary infiltration
30G - maxillary infiltration, anterior primary dentition (Age

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9
Q

What are the post operative instructions after giving local anesthesia?

A
  1. Childs lip, tongue, and cheek will be numb for about an hour
  2. Watch child to prevent chewing and causing an injury
  3. Give Motrin or Tylenol before anesthesia wears off
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10
Q

What is Oraverse?

A

Oraverse is phentolamine, and alpha 1 antagonist.

It is used to reverse effects of local anesthesia

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11
Q

What is the limitations of Oraverse?

A

It is not used as an emergency medication to reverse local anesthetic toxicity.

It is only recommended for use in children less than 6 years of age or weight less than 33lbs.

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12
Q

What is the adult dosage for Oraverse?

A
  1. 2mg if 1/2 cartridge of anesthesia was administered
  2. 4mg if 1 cartridge of anesthesia was administered
  3. 8mg if 2 cartridges of anesthesia were administered
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13
Q

What is the pediatric dosage of Oraverse?

A

15-30kg (33-67lbs): 0.2mg maximum dose

Children >30kg (67lbs) and 30kg and >=12years: refer to adult dosing

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14
Q

Name some amide-type anesthetics

A

Lidocaine
Mepivacaine
Prilocanine
Articaine

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15
Q

Name some ester-type anesthetics

A

Procaine
Benzocaine
Tetracaine

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16
Q

True or false: local anesthetic effects work rapidly in inflamed areas?

A

False - the pH drops in highly inflamed areas, thus, inhibits anesthetic actions

17
Q

Up till how much depth is topical anesthetic effective?

A

2-3mm in surface tissue depth

18
Q

When is compounded topical anesthetics used?

A

Orthodontic treatment and pediatric dentistry to anesthetize palatial tissues prior to injection and for extraction of loose primary teeth

19
Q

True or false: allergy to one amide-type anesthetic means that you are allergic to all amide-type anesthetics

A

False - allergy to one does not mean allergy to all.

20
Q

True or false: allergy to one ester-type anesthetic means allergy to all

A

True

21
Q

What does an allergy to bisulfate mean in terms of using local anesthesia?

A

You cannot use a local anesthetic with vasoconstrictors (bisulfate used to preserve vasoconstrictors in anesthesia)

22
Q

What is the risk of using prilocaine?

A

There is a risk of inducing methemoglobinemia

23
Q

True or false: allergy to local anesthesia is due to dosage

A

False - it is due to the patient’s capacity to react to even a small dose

24
Q

Which local anesthetics have the highest risk of parenthesia?

A

Articaine and prilocaine

25
Q

Can you use local anesthetics with sedatives?

A

No because they both depress the CNS

26
Q

Can you use local anesthetics with opioids? With narcotics?

A

No because toxicity increases with opioids

Narcotics + local may decrease protein binding and elevate CO2, thus, increase CNS sensitivity to convulsions

27
Q

When do we need local anesthesia? (4)

A
  1. Extraction of a tooth
  2. Accessing a vital pulp
  3. Preparing a cavity into dentin
  4. Rubber dam application

Children's Dentistry (7 decks)

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