FINALS

• • a regional anesthesia confined to a specific limited part of the body without loss of consciousness
  • extraction
  • in cases of pedodontics, pulpectomy in live tooth


  Local Anesthesia
• prevent the normal passage of ions through the nerve membrane, thus preventing the conduction of nerve impulses


  Mode of Action of Anesthesia
• (1) Nerve block

  (a) IAN Block

  (b) Akinosi nerve block

  (c) Gow-Gates nerve block

  (d) Greater palatine nerve block

  (e) Nasopalatine nerve block

  (2) Field block

  (a) secondary branches of main nerves

  (3) Local infiltration

  (a) terminal branches


  Local Anesthesia Obtained Anatomically
• (1) Amides - less allergenic substances; most potent in lower concentration

  (a) Lidocaine 2% (Xylocaine)

  (b) Mepivacaine 2% (Carbocaine)

  (2) Esters - allergic to amides

  (a) Propoxycaine 2% (Ravocaine)


  Local Anesthetics Used In Dentistry
• 1. Hydrophilic amide component – easily diffused in interstitial fluid; easier to reach nerve trunks
  2. Lipophilic aromatic component – easily penetrate lipid rich membrane
  3. Intermediate-chain component – will determine if anesthesia is amide or esters


  Molecular Configuration of Local Anesthetic
• 1. Gel
  2. Liquid
  3. Ointment
  4. Pressurized spray (usually used in pedodontics)


  Topical Anesthetics
• 1. Ophthalmic
  2. Maxillary
  3. Mandibular


  Anatomic Distribution of Trigeminal Nerve
• Sleeping Juice


  Pediatric term for Anesthesia
• Worms


  Pediatric term for Caries
• 1. Pressure Injection (Jet Injection)
  2. Conventional Injection


  Two Types of Local Anesthesia Injection
• Example: Syrijet Mark II

  Indications

  1. Gingival anesthesia
  2. Soft Tissue Anesthesia
  3. Nasopalatine, anterior palatine, long buccal nerve block


  Pressure Injection (Jet Injection)
• Example: Conventional Aspirating Syringe

  Indications

  1. IAN Block (Conventional Mandibular Block)
  2. Lingual Nerve Block
  3. Long Buccal Nerve Block
  4. Infiltration for Mandibular Incisors
  5. Mandibular Conduction Anesthesia (Gow-Gates Mandibular Block Technique)


  Conventional Injection
• Supraperiostal technique (Local Infiltration)


  Technique Used for Anesthetizing Maxillary Primary & Permanent Incisors & Canines
• 1. nasopalatine nerve block
  2. greater (anterior) palatine injection


  Technique Used for Anesthetizing the Palatal Tissues
• 1. Infraorbital nerve block
  2. Mental nerve block
  3. Periodontal ligament injection (intraligamentary injections)
  4. Intrapulpal injection
  5. Intraosseous injection & interseptal injection

  Supplemental Injection Techniques
• 1. True emergencies
  2. Anesthetic toxicity
  3. Trauma to soft tissue


  COMPLICATIONS AFTER LOCAL ANESTHETIC
• • psychologic effects of administration
  • the insertion of needle
  • absorption of the anesthetic solution


  True emergencies (Complications after Local Anesthetic)
• compute for the anesthetic solution, do prescription NSAIDs, antibiotics while waiting for skin test


  Anesthetic toxicity (Complications after Local Anesthetic)
• • 1 hour or more soft tissue will be without sensation
  • Traumatic ulcer due to patient chewing on injection site

  Trauma to soft tissue (Complications after Local Anesthetic)
• 1. Local
  2. Systemic

  COMPLICATIONS OF LOCAL ANETHSTHESIA (Pinkham)
• • Masticatory trauma
  • Hematomas
  • Infections
  • Nerve damage by the needle
  • Trismus
  • Needle breakage in the soft tissue


  Local (Complications of Local Anesthesia)
• (1) Allergic reactions

  • can have delayed reactions

  (2) Cardiovascular dysfunctions

  • myocardial depression

  (3) CNS dysfunctions

  • Dizziness
  • Blurred vision
  • Anxiety to tremors
  • Convulsions
  • CNS depression
  • Death


  Systemic (Complications of Local Anesthesia)
• • Procedures or courses of action which prevent the onset of dental disease
  • Preventing oral disease before it starts is the most desirable way of ensuring good health for any dental patient


  Preventive Dentistry
• • Influence dental knowledge and education
  • Effective and cost-efficient


  Objectives of Oral Health Education
• • Mass media
  • Social media
  • Word of mouth


  Parents and guardians should have good oral hygiene Dentist formulates an individual program reinforced by:
• Dental visit starts at

  6 months
• • Diet and nutrition influence dental caries by affecting
  • Caries can develop only in the presence of sugar
  • Stressed the foods from the 4 basic food groups (milk, meat, fruit-vegetable & grain)
  • Between-meal eating is not practical


  DIET COUNSELING
• Diet and nutrition influence dental caries by affecting:

  (a.) Type & virulence of the microorganisms in dental plaque

  (b.) Resistance of teeth and supporting structing structure

  (c.) The properties of saliva in the oral cavity (relationship of diet and dental caries)

  Diet Counseling
• • Mechanical way of removing dental plaque
  • Universally acceptable

  Objectives:

  1. To remove plaque & food debris
  2. To atraumatically stimulate the gingival tissues

  TOOTHBRUSHING
• • Bilevel
  • Orthodontic
  • Regular
  • Rippled
  • Bilevel
  • Multilevel/oval
  • Multilevel/rectangle


  TYPES OF TOOTHBRUSHES
• 1. Horizontal Reciprocating – Scrub Method Brushing technique should be individualized according to patient level of intelligence, cooperation & manual dexterity
  2. Vertical Sweeping – Roll & Physiologic Method
  3. Circular – Fones Method
  4. Vibratory – Charters, Stillman & Bass Methods

  BASIC BRUSHING MOTIONS
• Manual dexterity and level of responsibility of the kid should be known to know which toothbrushing method is best for the kid

  BASIC COMPONENTS OF TOOTHBRUSHING PROGRAM FOR CHILDREN
• • Assessment of patient & parent dexterity
  • Disclosing plaque
  • Systemic approach to brushing (buccal, lingual, occlusal)
  • Time devoted to brushing (2 minutes)
  • Frequency of brushing
  • Flossing
  • Age & flossing skills
  • Flossing techniques – to not injure the soft tissues
  • Floss holders

  TOOTHBRUSHING PROGRAM FOR CHILDREN
• Time devoted to brushing (2 minutes)

  • 1st min – free fluoride from saliva will meet and bind together with the fluoride content released from the toothpaste
  • 2nd min – fluoride will be absorbed by the teeth

  TOOTHBRUSHING PROGRAM FOR CHILDREN
• Frequency of brushing

  • 3x a day
  • 30 mins after meals
  • Pea-sized toothpaste for kids

  TOOTHBRUSHING PROGRAM FOR CHILDREN
• Flossing

  • 18 inches


  TOOTHBRUSHING PROGRAM FOR CHILDREN
• Age & flossing skills

  • Eye and hand coordination
  • Insert, release and pull outwards


  TOOTHBRUSHING PROGRAM FOR CHILDREN
• 1. Disclosing agent (disclosant)
  2. Toothbrushes
  3. Dental floss
  4. Flossing aids
  5. Dentifrices
  6. Other adjuncts

  PLAQUE CONTROL ARMAMENTARIUM
• Disclosing agent (disclosant)

  Types:

  • Solution (painted on the tooth)
  • Tablet (chewed and swished)


  PLAQUE CONTROL ARMAMENTARIUM
• Toothbrushes

  • (change every three months or depending on frequency of toothbrushing and quality of bristles)
  • Types
  • Conventional manual toothbrush
  • Powered toothbrush


  PLAQUE CONTROL ARMAMENTARIUM