Basic Injection Techniques

Flashcards for dental anesthesia lecture review.

Surface Anesthesia

Blocks free nerve endings supplying mucosal surfaces; short-lasting effect limited to direct contact area.

Infiltration

Used when soft tissue anesthesia is needed in a limited area, depositing anesthesia close to smaller terminal nerve endings.

Field Block

Form of regional anesthesia deposited near large terminal nerve branches; involves pulpal and soft tissue anesthesia of a single tooth.

Nerve Block

Injection of local anesthetic near a major nerve trunk to anesthetize the nerve's area of innervation.

Vasodepressor Syncope

The most common medical emergency observed in the dental office, frequently linked to local anesthesia administration.

Preanesthetic Patient Assessment and Consultation

The first step in providing a successful injection, involving patient assessment, vital signs, and consultations.

Selection of Anesthetic

Factors to consider include physical status, duration of treatment, volume of anesthetic, need for hemostasis, and possibility of self-mutilation.

Confirm Care Plan

Local anesthesia should only be administered in areas of treatment completed in one visit; dividing the mouth into quadrants or sextants.

Informed Consent

Benefits, risks, type of anesthetic, injection procedure, and temporary numbing feeling should be discussed.

Selection of Injection

Areas needing to be anesthetized, presence of infection, and hemostasis all dictate what to use.

Preparation of Equipment

Equipment should be covered or placed out of the patient’s sight.

Check the Anesthetic Equipment

Check needle bevel orientation, expel anesthetic, confirm harpoon is secured.

Patient Position

Supine positioning with feet slightly elevated.

Tissue Preparation and Patient Communication

Apply topical antiseptic and anesthetic, using supportive communication.

Dry Tissue and Visualize or Palpate

Re-dry injection site and visualize or palpate.

Establish a Fulcrum

A firm hand rest is essential for safe, comfortable injections.

Make the Tissue Taut

Assists operator with visibility and allows easier needle insertion.

Gently Insert the Needle/ Watch/ Communicate

Gently insert the needle, watch for signs of discomfort, and communicate.

Aspiration

Should be conducted before anesthetic solution is deposited.

Slowly Deposit the Local Anesthetic Solution

Slowly deposit the local anesthetic solution

Slowly Withdraw the Syringe and Safely Cap the Needle

Slowly withdraw the syringe and safely cap the needle.

Observe the Patient for Possible Reaction to Anesthetic

Observe the patient for possible reaction to anesthetic.

Document Procedure

Date, LA used, concentration, vasoconstrictor, amount, gauge/type of needle, type of injection, time, pt reaction.

Intradermal Injection

A shallow or superficial injection of a substance into the dermis.

Examples of Intradermal Injections

Tuberculin injection, allergy sensitivity tests, local anesthesia, BCG vaccine.

Pre-injection Technique

Blocking free nerve endings to numb mucosal surfaces before injection.

Infiltration Uses

Used for perio therapy and bleeding control with vasoconstrictors.

Maxillary Teeth in Field Block

More effective on these teeth due to bone density.

Nerve Block Disadvantage

Increases potential for piercing artery or vein.

Local Anesthetics

Medical and dental consultations are completed before administering these.

MRD (Maximum Recommended Dose)

Determining this is important when selecting an anesthetic.

Self-Mutilation

Administering LA to both mandibular right and left quadrants increases this possibility.

Facial Anesthesia

Administering this before palatal anesthesia is important.

Epinephrine 1:50,000

Greatest hemostatic control is achieved with this concentration of epinephrine.

Bone

Bevel should be oriented towards this structure.

Supine Positioning

Recommended to help decrease the risk of a patient fainting.

Topical Antiseptic

This step reduces the possibility of septic material entering tissues.

Topical Anesthetic Application

Good time for supportive communication with the patient.

Large Window on Syringe

Facing up assists visualization of injection site.

Patient’s Arm

Do not use this as a fulcrum.

2x2 Gauze

Use this if tissues are slippery.

Signs of Discomfort or Stress

Watch for these when inserting the needle.

Negative Aspiration

Clear air bubble or no return indicates this.

5 Minutes

Most dental emergencies occur within this time frame after LA administration.

Bleb/Wheal or Blister

Slowly inject the medication, watching for this to develop on the skin's surface during intradermal injection.

Ventral Aspect of the Forearm

Area of the arm used for intradermal injections.

5- to 15-Degree Angle

Angle of needle insertion for intradermal injections.

Vital Signs

This should be obtained and recorded during the Preanesthetic Patient Assessment.

Nerve Block Advantage

Provides profound pulpal and soft tissue anesthesia over a larger area.

Expelling Anesthetic

This ensures free flow of the solution.