Local Anesthesia and

Use of Rubber Dam in Pediatric Dentistry

Maha ALSARHEED

Local Anesthesia in pediatric dentistry requires understanding of

• Child growth and development• Behavioral management• Physiologic pain and modulation• Pharmacology of local anesthesia

Continued

• Children’s perception to pain varied with ages < 2 yrs- unable

2-10yrs- begin to distinguish

>10 yrs- able to participate

Anesthesia in Children

• Topical Anesthesia (TA)

• Local Anesthesia (LA)

• General Anesthesia (GA)

Topical Anesthesia (TA)• Its reduce the discomfort within the mucosal membrane

• TA is used to anesthetize 2-3mm depth of surface tissue when used properly

• A number of different preparation varying in the active agent and in concentration are available for intra-oral use

• TA provided as sprays, solutions, creams ointments and the mostly used in children is gel in different flavored

Local AnesthesiaDefinitionA reversal temporary cessation of painful impulses

from a particular region in the body

Mechanism of ActionLA agent penetrate the nerve cell membrane

and block receptor site that control the influx

of Na+ associate with membrane depolarization

Local Anesthesia Agents Ethers

Amides

Local Anesthesia properties

LA properties vary as a function of intrinsic properties of the anesthesia agent and the regional anesthetic procedure employed

Operator technique

TECHINIQUES

Maxillary Primary and Permanent Molar Anesthesia

Maxillary Primary and Permanent Incisor and Canine Anesthesia

Infraorbital block injection

Nasal palatine block

• Mandibular Tooth Anesthesia

• Papillary injection

• Intraligamentary injection

Complication of LA

1. Localized complications

2. 2. Systemic complications

Management of Complication

3. Prevention

4. Management

Conclusion

• Justification• Calculate maximum safe dose for each

patient• Practice techniques• Use vasoconstrictor• Knowledge of the intrinsic properties of

LA

Rubber Dam in Pediatric Dentistry Advantage of using Rubber Dam

1. Improving of child’s safety by reduced damage to the soft tissue and swallowing or inhalation items

2. Ensure a dry field by moisture control

3. Decrease operating time

4. Reduce stress and child become more quite and relaxed

5. Better view of the operating field by retracting of tongue, cheeks and gingival tissue

6. Enhance nasal breathing for N2O administration

7. Reduce risk of cross-infection

Contraindication in using Rubber Dam

1. Presence of fixed appliance

2. Recent erupted tooth

3. Child with upper respiratory infection, congested nasal passages or nasal obstruction

4. In rare case allergy to latex.

Method of application