(Demerol) This is a synthetic analgesic similar to morphine. In dentistry it is used for moderate to severe pain and as a preoperative medication.
These drugs produce vasodilation by relaxing and enlarging the diameter of the blood vessels and smooth muscle of the arteries, thereby lowering the blood pressure.
Amy1 nitrite is primarily used in casualty care to treat blood agents. This will be discussed in chapter 13. Other uses are for urological conditions.
Nitroglycerin is indicated for the treatment and management of acute and chronic angina pectoris. Administration of this drug will be discussed in Dental Technician, Volume 2, NAVEDTRA 12.573, chapter 9.
Vacoconstrictors are the opposite of vasodilators; these drugs produce constriction of the blood vessels with consequent rise in blood pressure.
In dentistry, epinephrine is used in some dental anesthetics, rarely in gingival retraction cord processes, to help control diffuse bleeding, and can be used to treat severe allergic reactions, such as anaphylactic shock.
In local anesthetics, small amounts of epinephrine are added in dental carpules, with ratios ranging from: 1:50,000, 1:100,000, or 1:200,000 parts of epinephrine to anesthetic solutions.
Hemostatics are any agents, mechanical or chemical, that arrest bleeding. They are used to control hemorrhage from minute vessels or tissues by stopping bleeding or by forming of a clot. Examples of mechanical and chemical agents will be discussed in Dental Technician, Volume 2, NAVEDTRA 12573, chapter 5, "Oral Surgery Assistance."
This group of drugs delays or prevents blood coagulation. A common anticoagulant used in dental I.V. sedation is heparin sodium.
The word anesthesia means a partial or total absence of sensation to stimuli, such as cold, heat, or painful irritation.
In dentistry the words numb, frozen, or asleep are examples of how the mouth can feel when the anesthetic is administered.
Dental anesthesia comes in many forms such as gas, local, and topical to control pain and relax patients.
Control of anxiety and pain associated with dental care can be accomplished by administering local anesthesia and sedation. The most commonly used gas in dentistry is nitrous oxide sedation. It may produce a condition where the patient may laugh and become quite talkative. Nitrous oxide is supplied in blue steel tanks. Inhalation sedation with a mixture of 40% nitrous oxide and 60% oxygen (N20-02), delivered through a gas machine produces a conscious sedation that is a safe and effective means to manage the behavior, anxiety, and pain of many dental patients before and during a dental procedure. The advantages of N2 O-O2 sedation are:
Rapid onset of action.
Good control of the depth of the sedation.
Rapid and complete recovery.
Guidance to dental treatment facilities for the administration of nitrous oxide-oxygen (N2 O-O2 ) inhalation conscious sedation for dental outpatient services can be found in BUMEDINST 6710.68.
Most dental procedures require cutting or painful manipulation of living tissue. To make these procedures comfortable for the patient, the dental officer will inject local anesthetic agents for pain control. Local anesthetics temporarily prevent the conduction of sensory impulses such as pain, touch, and thermal change from a body part along nerve pathways to the brain. The dental officer can select regions of the mouth he would like to lose sensation to complete the dental procedure. About 15 different local anesthetics are available for dental use. These anesthetic solutions can be chemically classified into two different categories: amides and esters.
Amides - An organic compound that comes from ammonia. Examples of amide solutions are lidocaine, bupivacaine, and mepivacaine.
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