How is injection of local anesthesia into a blood vessel prevented?
Why is infiltration of local anesthesia into an infected area not advised? ([1] Inadequate anesthesia resulting from the different pH of infected tissue and [2] the risk of spreading infection.)
What is paresthesia? (Loss of feeling—numbness that lasts beyond the expected duration of the local anesthetic.)
Why should local anesthesia always be used in conjunction with nitrous oxide?
Although nitrous oxide and oxygen are nonaddictive, dental professionals and members of the public may easily become addicted to the feeling they experience when they inhale this gas.
It is important for the patient to remain awake throughout administration to permit proper titration of the gases according to the patient’s signs and symptoms.
When administering nitrous oxide to a child, make sure to have children’s nasal masks available. Regardless of the patient’s age, a qualified dental team member should stay with the patient at all times.
What is an example of a common nasal obstruction? (Deviated septum.)
In some medical conditions the use of N²O/O² is actually desirable because of the additional oxygen being delivered.
The dental assistant should also be familiar with the unit because he or she may be required to deliver pure oxygen to a patient in an emergency.
If portable units are in place, the valves are not usually opened unless the unit is about to be used.
Before the use of nitrous oxide, both cylinders should be checked for adequate remaining gas levels.
All parts of the delivery system should be in acceptable working condition. The reservoir bag should be checked frequently for leaks.
Be aware that a large amount of facial hair (especially a moustache) may interfere with an adequate seal of the nosepiece, decreasing the amount of the sedative delivered to the patient and perhaps increasing the amount of leakage to the surrounding environment and exposure to the dental team.
A scavenger system is essential for safely gathering and disposing of any unused or exhaled nitrous oxide outside the building.
What color represents nitrous oxide? (Blue.)
What color represents oxygen? (Green.)
The metal plate in the wall is an outlet for the nitrous oxide and oxygen supplies, as well as an outlet for the scavenging system to prevent nitrous oxide from accumulating.
Why is it important to discuss with patients the steps in the administration of nitrous oxide, as well as what they may expect from the dental procedure itself, before beginning a procedure?
An office should have a schedule in place for routine inspection of nitrous oxide equipment for safety and maintenance.
This photo depicts the nasal mask that is placed over the patient’s nose to deliver nitrous oxide, in combination with the scavenging device that collects excess or exhaled nitrous.
It is important that the mask be placed with the corresponding end over the bridge of the nose for a proper fit.
The nosepiece is placed over the nose and the tubing is secured behind the headset of the dental chair.
Should the baseline vitals be recorded? If so, where?
Discussing what the patients may or should expect, as well as addressing his other questions or concerns, will help avoid or alleviate any unwarranted anxiety during the procedure.
The tidal volume is the amount of air inhaled and exhaled with every breath.
Starting with pure oxygen will help patients get accustomed to having the nasal mask in place and practice breathing through their nose.
What does inhaling 100% oxygen at the end of the procedure help prevent? (Diffusion hypoxia.)
Antianxiety medications are used as an adjunct to dental treatment.
Patients with extreme dental fear may require this type of medication for the first few visits.
Anxiolytics are also sometimes prescribed to mentally challenged patients who may be uncooperative.
Diazepam is a benzodiazepine that is available in 2-, 5-, and 10-mg tablets; it may also be given intramuscularly, IV, or as an oral solution.
Secobarbital is a sedative-hypnotic barbiturate, chlordiazepoxide a benzodiazepine, and chloral hydrate a sedative-hypnotic, used more often in pediatric dentistry.