Scope of LA Flashcards
What are the charatesristic of a successful local anaesthesia adminstration?
- No Pain
- Long lasting - until end procedure
- (Allergy wise) - acceptable by majority of the population
- Wears off at the end of the treatment
- Dealing with patient’s anxiety
- Dosage and a short half-life
- No side affects
Define anaesthesia and Analgesia? Which one of them do we use?
- Anaesthsia: loss of all sensations. 2 types:
- Local anaesthesia - works in a specific area of the body & no loss of consciousness
- General Anaesthesia - works on the whole body & results in loss of conscoiusness
- Analgesia: loss of pain sensations
It would be better if we had analgesia but since we dont, we only use anaesthesia.
What are the GDC Expectations from us in regards to anaesthesia?
- Prevent, diagnose and manage patient anxiety
- Prevent, diagnose and manage patient pain
Are LA used in DDH single use or reusable?
- Now, all of LA use in DDH is single use only
Why do we use LA?
- Pain control during procedure and post operativley
- Diagnosis - ie. if patient complains from pain and the pain stops after adminestring LA that means you found the right tooth (source of pain)
- Haemostasis (reduced blood flow) - This happens as a result of the vasocontrictors in the anaesthetic agent eg. adrenaline. LA is used for Haemostsis to reduce blood during an operation.
List the different types/methods of Anaesthesia
- Topical Anaethesia
- Inflitration Anaesthesia
- Regional Anaesthesia/ Block anaesthesia
- Supplementary Techniques
What is Topical Anaesthesia? What is it used for?
- It’s applied to the surface to numb it
Uses:
- makes injections pain free
- minor oral surgeries
- Abscess incisions to drain it
- applied on the palate to reduce gag reflex when taking impression
What type of anaesthesia is this? How does it work & what does it’s effectiveness depend on?
- infiltation anaesthesia
- Anaesthesia is achieved by diffusion of the anaesthetic to the site of action (root apex)
- effectiveness depends on the permiability of the tissues that the solution has to diffuse through (especially bone).
How is inflitration anaesthesia administered
- Point the needle towards the root apex
- Inject 1ml of the solution
- Solution diffuses through the porous cortical bone to reach the nerve
- It then acts by knocking out the nerve and the labial soft tissue
When does inflitration technique work best? & when does it not work as well?
Works best when:
- adminstered where there is thin porous bone - upper anteriors
- Might work on lower molars when articane is used rather than lidocaine as articaine has better diffusive properties
Difficult to work:
- On upper molars due to thicker bone of the zygomatic process & the divergent root (more difficult for the solution to reach divergent root) > better to inject in a different region to reach the root e.g. palate
Will not work:
- inflitration with lidocaine on lower molars will never work due to the very dense outer cortical bone
What type of anaesthesia is this? How does it work?
- This is regional (block) anaesthesia
* it works by blocking the nerve trunk often at close proximity from the targeted nerve
What are the most common regional blocks?
- Inferior alveolar nerve block - inferior teeth
- mental and incisive
- Lingual - tongue region
- long buccal - cheek region (both upper and lower teeth)
- Greater palatine & naso palatine (only upper arch amd is more complicated)
How does the inferior alveolar block work?
- It’s injected in the back of the mouth where the nerve is exposed to knock out the lower anterior regeion
What are the different supplementary techniques? Explain each one
- Intraosseous Technique - not commonly used
- Direct intraosseous - Drill the cortical bone and insertthe needle in the drilled hole to inject into cortical bone
- indirect intraosseous - force needle throgh cortical bone and inject
- Intraligamentary Technique - more commonly used
- You inject the PDL space between tooth and bone
- Pressure is key
- Sucess rate varies
What percentage of people avoid attending the dentist as a result of fear?
- 45%
