Anesthesia and Pain Control – Chapter 37 Flashcards

70 question-and-answer flashcards covering key concepts from Anesthesia and Pain Control, Chapter 37 of Modern Dental Assisting 14th Edition.

What is the primary purpose of anxiety and pain control in dentistry?

To prevent and treat patient anxiety and pain before, during, and after treatment using psychological, physical, and chemical methods.

What dental term describes a temporary loss of feeling or sensation?

Anesthesia.

What are the drugs called that create a temporary loss of feeling or sensation?

Anesthetics.

Name the seven common methods of pain control used in dentistry.

Topical anesthesia, local anesthesia, inhalation sedation, antianxiety agents, intravenous (IV) sedation, general anesthesia, and mind-body medicine.

What does topical anesthesia do to the nerve endings on the oral mucosa?

Provides a temporary numbing effect on their surface.

Give two dosage forms in which topical anesthetics are commonly supplied.

Ointments, liquids, sprays, or patches (any two).

Which pain-control agent is most frequently used by dentists?

Local anesthesia.

Why is local anesthesia considered dependable for dental treatment?

It is safe, effective, has rapid onset, adequate duration, and is completely reversible.

State two desirable characteristics of an ideal local anesthetic.

Non-irritating to tissues and associated with minimal toxicity (others: rapid onset, profound anesthesia, sufficient duration, reversible, sterile).

Local anesthetics fall into which two chemical groups?

Ester-type anesthetics and amide anesthetics.

Which chemical group of local anesthetics is mainly used for topical applications?

Ester-type anesthetics.

How are amide local anesthetics primarily metabolized?

By the liver.

Besides the anesthetic drug itself, name two other components in a dental anesthetic cartridge.

Sodium chloride and distilled water.

What is the induction time of a local anesthetic?

The time from injection until complete and effective nerve conduction blockage.

Approximately how long does a short-acting local anesthetic last?

About 30 minutes.

What is the typical duration for an intermediate-acting local anesthetic?

About 60 minutes.

How long can a long-acting local anesthetic provide anesthesia?

About 90 minutes.

Why are vasoconstrictors added to local anesthetic solutions?

To prolong anesthesia by decreasing blood flow in the injection area.

Besides prolonging duration, what surgical benefit do vasoconstrictors offer?

They decrease bleeding in the operative area.

Name one vasoconstrictor commonly found in dental local anesthetics.

Epinephrine (others: levonordefrin, neo-Cobefrin).

Give one cardiac-related condition that contraindicates vasoconstrictor use.

Unstable angina (others: recent MI, recent coronary bypass, uncontrolled hypertension, uncontrolled CHF).

Which injection delivers anesthetic into the ligament around a tooth root?

The periodontal ligament (PDL) injection.

List the three basic items included in a local anesthesia setup.

Anesthetic syringe, anesthetic cartridges, disposable needle.

At what temperature should anesthetic cartridges be stored?

Room temperature, protected from direct sunlight.

Why should a discolored or cloudy anesthetic solution never be used?

It may indicate contamination or deterioration that could harm the patient.

What is the hollow center of a dental needle called?

The lumen.

On a disposable needle, what is the thicker end that penetrates the cartridge diaphragm?

The cartridge end.

What does the gauge number of a needle indicate?

The thickness or size of the needle.

Why is injecting anesthetic into an infected area discouraged?

Infection lowers tissue pH, making anesthesia less effective and spreading infection.

What term describes prolonged or permanent numbness after anesthesia?

Paresthesia.

Name one needle-free alternative method of delivering local anesthesia.

Electronic anesthesia, jet-injection device, or computer-controlled anesthesia (any one).

What mixture of gases is used for inhalation sedation in dentistry?

Nitrous oxide and oxygen (N2O/O2).

In which anesthesia stage does nitrous oxide/oxygen produce analgesia?

Stage I (analgesia stage).

State two advantages of using nitrous oxide sedation.

Simple administration, rapid recovery, minimal side effects, patient remains awake, excellent safety record, no anesthetist needed (any two).

What minor adverse effect might some patients experience with nitrous oxide?

Nausea or vertigo.

Nitrous oxide is contraindicated during which trimester of pregnancy?

The first trimester.

Why is nitrous oxide contraindicated for patients with COPD?

It can interfere with their respiratory drive/stimulus to breathe.

What color is the oxygen cylinder in a nitrous oxide delivery system?

Green.

What color identifies the nitrous oxide cylinder?

Blue.

Which device on an N2O/O2 machine shows the rate of gas flow?

The flow meter.

Where are nitrous oxide and oxygen mixed before reaching the patient?

The reservoir bag.

What equipment carries mixed gases from the reservoir bag to the patient’s nosepiece?

The gas hose.

Why must the patient breathe through the nose during nitrous oxide sedation?

The mask covers only the nose; nasal breathing ensures proper uptake of the gases.

What baseline clinical data must be taken before administering N2O/O2?

Pre-operative vital signs (blood pressure, pulse, respiration).

For how many minutes should 100 % oxygen be given after nitrous oxide sedation?

3 to 5 minutes.

Name one work practice that reduces dental staff exposure to nitrous oxide.

Use a scavenger system, well-fitting patient mask, discourage talking, vent gas outside, inspect equipment for leaks, monitoring badges (any one).

What class of drugs is most often prescribed to relieve dental anxiety?

Sedatives (antianxiety agents).

Give one clinical situation where an antianxiety drug may be prescribed.

Very nervous patient, long or difficult procedure, mentally challenged patient, very young child needing extensive treatment (any one).

How often are physiologic measurements usually recorded during IV sedation?

Every 15 minutes.

Give two parameters monitored during IV sedation.

Level of consciousness, respiratory function, oximetry, blood pressure, heart rate, cardiac rhythm (any two).

Define general anesthesia in dentistry.

A controlled state of unconsciousness with loss of protective reflexes, producing Stage III anesthesia.

Name one IV agent commonly combined with inhalation agents for general anesthesia.

Thiopental sodium or methohexital sodium.

What occurs during Stage II of anesthesia?

Excitement—patient may have uncontrolled movements and irregular breathing.

Which stage of anesthesia is associated with respiratory failure or cardiac arrest?

Stage IV.

Before general anesthesia, how long should a patient refrain from food or drink?

8 to 12 hours.

What written document must be signed prior to receiving general anesthesia?

A consent form.

Why should a patient not be left alone while regaining consciousness after general anesthesia?

To monitor safety until protective reflexes and orientation return.

What is mind-body medicine in a dental context?

Non-pharmacologic techniques used to reduce anxiety and pain.

Give one example of a mind-body technique that can be used chairside.

Distraction with music, guided relaxation, deep breathing, biofeedback, hypnosis, acupuncture (any one).

Why must the times when anesthesia begins and ends be documented?

To provide an official record for safety, legal, and billing purposes and to track drug exposure.

What postoperative measurement confirms patient recovery after sedation?

Postoperative vital signs compared to baseline.

During inhalation sedation, what does the term “tidal volume” refer to?

The amount of gas the patient normally inhales and exhales in one breath.

How can talking by the patient increase nitrous oxide hazards to staff?

Gas escapes around the mask, increasing ambient contamination.

What monitoring device can dental personnel wear to detect nitrous oxide exposure?

A dosimetry/monitoring badge.

What systemic benefit does adding a vasoconstrictor to a local anesthetic provide?

It slows absorption into the bloodstream, reducing toxicity risk.

What can freezing do to an anesthetic cartridge that makes it unusable?

It can cause cracks or leakage and alter the solution’s efficacy.

Why is it important not to preload a syringe with the needle attached for a long period?

Risk of contamination, cartridge leakage, or needle damage.

Name one possible systemic reaction to local anesthetic toxicity.

CNS excitation or depression, seizures, or cardiac effects.

Which part of the disposable needle is protected by the longer plastic cover?

The injection end (needle guard).