Local Infiltration Techniques Flashcards
What are the legal requierments of Local Infiltration?
- Hygienist / Therapist cannot practice unless they have annual enrolment on the GDC register
- Must be a written, signed treatment plan by a registered dentist for LA, unless PGD in place
- Medical history updated
- Dentist need not be on the premises
Difference between Infiltration vs. Block Analgesia photo.
What is the Armamentarium
(the medicines, equipment, and techniques available to a medical practitione)
- Consent
- Medical history
- Self aspirating syringe ( safety plus / conventional)
- Short needle
- Analgesic solution
- Topical analgesic
- Sharps box
What Position should the patient be in for local infiltration?
- Supine
- This position reduces the incident of vasovagal attack
- Operator light should be in a good position for full view of injection site.
What is Topical Anaesthesia?
•Ointment or spray
Topical Anaesthesia
- Dry site with cotton wool roll
- Small amount should be used on a pledget of cotton wool/bud at the site where the injection is proposed
- Wait 2 minutes before injecting
What does Self Aspirating Syringes help with
and what type of needle should be used with it?
- Should always be used
- Helps prevent intravascular injection
- Use with short needles
- Safety plus system
What is the technique for local infiltration.
- Clean/dry site
- Apply topical (2 mins)
- Retract tissues (use mirror where possible)
- Penetrate until you feel bone
- Withdraw very slightly
- Aspirate/reduce pressure – if no blood is visible in cartridge……
- Inject adequate amount of solution
- Withdraw slowly
- Massage site
why does an infiltration injection in maxillary teeth normally gives good anaesthesia?
The outer bone covering the maxillary teeth is usually quite thin and porous
what are The teeth and buccal gingiva innerated by?
•The teeth and buccal gingiva are innervated by the Superior alveolar nerves (anterior)
what is the palatal gingivae innervated by?
The palatal gingivae is innervated by the nasopalatine nerve
Where is the injection for upper incisors and canines given?
•The injection is given near or into the buccal fold. It should near bone towards the apex of the tooth to be anaesthetised.
•Slow injection of 1ml of solution will affect the target tooth and one or both of the adjacent teeth.
What are the pre molars innervated by?
•Innervated by the superior plexus
•Palatally via the greater palatine but some anastamosing branches of the nasopalatine
What are the maxillary molars innervated by?
- Innervated by the superior posterior alveolar nerve and supplies teeth, buccal gingiva and periosteum.
- Palatal anaesthesia can be gained by targeting the greater palatine nerve.
Where is the injection for the upper molars given and how much is administered?
•Injection is given close to the targeted tooth and into the buccal sulcus, when bone is felt near the apex 1ml can be injected.
How do you give a palatal injection and what is the aim?
- •Can be fairly uncomfortable*
- •Topical tends not to be useful*
- Aim for an equidistant point between median raphe and gingival margin of target tooth
- Inject a small amount slowly, blanching indicates anaesthesia has been achieved
What should the be done in an injection of the lower incisors and canines?
What do you sometimes need to do to get canines anaesthesised too?
- The tip of the needle must be in contact with the bone to stop injury or escape of solution into the surrounding soft tissues of the lip and chin.
- In some adults to achieve anaesthesia of the canine a mental block needs to be given.
What does the Buccal Infiltration do?
- Supplementary (addition) to ID block
- Gives anaesthesia to buccal gingivae
- Same principle applies as injection is directed towards apical area through the alveolar mucosa
