Additional Information
Book Details
Abstract
Prepare for practice with the only book on local anesthesia written specifically for dental hygienists! Local Anesthesia for the Dental Hygienist, 2nd Edition, provides complete instructions for the safe and effective administration of local anesthesia. Written by noted dental hygiene educator Demetra Logothetis, the first edition won a 2012 PROSE Honorable Mention award. This edition adds a new chapter on children and adolescent patients, plus new coverage of anesthetic agents and advanced techniques. With colorful and detailed illustrations showing dental anatomy and hundreds of clinical photos of injection techniques, as well as discussions of the Human Needs Paradigm to promote patient-centered care, this reference prepares you for success on board exams and confidence in practice.
- Clear, approachable writing style makes it easier to learn proper techniques and gain confidence, acknowledging not only the patient’s fear of injection but also the fears of the inexperienced clinician.Â
- An outstanding art program features more than 500 full-color photographs and illustrations.Â
- Technique and Procedures boxes provide illustrated, step-by-step instructions for performing specific procedures, including indications, contraindications, nerves and teeth affected, operator and patient positioning, insertion point, penetration, amount of anesthetic, and working time.
- Color-coded anesthesia boxes match the color scheme developed and used by the ADA (American Dental Association) and help in choosing the best agent for the type of anesthesia required, providing images, selection tips, precautions, and maximum dosing information.Â
- Review questions at the end of each chapter provide the opportunity to assess your understanding, and the Evolve companion website provides a 55-question mock examination and chapter practice quizzes.Â
- Case studies make it easier to apply concepts to the clinical setting and to develop problem-solving skills.
- Dental Hygiene Considerations boxes summarize key points and tips for optimal care.
- Key terms are highlighted within the text and defined in the glossary.Â
- Learning objectives begin each chapter and set goals for what you will accomplish; they also help you study for examinations.
- A focus on the Human Needs Theory relates the administration of local anesthesia and dental hygiene care to the eight human needs.
- Summary tables and boxes help you review and study concepts, procedures, and techniques.Â
- Expert author Demetra Logothetis is a dental hygiene educator with 20 years of experience teaching local anesthesia and pain control.
- End-of-chapter resources include lists of current, evidence-based literature for further research or study.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| IFC | ES1 | ||
| LOCAL ANESTHESIA for the DENTAL HYGIENIST | i | ||
| Copyright | ii | ||
| Dedication | iii | ||
| REVIEWERS | iv | ||
| CONTRIBUTORS | v | ||
| PREFACE | vi | ||
| INTENDED AUDIENCE | vi | ||
| NEW TO THIS EDITION | vi | ||
| ORGANIZATION | vi | ||
| KEY FEATURES | vii | ||
| EVOLVE COMPANION WEBSITE | vii | ||
| Question Test Bank | vii | ||
| Image Collection | vii | ||
| Case Studies | vii | ||
| Review Questions and Rationales | vii | ||
| Technique Appendices | vii | ||
| Case Discussions | vii | ||
| Practice Quizzes | vii | ||
| Full Glossary | viii | ||
| Supplemental Material | viii | ||
| ACKNOWLEDGMENTS | ix | ||
| TABLE OF CONTENTS | x | ||
| I - Introduction to Pain Control | 1 | ||
| 1 - Local Anesthesia in Dental Hygiene Practice: An Introduction | 2 | ||
| Introduction | 2 | ||
| HISTORY OF PAIN CONTROL | 2 | ||
| History of Local Anesthetics | 2 | ||
| ANESTHESIA IN DENTAL HYGIENE PRACTICE | 3 | ||
| PATIENT PERCEPTION OF LOCAL ANESTHESIA | 6 | ||
| HUMAN-NEEDS PARADIGM | 7 | ||
| Management of Fearful Patients | 8 | ||
| Stress Reduction Principles | 8 | ||
| 2 - Neurophysiology | 11 | ||
| INTRODUCTION | 11 | ||
| ORGANIZATION OF THE NERVOUS SYSTEM | 11 | ||
| Central and Peripheral Nervous Systems | 11 | ||
| Afferent and Efferent Divisions | 11 | ||
| Somatic and Autonomic Nervous Systems | 11 | ||
| NEUROANATOMY | 12 | ||
| Structure of Neurons | 13 | ||
| Classification of Neurons | 14 | ||
| Functional Regions of a Sensory Neuron | 14 | ||
| Dendritic (Input) Zone | 15 | ||
| Cell Body (Soma) | 15 | ||
| Axon Hillock (Summation Zone) | 15 | ||
| Axon | 15 | ||
| Output Zone (Synaptic Knobs) | 15 | ||
| Peripheral Nerve Anatomy | 16 | ||
| Myelinated Nerve | 16 | ||
| Nonmyelinated Nerve | 17 | ||
| Classification of Nerve Fibers | 18 | ||
| Neurophysiology | 19 | ||
| Depolarization and Firing Thresholds | 20 | ||
| Repolarization | 21 | ||
| Return to Resting State | 23 | ||
| MODE OF ACTION OF LOCAL ANESTHETICS | 23 | ||
| II - Local and Topical Anesthetic Agents | 27 | ||
| 3 - Pharmacology of Local Anesthetic Agents | 28 | ||
| INTRODUCTION | 28 | ||
| CHEMISTRY | 28 | ||
| ROUTES OF DELIVERY | 29 | ||
| PHARMACODYNAMICS OF LOCAL ANESTHETIC DRUGS | 29 | ||
| Infection in the Area of Injection | 32 | ||
| Buffering of Local Anesthetics | 32 | ||
| MECHANISM OF ACTION OF LOCAL ANESTHETIC AGENTS | 33 | ||
| Specific Protein Receptor Theory | 33 | ||
| The Membrane Expansion Theory | 33 | ||
| PHARMACOKINETICS OF LOCAL ANESTHETIC DRUGS | 33 | ||
| Onset of Action | 34 | ||
| Induction of Local Anesthetics | 34 | ||
| Induction Time | 35 | ||
| Recovery from Local Anesthetic Block | 35 | ||
| Reinjection of Local Anesthetic | 35 | ||
| Duration of Anesthesia | 35 | ||
| Absorption of Local Anesthetics | 35 | ||
| Distribution of Local Anesthetics | 36 | ||
| Metabolism (Biotransformation) of Local Anesthetics | 36 | ||
| Ester Local Anesthetics | 36 | ||
| Amide Local Anesthetics | 36 | ||
| Excretion of Local Anesthetics | 36 | ||
| Systemic Effects of Local Anesthetics | 37 | ||
| Effect of Local Anesthetics on the Central Nervous System | 37 | ||
| Effect of Local Anesthetics on the Cardiovascular System | 37 | ||
| 4 - Pharmacology of Vasoconstrictors | 41 | ||
| INTRODUCTION | 41 | ||
| CHEMISTRY | 41 | ||
| THE USE OF VASOCONSTRICTORS IN DENTISTRY | 42 | ||
| EPINEPHRINE (ADRENALIN) | 42 | ||
| Mechanism of Action | 43 | ||
| Epinephrine Dilutions | 44 | ||
| Sodium Bisulfite Preservative | 45 | ||
| Actions of Epinephrine on Specific Systems and Tissue | 45 | ||
| Termination of Action | 46 | ||
| Maximum Recommended Dose | 46 | ||
| LEVONORDEFRIN (NEO-COBEFRIN) | 46 | ||
| Actions of Levonordefrin on Specific Systems and Tissue | 46 | ||
| Termination of Action | 47 | ||
| Maximum Recommended Dose | 47 | ||
| Phenylephrine (Neo-Synephrine) | 47 | ||
| Felypressin | 47 | ||
| SIDE EFFECTS AND OVERDOSE OF VASOCONSTRICTORS | 47 | ||
| 5 - Local Anesthetic Agents | 51 | ||
| COMPOSITION OF LOCAL ANESTHETIC AGENTS | 51 | ||
| SELECTION OF LOCAL ANESTHETIC AGENTS | 51 | ||
| Duration of Action and Operative Pain Control | 52 | ||
| Posttreatment Pain Control | 54 | ||
| Patient Health Assessment and Current Patient Medications | 55 | ||
| Local Anesthetic, Sodium Bisulfite, and Metabisulfite Allergy | 55 | ||
| Need for Hemostasis | 55 | ||
| Mepivacaine | 57 | ||
| Prilocaine | 57 | ||
| Articaine | 59 | ||
| Bupivacaine | 68 | ||
| ESTER LOCAL ANESTHETIC | 69 | ||
| Procaine | 69 | ||
| APPENDIX 5-1 Summary of Amide Local Anesthetic Agents and Vasoconstrictors | 77 | ||
| 6 - Topical Anesthetic Agents | 78 | ||
| INTRODUCTION | 78 | ||
| MECHANISM OF ACTION OF TOPICAL ANESTHETICS | 78 | ||
| TOPICAL ANESTHETIC FORMS AND METHODS OF DELIVERY | 78 | ||
| Lidocaine | 82 | ||
| Dyclonine Hydrochloride | 83 | ||
| Tetracaine Hydrochloride | 83 | ||
| COMBINATIONS OF TOPICAL DRUGS | 83 | ||
| Benzocaine, Butamben, and Tetracaine | 84 | ||
| Eutectic Mixtures | 85 | ||
| EMLA: 2.5% Lidocaine/2.5% Prilocaine Cream | 85 | ||
| Oraqix: 2.5% Lidocaine/2.5% Prilocaine Gel | 85 | ||
| SPECIAL CONSIDERATIONS | 87 | ||
| III - Patient Assessment | 90 | ||
| 7 - Preanesthetic Assessment | 91 | ||
| INTRODUCTION | 91 | ||
| MEDICAL, DENTAL, AND DIALOGUE HISTORY | 91 | ||
| Vital Signs | 95 | ||
| Blood Pressure | 95 | ||
| Pulse | 95 | ||
| Respiration | 95 | ||
| Weight | 96 | ||
| PSYCHOLOGICAL EVALUATION | 96 | ||
| Adequate Pain Control and the Fear of the Needle | 97 | ||
| Selection of Local Anesthetic for the Anxious Patient | 97 | ||
| RISK ASSESSMENT | 98 | ||
| CONTRAINDICATIONS TO LOCAL ANESTHESIA | 99 | ||
| VASOCONSTRICTOR DRUG-DRUG INTERACTIONS | 99 | ||
| Tricyclic Antidepressants | 100 | ||
| Nonselective β Blockers | 100 | ||
| Cardiac Drugs | 100 | ||
| Phenothiazides | 100 | ||
| Illegal (Recreational) Drugs (Cocaine, Methamphetamine) | 100 | ||
| VASOCONSTRICTORS AND SYSTEMIC DISEASE INTERACTIONS | 100 | ||
| Cardiovascular Disease | 100 | ||
| Hyperthyroidism | 101 | ||
| Asthma | 101 | ||
| Sickle Cell Anemia | 101 | ||
| ALLERGIES | 101 | ||
| ESTER DERIVATIVE LOCAL ANESTHETIC INTERACTIONS | 102 | ||
| Sulfonamides | 102 | ||
| Atypical Plasma Cholinesterase | 102 | ||
| AMIDE LOCAL ANESTHETIC DRUG/DRUG INTERACTIONS | 102 | ||
| Histamine H2 Receptor Blockers | 102 | ||
| Beta Blockers | 103 | ||
| Methemoglobinemia | 103 | ||
| Liver Disease | 103 | ||
| Kidney Disease | 103 | ||
| Pregnancy | 103 | ||
| Bleeding Disorders | 104 | ||
| 7-1 - Sample Medical History Form in English/Spanish | 107 | ||
| 8 - Determining Drug Doses | 110 | ||
| INTRODUCTION | 110 | ||
| MAXIMUM RECOMMENDED DOSES OF LOCAL ANESTHETIC DRUGS | 110 | ||
| Calculation of Maximum Recommended Dose for Local Anesthetic Drugs | 111 | ||
| Step 1: Obtain Necessary Patient Information | 111 | ||
| Step 2: Calculate Milligrams of Selected Anesthetic Drug in One Cartridge | 111 | ||
| Step 3: Calculate Patient’s Maximum Recommended Dose of Anesthetic in Milligrams | 112 | ||
| Step 4: Convert Maximum Recommended Dose of Anesthetic to Cartridges | 112 | ||
| Step 5 (Optional): Convert Maximum Cartridges of Anesthetic to Milliliters | 113 | ||
| CALCULATING MILLIGRAMS OF ANESTHETIC ADMINISTERED | 113 | ||
| CALCULATING ADDITIONAL DOSES OF THE SAME DRUG | 113 | ||
| CALCULATING ADDITIONAL DOSES OF DIFFERENT DRUGS | 113 | ||
| MAXIMUM RECOMMENDED DOSE OF ANESTHETIC FOR MEDICALLY COMPROMISED PATIENTS AND ELDERLY PATIENTS | 115 | ||
| MAXIMUM RECOMMENDED DOSE OF ANESTHETIC FOR PEDIATRIC PATIENTS | 115 | ||
| Calculating Pediatric Doses | 115 | ||
| VASOCONSTRICTOR DOSES | 116 | ||
| Vasoconstrictor Dilutions | 116 | ||
| Maximum Recommended Dose for Vasoconstrictor Drugs | 116 | ||
| Calculating Vasoconstrictor Drug Doses | 116 | ||
| Step 1: Obtain necessary patient information | 116 | ||
| Step 2: Calculate Milligrams of Vasoconstrictor in One Cartridge of Anesthetic | 117 | ||
| Step 3: Obtain Maximum Recommended Dose of Vasoconstrictor | 117 | ||
| Step 4: Convert Maximum Recommended Dose of Vasoconstrictor to Cartridges | 117 | ||
| Step 5 (Optional): Convert Maximum Cartridges of Vasoconstrictor to Milliliters | 118 | ||
| CALCULATING MILLIGRAMS OF VASOCONSTRICTOR ADMINISTERED | 118 | ||
| Calculating Additional Doses of the Same Vasoconstrictor | 118 | ||
| DETERMINING THE LIMITING DRUG | 118 | ||
| 8-1 - Summary of Local Anesthetic Agents and Vasoconstrictors | 121 | ||
| 8-2 - Comparison of Previous and Current Maximum Recommended Doses of Local AnestheticDrugs per Appointment for Healthy Patients | 122 | ||
| 8-3 - Dosing Information for Regional Local AnesthesiaBoard Examinations Requiring CalculationsBased on 1.7 mL of Solution | 123 | ||
| IV - Local Anesthetic Techniques for the Dental Hygienist | 128 | ||
| 9 - Armamentarium/Syringe Preparation | 129 | ||
| INTRODUCTION | 129 | ||
| SYRINGES | 129 | ||
| Syringe Barrel | 129 | ||
| Piston and Harpoon | 130 | ||
| Finger Grip | 130 | ||
| Thumb Ring | 131 | ||
| TYPES OF LOCAL ANESTHETIC SYRINGES | 131 | ||
| Reusable Breech-Loading Metallic Cartridge-Type Aspirating Syringe | 132 | ||
| Reusable Breech-Loading Metallic Cartridge-Type Self-Aspirating Syringe | 132 | ||
| Reusable Breech-Loading Plastic Cartridge-Type Aspirating Syringe | 133 | ||
| Pressure-Type Syringes | 133 | ||
| Jet Injector Syringe | 134 | ||
| Computer-Controlled Local Anesthetic Delivery Devices | 134 | ||
| Disposable Safety Syringes | 135 | ||
| Routine Maintenance of Reusable Syringes | 136 | ||
| NEEDLE | 138 | ||
| Shaft | 139 | ||
| Hub | 140 | ||
| Cartridge-Penetrating End | 140 | ||
| Needle Shields | 141 | ||
| Gauge | 141 | ||
| Length | 143 | ||
| Care and Handling of Needles | 144 | ||
| Needle Problems | 144 | ||
| Pain on Insertion | 144 | ||
| Pain on Withdrawal | 144 | ||
| Needlestick Exposure to the Clinician | 144 | ||
| Needle Breakage | 144 | ||
| ANESTHETIC CARTRIDGES | 145 | ||
| Cartridge Components | 145 | ||
| The Glass Cylinder | 145 | ||
| Cartridge Labeling | 145 | ||
| Silicone Rubber Stopper | 145 | ||
| Diaphragm | 146 | ||
| Aluminum Cap | 146 | ||
| Care and Handling of the Cartridge | 146 | ||
| Cartridge Problems | 147 | ||
| Bubble in the Cartridge | 147 | ||
| Extruded Stopper | 147 | ||
| Sticky Stopper | 147 | ||
| Burning on Injection | 147 | ||
| Corroded Cap | 148 | ||
| Rust on Cap | 148 | ||
| Leakage during Injection | 148 | ||
| Broken Cartridge | 148 | ||
| SUPPLEMENTARY ARMAMENTARIUM | 148 | ||
| Topical Antiseptic | 148 | ||
| Topical Anesthetic | 148 | ||
| Applicator Sticks | 148 | ||
| Gauze | 148 | ||
| Hemostat or Cotton Pliers | 148 | ||
| PREPARATION OF THE BREECH-LOADING ASPIRATING SYRINGE | 149 | ||
| UNLOADING THE BREECH-LOADING ASPIRATING SYRINGE | 149 | ||
| ASSEMBLY OF THE WAND STA COMPUTER-CONTROLLED LOCAL ANESTHETIC DELIVERY SYSTEM | 149 | ||
| DISASSEMBLY OF THE WAND STA COMPUTER-CONTROLLED LOCAL ANESTHETIC DELIVERY SYSTEM | 149 | ||
| 10 - Anatomic Considerations for Local Anesthesia Administration | 167 | ||
| INTRODUCTION TO ANATOMIC CONSIDERATIONS | 167 | ||
| OROFACIAL SKULL BONES | 167 | ||
| Maxillae | 167 | ||
| Palatine Bones | 169 | ||
| Mandible | 170 | ||
| TRIGEMINAL NERVE | 173 | ||
| Ophthalmic Nerve | 173 | ||
| Maxillary Nerve | 174 | ||
| Zygomatic Nerve | 175 | ||
| Infraorbital Nerve | 175 | ||
| Anterior Superior Alveolar Nerve | 176 | ||
| Middle Superior Alveolar Nerve | 176 | ||
| Posterior Superior Alveolar Nerve | 178 | ||
| Greater and Lesser Palatine Nerves | 178 | ||
| Nasopalatine Nerve | 178 | ||
| Mandibular Nerve | 178 | ||
| Buccal Nerve | 178 | ||
| Muscular Branches and Auriculotemporal Nerve | 179 | ||
| Lingual Nerve | 181 | ||
| Inferior Alveolar Nerve | 182 | ||
| Mental Nerve | 182 | ||
| Incisive Nerve | 183 | ||
| Mylohyoid Nerve | 183 | ||
| FACIAL NERVE | 183 | ||
| VASCULAR AND GLANDULAR STRUCTURES | 183 | ||
| External Carotid Artery Orofacial Branches | 184 | ||
| Lingual Artery | 184 | ||
| Maxillary Artery | 184 | ||
| Pterygoid Plexus Of Veins | 187 | ||
| Maxillary Vein | 187 | ||
| 11 - Basic Injection Techniques | 190 | ||
| ADMINISTRATION TECHNIQUES | 190 | ||
| Surface Anesthesia | 190 | ||
| Local Infiltration | 190 | ||
| Supraperiosteal Injection | 190 | ||
| Nerve Block | 190 | ||
| STEPS TO PROVIDING A SUCCESSFUL INJECTION | 191 | ||
| Step 1: Preanesthetic Patient Assessment and Consultation | 191 | ||
| Determining Patient Anxiety | 191 | ||
| Selection of Anesthetic | 192 | ||
| Step 2: Confirm Care Plan | 192 | ||
| Step 3: Informed Consent | 192 | ||
| Step 4: Selection of Injection | 193 | ||
| Step 5: Preparation of Equipment | 196 | ||
| Step 6: Check the Anesthetic Equipment | 196 | ||
| Step 7: Patient Position | 197 | ||
| Step 8: Tissue Preparation and Patient Communication | 197 | ||
| Step 9: Dry Tissue and Visualize or Palpate the Penetration Site | 197 | ||
| Step 10: Establish a Fulcrum | 197 | ||
| Step 11: Make Tissue Taut | 199 | ||
| Step 12: Keep Syringe out of Patient’s Sight | 199 | ||
| Step 13: Gently Insert the Needle, Watch, Communicate | 199 | ||
| Step 14: Aspiration | 201 | ||
| Step 15: Slowly Deposit the Local Anesthetic Agent | 203 | ||
| Step 16: Slowly Withdraw the Syringe and Safely Cap the Needle | 203 | ||
| Step 17: Observe the Patient for Possible Reaction to Anesthetic | 204 | ||
| Step 18: Document Procedure | 204 | ||
| BASIC INJECTION TECHNIQUES FOR COMPUTER CONTROLLED LOCAL ANESTHETIC DELIVERY | 204 | ||
| Steps to Achieving a Successful Supraperiosteal Injection Using the Wand STA System | 204 | ||
| Steps to Achieving a Successful Inferior Alveolar Block Using the Wand STA | 204 | ||
| Steps to Achieving a Successful Anterior Middle Superior Alveolar Block Using the Wand STA | 204 | ||
| 11-1 - Sharps Management: Centers for Disease Controland Prevention Guidelines for Infection Controlin the Dental Health Care Setting1 | 209 | ||
| EXPOSURE PREVENTION FACTS | 209 | ||
| STANDARD PRECAUTIONS | 209 | ||
| Strategic steps for needlestick prevention programs | 209 | ||
| 11-2 - Safe and Unsafe Needle Recapping Techniques | 210 | ||
| 12 - Maxillary Anesthesia | 213 | ||
| INTRODUCTION TO MAXILLARY ANESTHESIA | 213 | ||
| MAXILLARY SUPPLEMENTAL INJECTIONS | 213 | ||
| Maxillary Supraperiosteal Injection | 214 | ||
| Target Area and Injection Site for Supraperiosteal Injection | 214 | ||
| Indications of Clinically Effective Supraperiosteal Injection and Possible Complications | 216 | ||
| Maxillary Intraseptal Injection | 216 | ||
| Target Area and Injection Site for Intraseptal Injection | 217 | ||
| Indications of Clinically Effective Intraseptal Injection and Possible Complications | 217 | ||
| Maxillary Periodontal Ligament Injection | 217 | ||
| MAXILLARY FACIAL NERVE BLOCKS | 219 | ||
| Posterior Superior Alveolar Block | 221 | ||
| Target Area and Injection Site for Posterior Superior Alveolar Block | 222 | ||
| Indications of Clinically Effective Posterior Superior Alveolar Block and Possible Complications | 226 | ||
| Middle Superior Alveolar Block | 227 | ||
| Target Area and Injection Site for Middle Superior Alveolar Block | 228 | ||
| Indications of Clinically Effective Middle Superior Alveolar Block and Possible Complications | 230 | ||
| Anterior Superior Alveolar Block | 230 | ||
| Target Area and Injection Site for Anterior Superior Alveolar Block | 234 | ||
| Indications of Clinically Effective Anterior Superior Alveolar Block and Possible Complications | 235 | ||
| Infraorbital Block | 235 | ||
| Target Area and Injection Site for Infraorbital Block | 235 | ||
| Indications of Clinically Effective Infraorbital Block and Possible Complications | 238 | ||
| PALATAL NERVE BLOCKS | 239 | ||
| Greater Palatine Block | 240 | ||
| Target Area and Injection Site for Greater Palatine Block | 243 | ||
| Indications of Clinically Effective Greater Palatine Block and Possible Complications | 244 | ||
| Nasopalatine Block | 244 | ||
| Target Area and Injection Site for Nasopalatine Block | 247 | ||
| Indications of Clinically Effective Nasopalatine Block and Possible Complications | 247 | ||
| Anterior Middle Superior Alveolar Block | 247 | ||
| Target Area and Injection Site for Anterior Middle Superior Alveolar Block | 250 | ||
| Indications of Clinically Effective Anterior Middle Superior Alveolar Block and Possible Complications | 250 | ||
| COMMON TECHNIQUE ERRORS ASSOCIATED WITH MAXILLARY INJECTIONS | 250 | ||
| Common Errors with Supraperiosteal Injections, Anterior Superior Alveolar, or Middle Superior Alveolar Blocks | 250 | ||
| Common Errors with Posterior Superior Alveolar Block | 251 | ||
| Common Errors with Infraorbital Block | 251 | ||
| 12-1 - ContinuedSummary of Maxillary Injections | 257 | ||
| 13 - Mandibular Anesthesia | 260 | ||
| INTRODUCTION TO MANDIBULAR ANESTHESIA | 260 | ||
| MANDIBULAR NERVE BLOCKS | 261 | ||
| INFERIOR ALVEOLAR BLOCK | 261 | ||
| Target Area and Injection Site for Inferior Alveolar Block | 265 | ||
| Inferior Alveolar Block Troubleshooting Paradigm | 268 | ||
| Indications of Clinically Effective Inferior Alveolar Block and Possible Complications | 270 | ||
| BUCCAL BLOCK | 272 | ||
| Target Area and Injection Site for Buccal Block | 275 | ||
| Indications of Clinically Effective Buccal Block and Possible Complications | 276 | ||
| MENTAL BLOCK | 276 | ||
| Target Area and Injection Site for Mental Block | 276 | ||
| Indications of Clinically Effective Mental Block and Possible Complications | 279 | ||
| INCISIVE BLOCK | 280 | ||
| Target Area and Injection Site for Incisive Block | 282 | ||
| Indications of Clinically Effective Incisive Block and Possible Complications | 283 | ||
| GOW-GATES MANDIBULAR BLOCK | 283 | ||
| Target Area and Injection Site for Gow-Gates Mandibular Block | 283 | ||
| Gow-Gates Mandibular Block Troubleshooting Paradigm | 285 | ||
| Indications of Clinically Effective Gow-Gates Mandibular Block and Possible Complications | 286 | ||
| VAZIRANI-AKINOSI MANDIBULAR BLOCK | 287 | ||
| Target Area and Injection Site for Vazirani-Akinosi Mandibular Block | 290 | ||
| Vazirani-Akinosi Mandibular Block Troubleshooting Paradigm | 291 | ||
| Indications of Clinically Effective Vazirani-Akinosi Mandibular Block and Possible Complications | 291 | ||
| MANDIBULAR SUPPLEMENTAL INJECTIONS | 291 | ||
| Mandibular Supraperiosteal Injection | 292 | ||
| Mandibular Intraseptal Injection | 292 | ||
| Mandibular Periodontal Ligament Injection | 292 | ||
| Target Area and Injection Site for Periodontal Ligament Injection | 293 | ||
| Indications of Clinically Effective Periodontal Ligament and Possible Complications | 296 | ||
| 13-1 - Summary of Mandibular Injections | 300 | ||
| Summary of Maxillary and Mandibular Injection Techniques With Distribution of Anesthesia | 303 | ||
| 14 - Local Anesthesia for the Child and Adolescent | 304 | ||
| INTRODUCTION | 304 | ||
| LOCAL ANESTHETIC SYSTEMIC TOXICITY IN CHILDREN | 304 | ||
| Preventing Local Anesthetic Systemic Toxicity: Calculating Maximum Recommended Dose | 304 | ||
| LOCAL ANESTHETIC AGENT SELECTION FOR CHILDREN | 305 | ||
| Postoperative Soft Tissue Injury | 305 | ||
| Preventive Measures of Soft Tissue Injury | 305 | ||
| Management of Self-Inflicted Soft Tissue Trauma | 306 | ||
| LOCAL ANESTHESIA DELIVERY TECHNIQUES | 306 | ||
| Patient Preparation | 306 | ||
| Apply Topical Anesthetic | 306 | ||
| Stabilization and Communication | 306 | ||
| Maxillary Anesthesia | 306 | ||
| Mandibular Anesthesia | 307 | ||
| 15 - Local Anesthetic Complications | 313 | ||
| INTRODUCTION | 313 | ||
| LOCAL COMPLICATIONS | 313 | ||
| Needle Breakage | 313 | ||
| Pain During Injection | 316 | ||
| Proper Technique | 316 | ||
| Sharp Needles | 316 | ||
| Topical Anesthetic | 316 | ||
| Anesthetics Placed in Disinfecting Solution | 316 | ||
| Inject Slowly | 316 | ||
| Room Temperature Agents | 317 | ||
| Burning During Injection | 317 | ||
| Hematoma | 317 | ||
| Management of Hematoma | 317 | ||
| Transient Facial Paralysis | 317 | ||
| Paresthesia | 320 | ||
| Trismus | 320 | ||
| Infection | 321 | ||
| Edema | 322 | ||
| Soft Tissue Trauma | 322 | ||
| Phentolamine Mesylate | 322 | ||
| Tissue Sloughing | 324 | ||
| Postanesthetic Intraoral Lesions | 324 | ||
| SYSTEMIC COMPLICATIONS | 324 | ||
| Local Anesthetic Overdose | 325 | ||
| Clinical Manifestations of Overdose | 326 | ||
| Central nervous system signs | 326 | ||
| Cardiovascular signs | 326 | ||
| Management of Local Anesthetic Overdose | 326 | ||
| Epinephrine Overdose | 326 | ||
| Causes and Prevention of Epinephrine Overdose | 327 | ||
| Clinical Manifestations and Management of Epinephrine Overdose | 327 | ||
| ALLERGIC MANIFESTATIONS | 328 | ||
| Prevention of Allergic Reactions | 328 | ||
| Clinical Manifestations and Management of Allergic Reactions | 328 | ||
| MANAGEMENT OF MEDICAL EMERGENCIES | 330 | ||
| 16 - Legal Considerations and Risk Management | 336 | ||
| RISK MANAGEMENT | 336 | ||
| Communication | 336 | ||
| Legal Issues Related to the Dental Hygienist | 336 | ||
| Documentation | 338 | ||
| EXPOSURE PREVENTION AND MANAGEMENT | 339 | ||
| Risk Reduction Protocol | 339 | ||
| Postexposure Management | 340 | ||
| GLOSSARY | 345 | ||
| A | 350 | ||
| B | 351 | ||
| C | 352 | ||
| D | 353 | ||
| E | 353 | ||
| F | 354 | ||
| G | 354 | ||
| H | 354 | ||
| I | 354 | ||
| J | 355 | ||
| K | 355 | ||
| L | 355 | ||
| M | 357 | ||
| N | 358 | ||
| O | 359 | ||
| P | 359 | ||
| Q | 360 | ||
| R | 360 | ||
| S | 361 | ||
| T | 362 | ||
| U | 362 | ||
| V | 362 | ||
| W | 363 | ||
| Z | 363 | ||
| IBC | ES2 | ||
| IBC | ES3 |