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150 Dental Auxilliary Practices > Pain And Anxiety Management > Flashcards

Pain And Anxiety Management Flashcards

1
Q

What 2 groups can local anesthesia be broken down into?

A

Esters and Amides

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2
Q

Esters

A

Higher incidence of allergic reaction

Shorter acting

Metabolized in the blood plasma

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3
Q

Amides

A

Low incidence of allergic reaction

Potential for toxicity & overdose

Metabolized in the liver

Causes vasodilation of local blood vessels

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4
Q

What are reasons to use vasoconstrictors?

A

Safety – potential for toxic reaction

Longevity- duration is increased

Effectiveness- depth and profoundness is increased

Hemostasis- decreased

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5
Q

Types of vasoconstrictors

A

Epinephrine- used in concentrations of 1:1000,000 and 1:200,000

Levonordefrin- Half as potent as Epinephrine and may have a less cardiac effect

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6
Q

Risks of using vasoconstrictors

A 
Hypersensitivity to drug
Medically compromised
Heart disease
Stroke
Recent heart surgery
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7
Q

Other names for lidocaine (amide)

A

Xylocaine, octocaine, lignospan

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8
Q

What is the first amide and still most widely used dental anesthetic that is also available as a topical?

A

Lidocaine

Used with vasoconstrictor (epinephrine)

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9
Q

What are indications for local anesthesia?

A

Any treatment that may cause the patient pain: scaling and root cleaning, excessive instrumentation, challenging areas like pockets and furcation, sensitive route surfaces, inflamed tissues and excessive bleeding

Also for application of crowns, bridges, Endo, surgeries etc.

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10
Q

Armamentarium needed for local anesthesia

A 
Syringe
Needle
Topical
Gauze
Anesthetic
Needle guard or recapping device
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11
Q

Describe the type of syringe that should be used

A

Should be an aspirating syringe

Made of metal or plastic that can be sterilized

Single use syringes can also be used

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12
Q

What are the different needle lengths?

A

Long- 1.5”/32-40mm
Short- 1”/20-25mm
Ultra short- 1/2”/10-12mm

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13
Q

What gauge needles do we use?

A

25, 27 and 30

The smaller the number the larger in size and stiffer= less breakage, more accurate and easier aspiration

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14
Q

Describe the cartridge or Carpule used

A

Made of glass that holds anesthetic. 1.7 to 1.8 mL

Labeled with type of anesthetic, manufacture and expiration date

Pre-sterilized, color-coded and disposable

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15
Q

Storage of anesthetic carpule

A

Store in a cool place away from light and it’s own container. Never in alcohol or any liquid solution

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16
Q

Do not use carpule if:

A

Cloudy, broken, bubble to large or small, expired, extruded stopped, rusted/corroded or rusted top

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17
Q

Major groups of topical anesthetic’s

A

Esters and amides

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18
Q

Esters used as topicals

A

Benzocaine, ethyl aminobenzoate (Hurricaine, cetacaine)

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19
Q

Amides used as topicals

A

Lidocaine and lidocaine hydrochloride

20
Q

How are topicals supplied?

A

As liquid, gel, ointment, spray and patch

21
Q

How long is the onset of effects from a patch?

A

2 to 5 minutes and full affect us after 15 minutes and duration is approximately 45 minutes

22
Q

How long is the onset for most topical esters?

A

Most answer is 30 seconds and reaches full affect after a few minutes and duration is approximately 10 minutes

23
Q

How long is the onset for topical amides?

A

I said is 1 to 2 minutes in full affect me take five minutes in duration is approximately 15 minutes

24
Q

What should you do before the application of topical anesthetic?

A

Consult medical history
Determine agent to be used
Explain purpose and effect to the patient
Dry the area
Apply with cotton tipped swab
After application, wipe area and rinse

25
Q

What are the four main types of pain management?

A

Topical (benzocaine, lidocaine, citanest (liquid), dentapatch, oraquix (injectable))

Drugs- codeine, Valium

General anesthesia- intravenous sedation

Nitrous oxide gas

26
Q

Basic injections in the maxillary arch

A 
ASA
MSA
PSA
Infraorbital (IO)
Greater Palatine (GP)
Nasopalatine (NP)
Infiltration
27
Q

What area does an ASA injection target? Where is the topical placed?

A

Canine and incisors and supporting structures

Topical placed at the Apex of the canine

28
Q

What does the MSA injection target? Where is the topical placed?

A

Middle superior alveolar- first and second pre-molars, Mesiobuccal root of first molar and supporting structures

Topical placed at the Apex of the maxillary second premolar

29
Q

What does the PSA injection target? Where is the topical placed?

A

Posterior superior alveolar- Second third and first molar excluding mesiobuccal root and supporting structures

Topical placed at the Apex of the maxillary second molar

30
Q

What does the infraorbital injection target? Where is the topical placed?

A

Premolars, canine, incisors and supporting structures. Includes ASA and MSA

Topical placed at the Apex of the maxillary first premolar

31
Q

What does the greater Palatine injection target? Where is the topical placed?

A

No hard tissues, soft tissues- palatal tissues from teeth to midline from distal of the third molar to the canine

Topical placed just distal to the first molar

32
Q

What does the nasopalatine injection target?

A

No hard tissues, palatal tissues from left canine to right canine

Topical placed at the incisive papilla

33
Q

What does and infiltration injection target? Where is the topical placed?

A

Teeth associated with the area

Topical placed at mucobuccal fold of tooth to be injected

34
Q

What are the different mandibular injections?

A

Long buccal
Inferior alveolar with lingual (mandibular block) (IAMB)

Gow-Gates techniques

Akinosi

Mental and incisive

35
Q

What does the long buccal injection target? Where is the topical placed?

A

No hard tissue and facial of molars

Topical placed distal to the third molar

36
Q

What does the inferior alveolar with lingual injection target?

A

Molars, premolars, canine and incisors to midline as well as supporting structures

Topical is placed in the retromolar area

37
Q

How to place an inferior alveolar nerve block

A

Retract the lip
Placed thumb on anterior surface of the ramus
Approach from the opposite pre-molars

38
Q

What does the lingual injection target? Where is the topical placed?

A

No hard tissue and all of the lingual gingival to midline, 2/3 of the tongue and floor of the mouth

Topical placed in the retromolar area

39
Q

What does the show-Gates technique target?

A

Hard tissue- mandibular teeth to midline, body of mandible and inferior portion of ramus and soft tissue is facial and lingual, anterior 2/3 of tongue, floor of the mouth, posterior area of cheek and temporal regions

Topical placed in retromolar area

40
Q

What does the Akinosi injection target? Where is the topical placed?

A

Closed mouth mandibular block. Used for patients that have trouble opening

Topical is placed in the retromolar area

41
Q

What does the mental and incisive injection target? Where is the topical placed?

A

Hard tissues- premolar, canine, incisors and associated supporting structures. Soft tissues

Topical placed in the mucobuccal fold between pre-molars

42
Q

Injections that can be used in either arch

A

Inter-papillary

Periodontal ligament

43
Q

What does the inter-papillary injection target?

A

No hard tissue, tissue surrounding the tooth

44
Q

What does the periodontal ligament injection target?

A

Hard tissue- Individual teeth and adjacent soft tissue

45
Q

Uses for topical anesthesia

A 
Preparation for local anesthesia
Prevent gagging while taking radiographs
Temporary relief of ulcers and wounds
During instrumentation
Suture removal

150 Dental Auxilliary Practices (16 decks)

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