When you are assisting during an amalgam restoration, load the amalgam into the carrier and pass the loaded carrier to the dentist. You may sometimes use two or more amalgam carriers, which lets you fill the barrel of one while the dentist is using the other. You must also add into this sequence of filling and refilling the amalgam carriers the passing of condensing instruments to the dentist during the amalgam restoration process.
During the use of cements, most dentists prefer that you leave the mixed cement on the glass slab or mixing pad and then hold the pad or slab in your hand near the treatment site. The dentist can select the amount desired. In your other hand, you can hold the air syringe to dry the area for application and placement of the material. With the use of some materials, you may need to hold a gauze sponge in your hand (rather than the air syringe) to wipe excess material from the application instrument.
The overall idea in passing and receiving dental instruments and materials is to have the needed item at the right place, in the right position, at the right time. In doing this, the dentist is then free to concentrate more on the area of treatment.
Some basic dental procedures, such as admini- stration of local anesthetic, irrigation, aspiration, and retracting of tissues, are performed in nearly all aspects of all clinical dentistry. Others such as rubber dam application and assembling of matrices are performed in operative procedures. Except for the administration of local anesthetic, you must be able to perform these procedures. When administration of local anesthetic is required, you need to prepare all the items used for this procedure.
Before doing a possibly painful dental procedure, the dentist will give the patient a local anesthetic to make the treatment site insensitive to pain. You must be knowledgeable of the various techniques used to prepare for the correct type of injection. These techniques such as topical, infiltration, and block injections have been discussed in Volume I, chapter 7, "Oral Pharmacology."
Before giving a local anesthetic, the dentist may use the following pre-injection items to prepare the injection site:
2 x 2 inch gauze sponges
Cotton tip applicators
The dentist may have the patient use an antiseptic mouthwash to rinse the oral cavity before applying a topical anesthetic. The gauze sponges are used to dry the injection site mucosa before applying the topical anesthetic. The topical anesthetic, usually supplied in an ointment, is applied with a cotton tip applicator to reduce the pain associated with the injection of the needle.
The items used to give local anesthetics are an aspirating syringe, needle, and carpule. It is also important to know the different types of anesthetic and how to assemble and disassemble the aspirating syringe properly for the dentist's use.
You'll find many types of anesthetic carpules in Navy dentistry. As discussed in Volume I, chapter 7, "Oral Pharmacology," the two most common local anesthetics used in dentistry are 2% lidocaine hydrochloride and 2% mepivacaine. Each type of anesthetic is sealed in a 1.8-cc glass carpule. The needle end of each carpule is sealed with rubber membrane held in place by a metal band. The other end has a different colored rubber stopper. Each type of anesthetic has a different colored rubber stopper.
Based on the patient's health history and the procedure to be performed, the dentist will inform you which type of anesthetic (including vasoconstrictor content), needle length, and needle gauge to use to prepare the syringe. You will become familiar with each dentist's preference and various procedures for needle length and gauge. However, always verify the type of anesthetic solution. Assemble the syringe out of the patient's view to reduce unnecessary patient apprehension. Assembly can be done while the dentist administers the topical anesthetic. 4-19