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Maximize performance and survivability of the warfighter
IDC
Dental Anesthesia
UNIT 14.1
CAPT RONCONE, DC, USN
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Maximize performance and survivability of the warfighter
EO 2
• Basic injection techniques for local
anesthesia.
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Maximize performance and survivability of the warfighter
Dental Anesthesia
• Indications:
– Control dental pain resulting from pathology or trauma
– Manage anatomic area for dental procedure(s)
– Limit the amount of medication given
– Around infection sites for I&D
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Dental Anesthesia
• Contraindications:
- Hx of allergy or reaction to local
anesthetic
–ALWAYS review Health Questionnaire
and pay close attention to allergies to
agent
–Uncooperative patients
–Patients at risk for hematoma
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Dental Anesthesia
• Complications:
– Syncope
– Broken needle
– Bleeding/Hematoma
– Persistent paresthesia
– Ischemic ulcer
– Blanching
– Tachycardia
– Paralysis
– Visual disturbance
– Over dosage
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Equipment
10 mL Luer-Lok syringe Dental Anesthetic Syringe
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Equipment
long or short needle 27 Gauge Long needle
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Equipment
2% Lidocaine with 1;100K epi .5% Bupivacaine with 1:200K epi
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Equipment
Syringe harpoon Must be engaged in stopper
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Aspirating Dental Syringe
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Topical Anesthetic
20% Benzocaine Apply with applicator to injection site
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Dental Anesthesia
• Two basic techniques:
1. Local Infiltration (near the tooth)
2. Regional Block (a nerve block)
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Maximize performance and survivability of the warfighter
Dental Anesthesia
• Infiltration
–Primary mode for maxillary teeth
1. Approximate needle tip to apex of
tooth (local nerve block at the level of
the apical foramen)
2. Aspirate
3. Deliver local anesthetic (SLOWLY)
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Local Infiltration
Maxillary Local Infiltration
Short (20-25 mm) needle Block nerve impulses at the
level of the Apical Foramen
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Maxillary Local Anesthesia
Mucobuccal Fold Short Needle: hub to the free gingival margin
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Maxillary Local Anesthesia
Mid-line of tooth, parallel with the root
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Maximize performance and survivability of the warfighter
Maxillary Local Anesthesia
Needle hub to the free gingival margin
Local (single tooth)
anesthesia
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Trigeminal Nerve: V3
Foramen Ovale:
5th (V) Cranial Nerve Branches of V3
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Maximize performance and survivability of the warfighter
Dental Anesthesia
• Block (nerve)
–Primary mode for mandibular teeth
1. Approximate needle tip near
inferior alveolar canal and/or mental
foramen
2. Aspirate
3. Deliver local anesthetic
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Mandibular Intraoral Block
Inferior Alveolar Nerve
(V3) and Artery
Entering the Mandibular
Canal
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Mandibular Intraoral Block
Inferior Alveolar Nerve
Needle Target Site
Anesthesia of entire hemi-
mandible
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Mandibular Intraoral Block
• V3 Block Anterior Landmark: Coronoid Notch
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Maximize performance and survivability of the warfighter
Mandibular Intraoral Block
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Maximize performance and survivability of the warfighter
Mandibular Intraoral Block
IA Nerve Block: proper depth of (long) needle insertion
Hemi-mandibular Anesthesia
will be achieved
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Maximize performance and survivability of the warfighter
Mandibular Intraoral Block
IA Nerve Block: needle inserted too far to the anterior
Too far from the Lingula
and Mandibular Canal
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Questions?