Local Anesthesia Review

AADHNMS -05-1-2024-15

This course provides the dental practitioner with a review of local anesthetics. This is not a certification course. Dental Professionals must know how to assess and treat dental pain and anxiety, with special concern given to the patient’s individual needs and health status. This course will provide a review of local anesthetics, pharmacology, injection techniques, and how to effectively assess situations where anesthetics should be administered and do so in a safe effective manner.

1. Explain pain/impulse conduction related to nerve anatomy and physiology.
2. Discuss the modalities of pain and mechanisms used to control pain.
3. Discuss the different types of nerve fibers and their functions.
4. Describe the pharmacological properties, actions, considerations, and 
   contraindications of local anesthetic agents, vasoconstrictors, and nitrous oxide.
5. Evaluate and describe the relationship between pKa and pH as well as the clinical
   relevance of both.
6. Evaluate and discuss the signs, symptoms, and effects of local anesthetics in the 
   central nervous system (CNS)
7. Evaluate and discuss the signs, symptoms, and effects of local anesthetics in the
   cardiovascular system (CVS)
8. Outline and discuss the biotransformation of esthers and amides and the half-life
   concept.
9. Identify and discuss vasoconstrictors. Similarities/differences between epinephrine
   and levonordefrin.
10. Describe and distinguish between clinical signs and symptoms of vasoconstrictors vs. 
    local anesthetics.
11. Define and discuss what a maximum recommended dose is.
12. List maximum recommended doses for anesthetics and vasoconstrictors.
13. Discuss the topical anesthetics available in dentistry and determine their potency.
14. Describe signs, symptoms, and adverse reactions, of topical anesthetics.
15. Assess the client’s medico-dental history as it relates to the choice of technique and 
    agents used in the administration of local anesthetic and nitrous oxide-oxygen 
    analgesia.
16. Determine the appropriate pain control armamentarium, agents, and techniques 
    needed to ensure patient safety and comfort during the administration of local
    anesthesia and nitrous oxide-oxygen analgesia.
17. Explain the proper sharps management to be used when handling local anesthetics
    and needles.
18. Explain proper protocols to manage adverse reactions to local anesthetics and
    vasoconstrictors in the dental office.
19. List and describe adverse reactions of local anesthetics in the CNS and CVS.
20. Evaluate and explain situations that require medical consultation before the
    administration of local anesthetics.
21. Describe signs and symptoms of undiagnosed medical conditions that can affect
    local anesthetic administration.
22. Determine ways to prevent and manage potential emergencies associated with
    dental anesthetics and nitrous oxide.
23. Describe the basic technique for administration of the following injections:

• Infiltrations
• ASA nerve block
• MSA nerve block
• IO nerve block
• PSA nerve block
• IA nerve block
• lingual nerve block
• Buccal nerve block
• Mental nerve block
• Incisive nerve block
• Gow- Gates nerve block
• Vazirani-Akinosi (Akinosi) nerve block.