LA
What are the 3 absolute contraindications to LA?
Cocaine/meth use within 24 hours
Allergy to LA
Allergy to sodium bisulfite (Epi only)
What are the symptoms of a stroke and how is it managed?
Headache
Face drooping
Arm weakness
Slurred speech
Time is of the essence
Reassure patient, call 911, 02, ABCs, record time
The ultrasonic instrument has the same angulation as the periodontal probe which is _____________ degrees
0-15 degrees
This injection cannot be given to individuals with bleeding disorders or who are on blood thinners
PSA
How often is HH checked/updated
Every visit
What local anesthetics are available for use at CNC?
Lidocaine 2% 1:100,000
Prilocaine 4% Plain
Mepivacaine 3% Plain
Articaine 4% 1:200,000
What are 3 ways we prevent medical emergencies
1. Comprehensive HH and risk assessment
2. Check meds and med usage
3. Anxiety recognition and stress management
Once the ultrasonic has been set up, what needs to be done before the instrument insert can be placed in the cavitron hand piece?
The handpiece must be filled with water
This injection does not provide pulpal anesthesia unless pressure is applied firmly to the area
Incisive
Explain the contaminated needle injury protocol at CNC
Let the wound bleed
Wash with soap and water thoroughly
Inform and instructor
Be seen by a Dr or the Emergency department within 4 hours of injury
Which local anesthetics are safe for pregnancy?
Lidocaine and Prilocaine
A patient undergoing this medical emergency should not be given oxygen
hyperventilation
What does it mean when the ultrasonic handpiece gets very hot and how is it corrected
not enough water to cool it; turn up the water
Pressure anesthesia is also a requirement in addition to topical for these injections
Nasopalatine
Greater palatine
What are the differences between primary and permanent teeth
Primary: smaller; whiter; pointed cusps; shorter roots, larger pulp chambers, thinner enamel
Permanent: Larger; darker; blunt cusps; longer roots; smaller pulp; newly erupted have mamelons; thicker dentin
What are the Relative contraindications to Epi?
BP 140/90+
Meds: TCA, MAOi, Non-specific beta blockers, phenothiazines
Hyperthyroid
Sig. Cardiovascular disease (ASA III or higher)
Uncontrolled diabetes
What should you do if your patient starts having a medical emergency at CNC
•Stay with patient
•Send for instructor
•Someone to bring O2 tank + emerge kit
•Student to provide a synopsis of medical history
•Instructor will assess situation, take VS, determine need for distress call, initiate or continue appropriate emergency measures
Small horizontal strokes that move apically along the tooth is also known as this technique
channeling
These two injections are given using a 25G long needle
IA and Long Buccal
Explain 5 various management strategies a DH might implement for a person with periodontal risks.
1. More frequent recalls
2. Chlorhexidine rinses
3. OHI
4. Lifestyle counseling (smoking cessation, diet changes)
5. Referral to periodontist
What are the 8 relative contraindications to LA
Pregnancy
Malignant hyperthermia
Methemoglobinemia
Atypical plasma cholinesterase
Opioids
Sig. Kidney disease
Sig. Liver disease
Sulfoamides (esters)
Stable vs Unstable angina
Stable: predictable (common triggers), ASA III, can be managed with nitroglycerine
Unstable: spontaneous/unpredictable pain, ASA IV, can lead to cardiac distress, call 911
The 4 ultrasonic stroke types
Horizontal
Vertical
Oblique
Tapping
This injection has very limited use for dental hygienists
Infiltration
What do the different Tri-plaque colours mean and what 2 allergies contraindicate the use.
Pink = fresh/pellicle
Purple = mature biofilm (at least 48 hours old)
Blue = cariogenic biofilm (very acidic)
Parabens and red dyes