Anesthesia in Endodontics
Anesthesia in endodontics is essential for releaving pain while working on vital teeth and this covers the important aspects of anesthetics in endodontics.
1. How are anesthetics useful in endodontic therapy?
Anesthetics are used in endodontic therapy for elimination of pain while treating vital teeth. It blocks the transmission of nerve impulses and the therapy can be carried out with patient comfort.
Ref: Endodontics,Arnaldo Castelluci,IL Tridente, vol 1;208
2. Why is anesthesia not indicated for all endodontic therapies?
Anesthetics are not used when the treatment planned is a painless procedure such as cleaning and shaping of a necrotic canal or filling the canal. Also in case of a necrotic tooth, ‘cavity test’ is performed to find the origin of the lesion, whether endodontic or periodontal. So anesthesia in such cases will mask the actual response of the patient leading to a wrong diagnosis.
Ref: Endodontics,Arnaldo Castelluci,IL Tridente, vol 1;208
3. What are the precautions taken while injecting the mucosa overlying the alveolar abscess?
When the mucosa overlying the abscess in infiltrated, the needle should not penetrate the purulent collection. It should be injected tangentially to the mucosa so that it is visible through the transparency of the tissues. Alternatively, Ring anesthesia or nerve block is given.
Ref: Endodontics,Arnaldo Castelluci,IL Tridente, vol 1;209
4. How are lower canine and first premolar effectively anesthetised?
Lower canine and first premolar are effectively anesthetized at the level of the mental foramen by a mental nerve block. The advantage is that it acts sooner and anesthesia of tongue is avoided.
Ref: Endodontics,Arnaldo Castelluci,IL Tridente, vol 1;212
5. Why should mental nerve block be given carefully?
Care should be taken not to injure the mental nerve with the point of the needle. The needle should not be introduced into the mental foramen also.
Ref: Endodontics,Arnaldo Castelluci,IL Tridente, vol 1;212
6. What anesthetic procedure do extraction / surgery in the anterior palate require?
The soft tissues of the anterior palate are innervated by the anterior palatine nerve emerging through the incisive foramen. This nerve is blocked by injecting the anesthetic next to the incisive papilla, under pressure. The procedure is quite painful.
Ref: Endodontics,Arnaldo Castelluci,IL Tridente, vol 1;213
7. When is the anterior palatine nerve blocked to achieve anesthesia?
The posterior two thirds of the palate is innervated by the anterior palatine nerve that emerges from the greater palatine foramen between the second and the third molar. The nerve is anesthetized for any surgical procedure in the soft tissues of the hard palate from the tuberosity to the region of canine or from the midline of the palate to the gingival margin by injecting near the point of emergence of the nerve from the foramen.
Ref: Endodontics,Arnaldo Castelluci,IL Tridente, vol 1;213
8. How is the usage of rubber dam advantageous in endo practice?
The usage of rubber dam protects the ingestion or aspiration of instruments, irrigating solutions or small fragments. It gives an opportunity to work in a clean surgical field, retraction and protection of soft tissues is achieved, provides better visibility, prevents transmission of infection from patients’ saliva to the operator, creates a comfortable atmosphere for the operator and comfort feeling for the patients.
Ref: Endodontics,Arnaldo Castelluci,IL Tridente, vol 1;226
9. When is the usage of rubber dam contraindicated?
The rubber dam is contraindicated when the patient is allergic to the chemical constituents of the rubber. No latex dam is available to be used on allergic patients.
Ref: Endodontics,Arnaldo Castelluci,IL Tridente, vol 1;226