Dental clinics of North America
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Dent. Clin. North Am. · Oct 2010
ReviewNeedle phobia: etiology, adverse consequences, and patient management.
Needle phobia has profound health, dental, societal, and legal implications, and severe psychological, social, and physiologic consequences. There is genetic evidence for the physiologic response to needle puncture, and a significant familial psychological component, showing evidence of inheritance. Needle phobia is also a learned behavior. ⋯ Needle phobia is highly associated with avoidance behavior, and the dentist must exhibit compassion and respect. To avoid bradycardia, hypotension, unconsciousness, convulsions, and possibly asystole, oral premedication with benzodiazepines or other antianxiety agents must be considered for patients who are needle phobic. Management of needle phobiaeinduced syncope includes perioperative monitoring, oxygen administration, positioning, atropine, and vasopressors.
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Dentistry has two medications in its pain management armamentarium that may cause the potentially life-threatening disorder methemoglobinemia. The first medications are the topical local anesthetics benzocaine and prilocaine. ⋯ It is in the interest of all dental patients that their treating dentists review this disorder. The safety of dental patients mandates professional awareness.
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Local anesthetics are commonly used in both dentistry and medicine. These drugs are also used in some office-based medical practices. ⋯ Both ester and amide local anesthetics are routinely used in medical practice. This article reviews the types and uses of local anesthesia in anesthesiology.
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Within the last 30 years, the role of dental hygienists has expanded to include the administration of local anesthesia. Several studies have been performed to assess practice characteristics and effectiveness of these changes in state licensure regulations. Findings indicate an acceptance of this expansion in dental hygiene practice; however, the delegation of this pain control procedures remains controversial. To address this controversy, the authors have reviewed of current literature to assess the practice of local anesthesia administration by dental hygienists.
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Dent. Clin. North Am. · Oct 2010
ReviewLong-acting local anesthetics and perioperative pain management.
Although the use of long-acting local anesthetics has become a useful therapeutic approach for managing peri- and postoperative pain, recent evidence reveals unexpected outcomes. This article reviews the clinical use of long-acting local anesthetics, presents current clinical research findings, and makes recommendations for their use.