Students are informed and assessed on basic techniques at Pacific Dugoni with regards to delivery and patient management aspects of providing local anesthesia. In addition, students undergo discussions within the Local Anesthesia Curriculum and other Dental Practice Courses that present thought processes concerning armamentarium available and its application to patient management.
Students enter the main clinic having knowledge and understanding of the following:
- The proper set up and break down of anesthetic syringes.
- How to properly document anesthesia delivery and any complications that may have occurred.
- For procedures in the main clinic, 2 cartridges can be given to the patient after the start check, and if more anesthetic is determined appropriate then students MUST receive faculty approval.
- For procedures in Oral Surgery, 5 cartridges can be given to the patient after the start check, and if more anesthetic is determined appropriate then students MUST receive faculty approval.
- 2% Lidocaine 1:100,000 epinephrine (red) is the recommended drug of choice and it along with 3% Mepivacaine HCL (tan) are available at the dispensary windows. After discussion and approval from faculty, students can obtain 4% Septocaine 1:100,000 (gold) from dispensary windows.
- 4% Articaine 1:200:000 epinephrine (silver), 2% Lidocaine 1:50,000 epinephrine (green), 0.5% Bupivacaine 1:200,000 epinephrine (blue), and 4% Prilocaine 1:100,000 HCL (yellow) are available but need faculty approval AND faculty signature in order to obtain cartridges from the Oral Surgery dispensary window.*
- 27(yellow sheath) or 25 (red sheath) gauge long needles are used for mandibular nerve block injections.
*Students are taught the risks and precautions regarding 4% anesthetic solutions and should NOT use these solutions for inferior alveolar nerve block injections. For hard to anesthetize patients, it is imperative that students directly contact a faculty member to assist in determining the best course of action for the patient and their care. The above restrictions apply to students and not faculty, as long as faculty are aware of the risks mentioned above. The reasoning behind these rules is with an understanding that the risks of neurological damage with 4% anesthetic solutions are very low and that 2% Lidocaine 1:100,000 epinephrine is as statistically effective with a lower risk.
Maxillary Injection Summary
Mandibular Injection Summary
- Haas DA & Lennon D, A 21 year retrospective study of reports of paresthesia following local anesthetic administration. J Can Dental Assoc., 1995;61(4).
- Brandt RG et al. The pulpal anesthetic efficacy of Articaine versus Lidocaine in dentistry: A meta-analysis, JADA, May 2011;142(5).
- Malamed, Stanley F, Kenneth Reed, and Susan Poorsattar. "Needle breakage: incidence and prevention." Dental Clinics of North America, 2010;54.(4): 745-756.