Practical Techniques Flashcards
what are the 2 types of topical normally used in dentistry?
- benzocaine gel
- xylonor gel
what are the 3 types of LA available?
- Xylocaine (adrenaline 1:80,000)
- citanest (4% with no vasoconstrictor / 3% with octapressin)
- mepivacanine
what is a extra short needle used for?
30G for intraligamentory
what is a short needle used for?
30G for infiltration and mental block
what is a long needle used for?
27G for dental block.
what nerve supplies the lower teeth?
mandibular branch of the trigeminal nerve.
what nerve supples the lingual soft tissues of the mandible?
lingual nerve
what nerve supplies the buccal tissue of the mandible?
buccal nerve
why cant the infiltration technique be used on the lower teeth?
because the bone is thicker around the lower teeth.
what muscle does the inferior alveolar nerve block go through?
buccinator muscle.
what teeth/soft tissues does the inferior alveolar nerve block numb up?
lower molars and premolars. lingual nerve (lingual soft tissues)
how much La should be used for a long buccal injection?
1/4 cartridge of LA.
what teeth/soft tissues does the mental injection numb up?
La to lower premolars and canines.
how can you ensure that LA solution has entered the mental foramen?
massage solution around the area after injection.
what nerve supples the upper teeth?
anterior, middle and posterior branches of the maxillary division of the trigeminal never.
what nerves supples the upper palatal soft tissues?
long sphenopalatine nerve and greater palatine nerve.
what nerve supplies the upper buccal soft tissues?
superior alveolar nerve.
why is is best to give LA slowly in upper teeth?
more comfortable for the pt and beuase solution needs to pool around the apex of the tooth.
when is the papillary injection used?
used for perio procedures.
how is the papillary injection administered?
the papilla mesial and distal to the tooth. Needle inserted at the level of the cervical margin into papilla.
what is consious sedation?
depresses the CNS enabling tx to be carried out but still being able to communicate.
why would a patient need sedation?
due to anxiety and medical issues.
what are the social contraindications for the use of sedation?
- alcohol and drug use - may have damage to the liver.
- lack of appropriate adult escort - mildly sedated for 24 hours after.
what are the medical contraindications for the use of sedation?
- sever/uncontrolled systemic disease
- midication interactions with the sedation drug
- allergy
- pregnancy
- psychosis (may disinhibit pts current meds)
- respiratory infection
what are the dental contraindications for the use of sedation?
- anterior teeth are difficult with inhalation sedation
- multi-rooted endo and long procedures not ideal.
what is sedation taken orally used for?
as a premedication.
what type of drug is different as a premedication for sedation?
- benzodrazepines ( midazolam for sedation and diazepam as the premedication)
what are the advantages of taken a sedation drug orally?
- simple to give
- cheap
- can be very effective
- patient friendly
- self administered
what are the disadvantages of taken a sedation drug orally?
- unpredictable
- cannot give a little and see how it works
- rapid recovery
- still may need to cannulate.
what are the advantages of inhalation sedation?
- reduces pts perception og pain
- safe for children.
- no needles
- reliable and predictable
- good safety record
- no special pt arrangements.
what are the disadvantages of inhalation sedation?
- specialist equiptment
- occupational side effects (VitB12, fertility issue, if not placed correctly can effect operator)
- nitrous oxide pollution
- claustrophobia
- nasal obstruction
- requires psychological back up
what are the advantages of intravenous sedation?
- non-irritant
- wide margin of safety
- no set does, so can give a little at a time.
- rapid induction
- reversible
- amnesiac effect (pt cannot remember after)
what are the disadvantages of intravenous sedation?
- respiratory depression
- paradoxical disinhibition
- no analgesia
- post-op supervision
- monitoring equipment needed
- amnesiac effect (pt cannot remember after)
How is intra-nasal sedation different to intravenous?
given up the nose.
with intra-nasal sedation is a canula still required?
yes but it can be given after sedation.
what are the environmnetal factors that allows for sedation to be carried out in the dental practice?
- ground floor
- protected entrance area
- parking close by
- tx rooms adequate size
- recovery room.
In regards to LA what should be recorded in the patients notes?
- type and site of injection
- type and dose of LA and vasoconstrictor given.
- type of needle used
- pts weight (if significant)
- adverse reactions seen.
- post-op instructions + warnings given
- record of consent and advise.
- batch numbers of materials used.
