pacemaker/ implanted defribrilator

cardiovascular disease

tricyclic antidepressants

nonselective beta blocker use

diabetes

controlled hyperthyroidism

phenothiazines

digital glycosides

MI within 6 months

recent coronary bypass surgery within 6 months

patients with implanted defibrilator

uncontrolled angina

uncontrolled high blood pressure

sulfite allergies

pheochromocytoma (tumors of adrenal gland)

uncontrolled hyperthyroidism

cocaine or methamphetamines abuses

glaucoma

steroid use within last year

teeth anesthatized: maxillary central, lateral and incisor

insertion: height of mucobuccal fold at apex of canine

deposit location: superior to apex of maxillary canine

needle type: short 27 gauge

depth 5mm or 1/4 depth of short needle

anesthetic amount: 1/3 to 1/2 cartridge

time 30-60 seconds

teeth:  max first and second premolars, MB root of max 1st molar.

insertion: height of MB fold at apex of max 2nd premolar

deposit location:  superior to apex of maxillary2nd premolar

needle: short

depth: 5mm or 1/4 of short needle

amount of anesthetic: 1/2-2/3 cartridge

60-90 seconds

teeth: max 3rd, second and 1st molar (may or may not reach MB root of 1st molar.)

needle insertion: height of MB fold superior to apex of max 2nd molar.

deposit location":  superior to apex of maxillary second molar.

needle type: short 27 guage

depth:16mm or 3/4 of depth of needle

anesthetic amount: 1/2-1 cartridge

time 60-120 seconds

GP

Greater Palatine

teeth:  none lingual soft tissue of maxillary molars and premolars.

needle insertion: anterior to greater palatine foramen.

deposit location: at greater palatine foramen

needle: short 27

depth: 3-6 mm or until contact with palatine bone

anesthetic amount:  1/4 cartridge-until tissue blanches

time 20-30 seconds

NP

Nasopalatine

teeth: none, anesthatizes lingual soft tissue of max anterior teeth from canine to canine.

insertion: lateral to incisive papilla

needle : short

Depth:  3-6 mm or until contact bone

anesthetic amount: 1/4 cartridge or until tissue blanches

time: 20-30 seconds

IA

inferior Alveolar

teeth: mandibular teeth to midline

needle insertion point:  pterogomandibular fold.

deposit location: at mandibular foramen with inferior alveolar nerve.

needle type:  20-25mm or 2/3-3/4 depth of long needle.

anesthetic amount: 1-3 cartridges

time 60-120 seconds

B

long buccal

teeth anesthatized: none, only buccal gingiva of mandibular molars.

needle insertion point: in vestibule DB to most distal molar at height of occlusal plain.

deposit: long buccal nerve as it passes over anterior border of ramus.

depth: 1-4mm

anesthestic amount: 1/8-1/4 cartridge

time: 10-20 seconds

teeth anesthatized:  none, only the facial gingival tissue mental foramen to midline, and anterior to foramen if incisive.

needle insertion: depth of MB fold anterior to mental foramen.

deposit location: mental foramen between apices of mandibular premolars or location determined by radiographs.

depth: 5-6 mm or 1/4 of short needle

anesthetic amount: 1/3 cartridge

time 30-60 seconds

amalgam scraps

old lead aprons

silver crystals

chemical spill kit: in classroom and lab and dark room

bloodbourne pathogen:  sterilization room, classroom and lab

health

insurance

portability

and

accountability act

privacy

confidentiality

patient information

aspirating syringe

disposable hypodermic needle

single dose cartridge

to provide negative pressure inside cartridge.

causes retraction of rubber stopper

if blood enters then positive aspiration has occurred.

can see cartridge in window

ease of aspiration with small hands

autoclavable

rust resistent

size may be too large for small hands

harpoon disengagnement

discoloration of plastic from autoclave

used for periodontal ligament injections

dosage of 0.2ml of anesthetic

disadvantage is cost

gauge is the size or lumen of needle

smaller gauge number the larger the diameter of needle

larger number has more deflection

selection should be determined by depth of penetration and risk of intravascular injections.

t/f

needles are presterilized and disposable

larger lumen= better visibility

more rigidity

less deflection

greater acuracy toward target location

needle breakage diminished

pain on insertion

pain on withdrawal

needlestick exposure to administrator

needle breakage (bend of needle, sudden direct changes, forcing needle against resistence, using 30 gauge needles)

original container at room temp in dark place

note expiration, discard if expired

small bubbles

large bubbles

extruded stopper

sticky stopper

burning on injection

corroded cap

rust on cap

leakage during injection

broken cartridge