Amy Dukoff
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 NESTHETIZING
the patient has been getting easier. New technology, tools, and delivery
systems have enabled the practitioner to get the patient numb with greater
ease. Today, Oraqix and the VibraJect have made establishing anesthesia
easier. It’s easy to incorporate these items as part of the routine.
Oraqix is marketed toward use during the periodontal procedures
of scaling and root planing. It is primarily designed to provide
anesthesia for periodontal procedures. However, its use can be broadened
to include endodontics. Oraqix anesthetic is not injected; instead
it is applied on the gingival margin around the selected teeth using the
blunt-tipped applicator included in the package. In endodontic procedures,
Oraqix can be applied to the gingival prior to rubber dam placement.
The benefit of using Oraqix anesthetic is that it provides a “needle-free”
delivery system. The gingiva in this area can be very sensitive.
The blunted applicator allows for placement of the anesthetic on the gingival
surface rather than piercing the gingiva. The anesthetic is a lidocaine
and prilocaine liquid that sets to form a gel at body temperature.
The onset is within 30 seconds. The patients do not experience pain
upon application of the anesthetic. The clamp can go on readily without
the patient’s feeling the stress of “pinching” of the gingiva. I
recommend using this technique particularly on the palatal surfaces on
teeth. The patients seem to be very pleased by this delivery system,
for they say they feel nothing.
The VibraJect attaches onto the barrel of the injection
syringe and vibrates the needle at a high frequency while injections are
administered. Its effectiveness is based on the gate control theory
of nerve function proposed in 1965 by psychologists Ronald Melzack and
Patrick Wall. In short, the theory suggests that nerve endings sense
vibrations first and then cannot transmit feelings of pain. So the vibrations
essentially mask patients’ discomfort, putting them at ease during even
the most dreaded injections. The patients feel that the vibration
is a welcome distraction. Most of the patients feel a noticeable
decrease in the pain associated with the injection. Furthermore,
the patients like the “newness” of the injection. Since the perception
of pain is greatly diminished, the technique works well. The patients
say that they find the “needle stick” relatively hardly noticeable.
The VibraJect is a wonderful addition to the dental armamentarium.
Thanks to the newer techniques in anesthesia delivery,
patients accept the administration of anesthesia more willingly. They do
not fear it as much as before. Also, the techniques make for a calmer
and more relaxed patient during the procedure.
July - August 2006
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Thanks
to the newer techniques in anesthesia delivery, patients accept the administration
of anesthesia more willingly.
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Do not force the Peeso drill when removing
gutta percha to make a post hole. Gutta percha is really soft, so running
the drill at full speed with gentle pressure should melt the gutta percha
away. If you have to push hard, then you are drilling into the tooth structure
and are going to perforate out through the root. |
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