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Dentistry > Local Anesthesia/Periodontal Disease > Flashcards

Local Anesthesia/Periodontal Disease Flashcards

1
Q

What’s the purpose of local anesthesia?

A

Reduces the depth of general anesthesia needed for pain control and minimizes complications from anesthesia

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2
Q

How do local anesthetics work?

A

By blocking the sodium and potassium channel ion currents

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3
Q

What is the local anesthetic of choice and what is the duration of action and onset?

A

Bupivacaine 0.5% +/- epinephrine

Duration is 6-10 hours and onset is 4-8 minutes.

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4
Q

What are the risk of blocks?

A

Toxicity, anaphylactic reactions, permanent nerve damage

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5
Q

What is the max dose of bupivacaine in each quadrant?

A

2mg/kg/day

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6
Q

What does inflammation do to bupivicaine?

A

Can render it less effect because inflammation causes tissue ph to lower

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7
Q

What are signs that bupivacaine hasn’t activated yet?

A

Increased HR, RR and BP with sx stimulation. Re-administer if under max daily dose.

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8
Q

What are infiltration blocks for?

A

Used postop to reduce discomfort, and blocks only the location where it’s given

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9
Q

What are regional blocks for?

A

Blocks an entire quadrant, but causes loss of sensation and function, and causes possible post-op self-inflicted injury to soft tissues.

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10
Q

How do you perform a regional block?

A

ID the sitem advance needle slowly, aspirate, rotate 90 degrees and aspirate if threading a canal, repeat 360 degrees. Inject small amount of drug and aspirate again. If clear, slowly inject full dose, use digital pressure to prevent bleeding. New needle each site and if blood is aspirated.

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11
Q

What does the rostral maxillary block effect and where is it injected?

A

Blocks incisor, canines and first 3 premolars.

Injected into the infraorbital foramen, ventral to the retracted infraorbital neurovascular bundle.

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12
Q

What does the caudal maxillary block effect and where is it injected?

A

Blocks the maxillary nerve (rostrally becomes the infraorbital nerve) and the sphenopalatine nerve. Blocks all maxillary teeth in that quadrant, adjacent bone and soft tissue. Needle is advanced far into the canal to the medial canthus.

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13
Q

What does the rostral mandibular block effect and where is it injected?

A

Blocks inferior alveolar nerve in the middle mental foramen, blocks incisors, canine and first 2 premolars. Inject at a 30 degree angle ventral to the mesial root of the 2nd premolar.

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14
Q

What does the caudal mandibular block effect and where is it injected?

A

Inferior alveolar nerve on lingual aspect of mandible, blocks all teeth (entire quadrant) of the mandible on side of infiltration and adjacent bone/soft tissue.

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15
Q

What is the caudal mandibular block landmark?

A

Notch is ventral to the condylar process, just in front of it. Caudal to the 3rd molar in dogs and 1st molar in cats.

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16
Q

What happens if you inject the tongue? What should you do?

A

Can result in self mutilation later. Sedate the patient until the block wears off.

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17
Q

What happens if bupivacaine is combined with buprinorophine?

A

It doubles the analgesia duration of buprinorphine

18
Q

What is periodontal disease?

A

Inflammation and infection of the tissues surrounding the tooth

19
Q

What does the periodontium consist of?

A

Cementum, alveolar bone, periodontal ligament

20
Q

How is plaque and tartar/calculus made?

A

Bacteria colonize on the tooth to make plaque. In 3-5 days, the bacteria absorb the calcium from saliva, calcifies and becomes tartar/calculus.

21
Q

Which type of bacteria releases toxins in the mouth?

A

Anaerobic gram negative bacteria (subgingivally)

22
Q

Inflammation causes what in the mouth?

A

Causes gingival pockets to form and acidifies tissue.

23
Q

OraStrip can be used to test what?

A

Thiols (by product or pathogenic bacteria)

24
Q

What are the classes of furcation?

A

Class 1: Exposure less than 1mm
Class 2: Exposure greater than 1 mm, not fully through
Class 3: Complete furcation, probe able to pass through

25
Q

What are the mobility index stages?

A 
M0-M3
M0- no movement
M1 - movement any direction 0.2-0.5 mm
M2- movement any direction 0.5-1mm
M3- movement any direction greater than 1mm
26
Q

What are the gingivitis index stages?

A

Type 1: Redness, reversible
Type 2: Redness w/edema, topography becomes irregular, reversible
Type 3: Pocket formation, attachment loss of 10%-30%, bleeding upon probing
Type 4: Advanced breakdown of support tissues, deep pockets, gingival recession, bone loss

27
Q

What are dental x-rays for?

A

Document/study the process and tx of dental/oral dz, finds unerupted/impacted teeth, periodontal dz, bone loss, oral fistulas.

28
Q

What should you check after extractions?

A

Make sure all roots and tooth fragments are taken.

29
Q

How far away is the dental x-ray head machine from the patient?

A

8-12 inches

30
Q

The parallel technique in dental radiography is used to evaluate what?

A

Caudal mandibular teeth and nasal cavity.

31
Q

What technique can be used in dental radiography as an alternative to the parallel technique?

A

Bissecting-angle technique, the plane of the tooth is at 90 degrees to the film, the bisecting angle is 45 degrees.

32
Q

What is elongation in radiography for dentistry?

A

Aiming for xray at the tooth but not the bisecting angles of the roots

33
Q

What it foreshortening?

A

Caused by aiming the radiographic cone towards the film

34
Q

What does the maxillary/mandibular caudal radiograph target?

A

Premolars and molars

35
Q

What does the maxillary/mandibular rostral radiograph target?

A

Canines and incisors/nasal cavity

36
Q

What angles are maxillary and mandibular radiographs taken?

A

Maxillary is 45 degrees, mandibular is 20 degrees

37
Q

What constitutes a complete study in cats?

A

6 primary views: R/L cranial maxilla, R/L caudal mandible, canine teeth, cranial maxilla/mandible

38
Q

What is some troubleshooting for radiographs?

A

Image is elongated, aim more at sensor. Image is foreshortened, aim at tooth. Too much crown, not enough root and supporting structures.

39
Q

On a radiograph, what should be charted?

A

Enamel, dentin, periodontal ligament space, pulp chamber, alveolar bone

40
Q

What is a normal radiograph finding in young dogs?

A

Thin dentinal wall with large pulp chamber, apex may be open, lamina dura lining tooth,

Dentistry (5 decks)

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