Local Anesthesia in Dentistry

Question 1

What are the three branches of the trigeminal nerve

Answer 1

1. ophthalmic
2. maxillary
3. Mandibular

Question 2

What are the relevant branches of the maxillary nerve

Answer 2

1. infraorbital nerve (ASA, MSA, upper teeth, upper lip, cheek, side of the nose)
2. zygomatical facial (lateral Cheek)
3. zygomatical temporal (side of forehead)

Question 3

What are the relevant branches of the mandibular nerve

Answer 3

1. buccal nerve (mucosa of the mouth and buccal gingiva)
2. lingual nerve (anterior 2/3 of tongue, lingual gingiva, and lingual mucosa)
3. inferior alveolar nerve (lower teeth, gums)
4. Mental nerve (chin and lower lip)

Question 4

What color is the cartridge for 2% lidocaine 1/100000 EPI

Answer 4

Red

Question 5

what color is the cartridge for .5% bupivicaine (Marcaine) with EPI

Answer 5

Blue

Question 6

What color is the cartridge for 2% mepivicaine (carbocaine) Without EPI

Answer 6

Brown

Question 7

What color is the cartridge for 4% articaine (septocaine) with 1/100000 EPI

Answer 7

Gold

Question 8

What is the other name for lidocaine

Answer 8

lidocaine

Question 9

what is the other name for articaine

Answer 9

septocaine

Question 10

what is the other name for marcaine

Answer 10

bupivicaine

Question 11

what is the other name for mepivicaine

Answer 11

carbocaine

Question 12

When is an inferior alveolar block indicated

Answer 12

• anesthetizing mandibular molars

- anesthetizing premolars, canines, incisors

Question 13

Where do you deposit the anesthetic when performing an inferior alveolar block

Answer 13

near the Inferior Alveolar nerve as it enters the mandibular foramen

Question 14

What are the steps in administering an inferior alveolar nerve block

Answer 14

1. patient must open mouth wide
2. palpate internal and external oblique ridges and not pterygomandibular raphe
3. insert the needle .5 cm slightly above the occlusal plane and lateral to the pterygomandibular raphe
4. inject .5ml of solution here for lingual nerve block
5. move needle horizontally to contact the lingula
6. slightly withdraw needle and inject remainder of anesthetic

Question 15

What must we understand about the nerve to mylohyoid

Answer 15

it can sometimes innervate teeth on the mandible, so if you are struggling to get profound anesthesia you may consider a mylohyoid nerve block

Question 16

What is a Gow Gates nerve block

Answer 16

when you inject LA higher upstream on the Inferior Alveolar nerve to get more complete anesthesia

Question 17

When do you use an akinosi technique

Answer 17

when the patient is unable to open their mouth

Question 18

how is an akinosi technique performed

Answer 18

patients mouth is closed, the needle is inserted parallel to the occlusal plane and at the height of the mucogingival junction of the maxilla

Question 19

Where is the mental foramen usually located

Answer 19

just apical to and between the first and second mandibular premolars

Question 20

what does a mental nerve block do

Answer 20

provide limited analgesia of premolars and canines, and to a lesser degree the incisors on the same side. also soft-tissue analgesia

Question 21

How is a mental nerve block performed

Answer 21

place the lip on tension and insert the needle parallel to the long axis of the premolars angling towards the bone and deposit LA, then massage the location to assist absorption.

Question 22

Why shouldn’t you try to directly administer LA to the mental foramen

Answer 22

because doing so could damage the nerve

Question 23

is the buccal nerve anesthetized when doing a IA nerve block

Answer 23

no

Question 24

What does the buccal nerve innervate

Answer 24

tissues and periosteum buccal to the molars

Question 25

When should the buccal nerve block be done

Answer 25

when the soft tissues are involved in the treatment, not when the treatment is only on the teeth

Question 26

How is a buccal nerve block performed

Answer 26

insert the needle about 2-4 mm deep into the mucous membrane distal to the last molar until you gently contact bone, aspirate, then deposit 1/8 of the cartridge

Question 27

how is a sublingual nerve block performed

Answer 27

place the needle just submucosally lingual to the premolars and use .5 ml of LA

Question 28

How is an infra-orbital block performed

Answer 28

you palpate the infraorbital foramen and place your finger on it, then pull back the lip and insert a 25 gauge long needle in the muccobuccal fold over the first premolar and insert the needle toward your finger but stop short of reaching the finger, depost LA.