Local Anaesthetic

Question 1

When can a dental therapist give LA

Answer 1

Scaling
RSD
Restorations
Deciduous extractions

Question 2

What should you do before giving LA?

Answer 2

Review medical history
Explain procedure
Obtain informed consent
Have a 3rd person who is CPR competent present

Question 3

Trigeminal Nerve

Answer 3

V cranial nerve
Mixed nerve
3 divisions - opthalmic, maxillary and mandibular
Maxillary - sensory only

Question 4

Branches of Maxillary division

Answer 4

in pterygopalatine fossa:

• PSD*
• zygomatic
• greater and lesser palatine*
• long sphenopalatine*
• pharyngeal

Question 5

PSD

Answer 5

• 2-3 nerves
• from ppf into infratemporal fossa
• some branches form a plexus with the MSD and ASD nerves
• other branches supply gingivae near molars

Question 6

Where does PSD supply?

Answer 6

• Pulps of upper molars
• gingivae of upper molars
• mucus membrane of antrum

Question 7

MSD

Answer 7

descends down the side of the antrum and joins plexus with PSD and ASD

Question 8

Where does MSD supply?

Answer 8

• pulps of upper premolars
• supporting tissues of upper premolars
• mesio-buccal root of upper 1st permanent molar (6)
• mucus membrane of antrum

Question 9

ASD

Answer 9

joins plexus with PSD and MSD

Question 10

Where does ASD supply?

Answer 10

• pulp and labial gingivae of upper anteriors
• nasal mucous membrane
• mucous membrane of antrum

Question 11

Greater palatine nerve

Answer 11

Emerges from GP foramen

Question 12

Where does G palatine supply?

Answer 12

• mucoperiosterum of hard palate

Question 13

Lesser palatine nerve

Answer 13

Emerges from LP foramen

Question 14

Where does L palatine supply?

Answer 14

• mucous membrane of soft palate and palatine tonsil

Question 15

Long sphenopalatine nerve

Answer 15

runs to incisive foramen

Question 16

Where does Long sphenopalatine nerve supply?

Answer 16

• mucous membrane around incisive papilla and palatal gingivae of upper incisors

Question 17

Which nerve supplies upper molars and buccal gingivae?

Answer 17

PSDN

Question 18

Which nerve supplies upper premolars and buccal gingivae?

Answer 18

MSD or in 50% of people, a plexus of PSD and ASD

Question 19

Which nerve supplies upper canines and incisors and labial gingivae incisive region?

Answer 19

ASD

Question 20

Which nerve supplies palatal gingivae in the upper molar/premolar region?

Answer 20

Greater palatine nerve

Question 21

Which nerve supplies palatal gingivae in the upper incisive region?

Answer 21

Long sphenopalatine

Question 22

Mandibular division

Answer 22

• sensory and motor nerve
• anterior and posterior division
• anterior is motor
• posterior is sensory

Question 23

Anterior division of mandibular division

Answer 23

• masseteric
• deep temporal
• nerve to lateral pterygoid
• buccal

Question 24

Buccal nerve of ant man div

Answer 24

• runs between heads of lateral pterygoid

Question 25

Where does buccal nerve supply?

Answer 25

- buccal mucosa and gingivae of lower molars and premolars

Question 26

Posterior division of mandibular division

Answer 26

Auriculotemporal Inferior Dental* Lingual *

Question 27

Inferior Dental Nerve

Answer 27

Enters mandibular foramen Runs in inferior dental canal. Branches off into mental and incisive nerve.

Question 28

Where does the ID nerve supply?

Answer 28

Pulps of lower molars and premolars

Question 29

Where does the mental nerve supply?

Answer 29

Mucous membrane of lower lip, skin of lip and chin

Question 30

Where does incisive Nerve supply?

Answer 30

Pulps of lower incisor teeth

Question 31

Lingual Nerve

Answer 31

Descends near ID nerve and runs along medial of mandible

Question 32

Where does the lingual nerve supply?

Answer 32

Sensation to: - anterior 2/3 of tongue - mucus membrane of FOM - lingual surface of alveolar process

Question 33

Which nerve supplies pulps of lower teeth?

Answer 33

Inferior dental nerve

Question 34

Which nerve supplies buccal gingivae of lower molars/premolars?

Answer 34

Buccal nerve

Question 35

Which nerve supplies the labial gingivae of premolars/incisors

Answer 35

Mental nerve

Question 36

Which nerve supplies the lingual gingivae?

Answer 36

Lingual nerve

Question 37

Why is blood supply to the teeth relevant when anesthetising?

Answer 37

- Injecting LA directly into blood vessel increases risk of toxicity. - LA effect will not last as long, as blood supply will carry it away - prevent trauma and bleeding

Question 38

External Carotid artery branches

Answer 38

``` Superior thyroid Ascending pharyngeal Lingual* Facial* Occipital Posterior auricular Maxillary* Superficial temporal ```

Question 39

Lingual Artery supply

Answer 39

Tongue - FOM - lingual mucosa - lower teeth

Question 40

Facial Artery Supply

Answer 40

- cheeks | - lips

Question 41

Maxillary Artery Branches

Answer 41

PSDA | Palatine

Question 42

Where does PSDA supply?

Answer 42

- buccal gingivae of molars - mucous membrane and maxillary antrum - molar teeth

Question 43

Where does Palatine artery supply?

Answer 43

- mucoperiosteum of hard palate towards incisive foramen

Question 44

Consent for LA

Answer 44

Verbal consent is sufficient