METHODS OF ADMINISTRATION
In dentistry, drugs are introduced into the body by
different routes, each serving a specific purpose. We
will cover parenteral, oral, inhalation, and topical
administration of drugs next.
Parenteral medications are those introduced by
injection. All drugs used by this route must be pure and
sterile. Always check the solution to ensure it has not
expired and is clear in color. Several types of parenteral
administration can be used in dentistry.
IntravenousThe drug is introduced directly
into the vein. Example: Intravenous sedation.
Guidance to dental treatment facilities for the
administration of outpatient anesthesia services in
intravenous (IV) sedation to dental patients can be
found in BUMEDINST 6710.67.
InfiltrationThis method that is commonly
used to anesthetize maxillary teeth. The dental needle
and anesthetic are placed into the mucosa along the side
of the tooth (facial aspect) and alveolus that is being
treated. This technique is possible because the porous
composition of alveolus cancellous bone allows the
anesthetic to soak through the bone and anesthetizes the
apices of the teeth. It is also used in procedures such as
biopsy, gingivectomy, frenectomy, and the excision of
BlockBecause the mandibular bone is very
dense, infiltration techniques cannot always be used to
achieve adequate anesthesia. A block technique is the
most effective means to achieve anesthesia of the
mandibular teeth. A dentist will use various types of
blocks to anesthetize specific areas. When performing a
block technique, the dentist will place the needle and
anesthetic into the mucosa and aim them near a specific
nerve where the solution is deposited. The area of the
nerve is blocked and all surrounding areas the nerve
branches off to are also anesthetized. When a
mandibular block (inferior alveolar nerve block) is
performed, the patient will experience anesthesia on
half of the mandible, including the teeth and lower lip.
Periodontal ligament injectionIf this
procedure is needed, it can be used instead of an
infiltration injection. The needle and anesthetic are
placed directly into the periodontal ligament along the
side of the tooth, where the solution is deposited under
pressure. This injection is very painful.
Oral administration of medications comes in the
form of tablets, capsules, liquids, and suspensions.
Dental patients may receive medications by this
method preoperatively (before) or postoperatively
(after) a dental procedure. Another route closely
associated with oral administration is SUBLINGUAL.
The drug is placed under the tongue and is rapidly
absorbed directly into the blood stream. An example is
nitroglycerin sublingual tablets.
Inhalation is the introduction of medication
through the respiratory system in the form of a gas,
vapor, spray, or powder. The three major types are
vaporization, nebulization, and gas inhalation. The
most common type of gas inhalation used in dentistry
is nitrous oxide sedation and will be discussed later in
Topical agents are applied to a particular surface
area of the skin being treated. Examples of topical
agents are ointments, creams, lotions, shampoos,
paste, gels, and liquids. Dental topical agents will be
discussed in this chapter under anesthetics.
The definition of a drug is any chemical substance
that has an effect on living tissue but is not used for
food. Drugs are used on or administered to humans or
animals as an aid in the diagnosis, treatment, or
prevention of disease or other abnormal conditions, for
the relief of pain or suffering, or to control or improve
any physiological or pathological condition. A drug
may be classified in various categories, depending
upon different criteria. Examples are general,
chemical, and therapeutic.
GeneralDrugs are grouped according to their
source, whether animal, vegetable, or mineral in
ChemicalMedications are grouped by their
chemical characteristics. Examples are acids,
bases, or salts.
Therapeutic (Pharmacological)Drugs are
classified according to their action on the body.
A drug may have more than one action.