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Questions and Answers
What is the primary cause of paresthesia during an injection?
What is the common point of needle fracture?
What is the recommended approach for managing paresthesia?
What is the reason for the rarity of needle breakage in modern dentistry?
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What is the consequence of severe nerve damage due to paresthesia?
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What is a common factor that contributes to the risk of needle breakage?
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What is a recommended practice to prevent needle breakage?
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What is the consequence of reuse of needles?
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What is the most common age group to experience trauma during local anesthesia?
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What is the primary purpose of using a cotton roll during local anesthesia?
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What is the recommended treatment for a patient who experiences hematoma after local anesthesia?
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What is the most common cause of hematoma after local anesthesia?
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What is the primary method of preventing hematoma after local anesthesia?
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What is the recommended treatment for a patient who experiences trismus after local anesthesia?
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What is the primary reason for the reduction in infection rates after local anesthesia?
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What is the recommended treatment for a patient who experiences pain after local anesthesia?
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What is the recommended gauge of needle for an inferior alveolar nerve block?
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What should be done if a portion of the broken needle is visible in the tissue?
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What is the cause of facial nerve paralysis in relation to inferior alveolar nerve block?
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What is the result of solution deposition in the substance of the parotid gland?
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What should be done to comfort the patient who has experienced facial nerve paralysis?
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What is the consequence of not removing the broken needle from the tissue?
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Why is it important to stabilize the patient's jaws if a needle breaks during an inferior alveolar nerve block?
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What is the recommended action if the practitioner is unable to remove the broken needle from the tissue?
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What is the first step in the first aid treatment for a vasovagal attack?
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What is the purpose of Cardiopulmonary Resuscitation (CPR)?
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What is the recommended depth of chest compressions for adults in CPR?
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What is the recommended rate of chest compressions for adults in CPR?
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What is the most common cause of hypersensitivity reactions to local anesthesia?
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What type of local anesthetic agent is more commonly associated with hypersensitivity reactions?
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What is the approximate percentage of complications of local anesthesia due to hypersensitivity reactions?
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What is the recommended universal compression to ventilation ratio in CPR for adults?
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What is a common psychogenic factor that may trigger vasovagal syncope?
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What is the effect of the withdrawal of sympathetic nervous system tone on blood vessels?
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What is the primary mechanism of vasovagal syncope, regardless of the trigger?
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What is the result of the cardioinhibitory response in vasovagal syncope?
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What is a non-psychogenic factor that may predispose to vasovagal syncope?
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What is the primary goal of prevention in vasovagal syncope?
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What is the result of the vasodepressor response in vasovagal syncope?
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Why is it recommended to take a light meal prior to a dental appointment to prevent vasovagal syncope?
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Study Notes
Complications of Local Anesthesia
- Paresthesia: Caused by trauma to a nerve during injection, leading to a sensation of an electric shock throughout the affected nerve distribution.
- Paresthesia Causes: Injection of contaminated local anesthetic solution, hemorrhage, and infection near a nerve.
- Paresthesia Prevention: Strict adherence to injection protocol and proper care of dental cartridges.
- Paresthesia Management: Most cases resolve within 8 weeks without treatment; reassure the patient and provide strict follow-up.
Needle Breakage
- Causes: Weakening of the dental needle by bending, sudden patient movement, using smaller needles, reusing needles, incorrect use, and defective manufacturing.
- Prevention: Check needles before use, use larger gauge needles, and avoid redirecting inserted needles.
- Management: Stay calm, localize the broken part, and remove the visible portion with a hemostat; refer to an oral and maxillofacial surgeon if necessary.
Facial Nerve Paralysis
- Causes: Inserting the needle too far back and behind the ascending ramus, anesthetizing the facial nerve branches.
- Management: Reassure the patient of transient nature, advise using an eye patch, and provide symptomatic treatment.
- Prevention: Select appropriate local anesthetic duration and warn the patient against drinking hot fluids and biting lips or tongue.
Hematoma
- Causes: Penetration of blood vessels with the needle during injection.
- Prevention: Learn anatomical landmarks and injection technique, and avoid relocating the needle.
- Management: Apply direct pressure, inform the patient, and reevaluate treatment continuation; prescribe analgesics and antibiotics if necessary.
Infection
- Predisposing Factors: Psychogenic factors (anxiety, emotional stress, pain, and sight of blood), and non-psychogenic factors (prolonged standing, hunger, poor physical condition, and hot environment).
Vasovagal Syncope
- Mechanism: Brainstem activation by triggering stimulus, leading to simultaneous enhancement of parasympathetic and withdrawal of sympathetic nervous system tone.
- Prevention: Good preoperative assessment, light meal before appointment, proper injection technique, sedation for anxiety relief, and elimination of causes.
- Management: Lower the head, elevate the legs, loosen tight clothing, stimulate respiration, and provide spontaneous recovery.
Cardiopulmonary Resuscitation (CPR)
- Procedure: Combines chest compressions with artificial ventilation to preserve brain function until further measures restore spontaneous blood circulation and breathing in cardiac arrest patients.
- CPR Techniques: Chest compressions (5 cm deep, 100 per minute, 30:2 compression-to-ventilation ratio), and artificial ventilation through mouth-to-mouth resuscitation or mechanical ventilation.
Hypersensitivity or Allergy to Local Anesthesia
- Causes: Reaction to local anesthetic agent, vasoconstrictor, or additives like bisulfite.
- Incidence: Less than 1% of all complications of local anesthesia.
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Description
Learn about the causes, prevention, and management of paresthesia, a common complication of local anesthesia, including trauma to nerves and infection.
