Local Anesthesia in Dentistry Flashcards
What are the three branches of the trigeminal nerve
- ophthalmic
- maxillary
- Mandibular
What are the relevant branches of the maxillary nerve
- infraorbital nerve (ASA, MSA, upper teeth, upper lip, cheek, side of the nose)
- zygomatical facial (lateral Cheek)
- zygomatical temporal (side of forehead)
What are the relevant branches of the mandibular nerve
- buccal nerve (mucosa of the mouth and buccal gingiva)
- lingual nerve (anterior 2/3 of tongue, lingual gingiva, and lingual mucosa)
- inferior alveolar nerve (lower teeth, gums)
- Mental nerve (chin and lower lip)
What color is the cartridge for 2% lidocaine 1/100000 EPI
Red
what color is the cartridge for .5% bupivicaine (Marcaine) with EPI
Blue
What color is the cartridge for 2% mepivicaine (carbocaine) Without EPI
Brown
What color is the cartridge for 4% articaine (septocaine) with 1/100000 EPI
Gold
What is the other name for lidocaine
lidocaine
what is the other name for articaine
septocaine
what is the other name for marcaine
bupivicaine
what is the other name for mepivicaine
carbocaine
When is an inferior alveolar block indicated
- anesthetizing mandibular molars
- anesthetizing premolars, canines, incisors
Where do you deposit the anesthetic when performing an inferior alveolar block
near the Inferior Alveolar nerve as it enters the mandibular foramen
What are the steps in administering an inferior alveolar nerve block
- patient must open mouth wide
- palpate internal and external oblique ridges and not pterygomandibular raphe
- insert the needle .5 cm slightly above the occlusal plane and lateral to the pterygomandibular raphe
- inject .5ml of solution here for lingual nerve block
- move needle horizontally to contact the lingula
- slightly withdraw needle and inject remainder of anesthetic
What must we understand about the nerve to mylohyoid
it can sometimes innervate teeth on the mandible, so if you are struggling to get profound anesthesia you may consider a mylohyoid nerve block
What is a Gow Gates nerve block
when you inject LA higher upstream on the Inferior Alveolar nerve to get more complete anesthesia
When do you use an akinosi technique
when the patient is unable to open their mouth
how is an akinosi technique performed
patients mouth is closed, the needle is inserted parallel to the occlusal plane and at the height of the mucogingival junction of the maxilla
Where is the mental foramen usually located
just apical to and between the first and second mandibular premolars
what does a mental nerve block do
provide limited analgesia of premolars and canines, and to a lesser degree the incisors on the same side. also soft-tissue analgesia
How is a mental nerve block performed
place the lip on tension and insert the needle parallel to the long axis of the premolars angling towards the bone and deposit LA, then massage the location to assist absorption.
Why shouldn’t you try to directly administer LA to the mental foramen
because doing so could damage the nerve
is the buccal nerve anesthetized when doing a IA nerve block
no
What does the buccal nerve innervate
tissues and periosteum buccal to the molars
When should the buccal nerve block be done
when the soft tissues are involved in the treatment, not when the treatment is only on the teeth
How is a buccal nerve block performed
insert the needle about 2-4 mm deep into the mucous membrane distal to the last molar until you gently contact bone, aspirate, then deposit 1/8 of the cartridge
how is a sublingual nerve block performed
place the needle just submucosally lingual to the premolars and use .5 ml of LA
How is an infra-orbital block performed
you palpate the infraorbital foramen and place your finger on it, then pull back the lip and insert a 25 gauge long needle in the muccobuccal fold over the first premolar and insert the needle toward your finger but stop short of reaching the finger, depost LA.
