Question 1

Match the following:
-Aberrant innervation

Accepted Answer

A)  Response to drug based on time of day 
B)  Allows diffusion into spongy bone 
C)  Soft tissue restriction to flow of anesthesia 
D)  Expected variation 
E)  Accessory to mandibular incisors
F) Drug tolerance
G) Divided nerve
H) Unexpected variation
I) Hard tissue restricting flow of anesthesia
J) Accessory innervation to mandibular teeth 
A)  Response to drug based on time of day 
B)  Allows diffusion into spongy bone 
C)  Soft tissue restriction to flow of anesthesia 
D)  Expected variation 
E)  Accessory to mandibular incisors
F) Drug tolerance
G) Divided nerve
H) Unexpected variation
I) Hard tissue restricting flow of anesthesia
J) Accessory innervation to mandibular teeth

Question 2

Fibers from the greater palatine nerve may provide accessory innervation to the palatal roots of maxillary molars.

Accepted Answer

A) True 
 B)False

Question 3

The ________ injection technique requires penetration through the periosteum and cortical plate before injecting anesthetic solution.

Accepted Answer

The answer of The ________ injection technique requires penetration through...

Question 4

Match the following:
-Intraosseous injection

Accepted Answer

A)  Response to drug based on time of day 
B)  Allows diffusion into spongy bone 
C)  Soft tissue restriction to flow of anesthesia 
D)  Expected variation 
E)  Accessory to mandibular incisors
F) Drug tolerance
G) Divided nerve
H) Unexpected variation
I) Hard tissue restricting flow of anesthesia
J) Accessory innervation to mandibular teeth 
A)  Response to drug based on time of day 
B)  Allows diffusion into spongy bone 
C)  Soft tissue restriction to flow of anesthesia 
D)  Expected variation 
E)  Accessory to mandibular incisors
F) Drug tolerance
G) Divided nerve
H) Unexpected variation
I) Hard tissue restricting flow of anesthesia
J) Accessory innervation to mandibular teeth

Question 5

A pH below 3.3 can lead to failure of anesthesia because the solution is too acidic.

Accepted Answer

A) True 
 B)False

Question 6

Which of the following factors is most likely to correspond to anesthetic failures?

Accepted Answer

A)  Delivery devices 
B)  Needle bevel orientation 
C)  Needle deflection 
D)  Physical barriers 
A)  Delivery devices 
B)  Needle bevel orientation 
C)  Needle deflection 
D)  Physical barriers

Question 7

Which statement is true regarding tachyphylaxis?

Accepted Answer

A)  It is most likely to occur once sensation has returned to normal levels. 
B)  It is least likely to occur when effective anesthesia was initially achieved. 
C)  It is well understood as a problem related to inadequate local anesthesia. 
D)  It is related to the high pH of tissues in the presence of inflammation. 
A)  It is most likely to occur once sensation has returned to normal levels. 
B)  It is least likely to occur when effective anesthesia was initially achieved. 
C)  It is well understood as a problem related to inadequate local anesthesia. 
D)  It is related to the high pH of tissues in the presence of inflammation.

Question 8

Which of the following does not typically have an effect on the ability to achieve profound anesthesia?

Accepted Answer

A)  Anatomical barriers 
B)  Choice of anesthetic 
C)  Volume of anesthetic administered 
D)  Psychological barriers 
A)  Anatomical barriers 
B)  Choice of anesthetic 
C)  Volume of anesthetic administered 
D)  Psychological barriers

Question 9

Match the following:
-Fascial planes

Accepted Answer

A)  Response to drug based on time of day 
B)  Allows diffusion into spongy bone 
C)  Soft tissue restriction to flow of anesthesia 
D)  Expected variation 
E)  Accessory to mandibular incisors
F) Drug tolerance
G) Divided nerve
H) Unexpected variation
I) Hard tissue restricting flow of anesthesia
J) Accessory innervation to mandibular teeth 
A)  Response to drug based on time of day 
B)  Allows diffusion into spongy bone 
C)  Soft tissue restriction to flow of anesthesia 
D)  Expected variation 
E)  Accessory to mandibular incisors
F) Drug tolerance
G) Divided nerve
H) Unexpected variation
I) Hard tissue restricting flow of anesthesia
J) Accessory innervation to mandibular teeth

Question 10

PDL injections can overcome nearly all of the challenges that occur due to accessory and aberrant innervation.

Accepted Answer

A) True 
 B)False

Question 11

Mepivacaine plain solutions may be useful for reinjection following the use of lidocaine 2% with epinephrine for all of the following reasons except

Accepted Answer

A)  There is 50% more drug per volume. 
B)  It raises the pH at the deposition site. 
C)  Duration is enhanced by the presence of previously injected vasoconstrictor. 
D)  It is a strong vasodilator. 
A)  There is 50% more drug per volume. 
B)  It raises the pH at the deposition site. 
C)  Duration is enhanced by the presence of previously injected vasoconstrictor. 
D)  It is a strong vasodilator.

Question 12

Following a PSA nerve block of tooth 2 it is determined that the palatal root is inadequately anesthetized. Discuss two possible causes and three possible solutions the clinician should consider.

Accepted Answer

Two possible causes of inadequate anesth

Question 13

Dental hygiene procedures require less duration of anesthesia than restorative procedures.

Accepted Answer

A) True 
 B)False

Question 14

________ can deflect anesthetic solution away from ideal deposition sites, resulting in inadequate anesthesia.

Accepted Answer

The answer of ________ can deflect anesthetic solution away from...

Question 15

The Gow-Gates is successful in providing anesthesia of mandibular molars in the presence of accessory innervation from the mylohyoid or lingual nerves because

Accepted Answer

A)  An increased volume of solution is administered and the mouth is maintained in an open position following injection. 
B)  The deposition site is lower on the inferior nerve; therefore, it is closer to the mylohyoid and lingual nerves. 
C)  The IA nerve trunk is anesthetized higher on the inferior nerve. 
D)  A long, 25 gauge needle is used. 
A)  An increased volume of solution is administered and the mouth is maintained in an open position following injection. 
B)  The deposition site is lower on the inferior nerve; therefore, it is closer to the mylohyoid and lingual nerves. 
C)  The IA nerve trunk is anesthetized higher on the inferior nerve. 
D)  A long, 25 gauge needle is used.

Question 16

Needle bevel orientations are not considered critical to the success of any injection.

Accepted Answer

A) True 
 B)False

Question 17

The higher the gauge of a needle, the greater its ________ and deflection in tissues.

Accepted Answer

The answer of The higher the gauge of a needle,...

Question 18

Match the following:
-Dense bone

Accepted Answer

A)  Response to drug based on time of day 
B)  Allows diffusion into spongy bone 
C)  Soft tissue restriction to flow of anesthesia 
D)  Expected variation 
E)  Accessory to mandibular incisors
F) Drug tolerance
G) Divided nerve
H) Unexpected variation
I) Hard tissue restricting flow of anesthesia
J) Accessory innervation to mandibular teeth 
A)  Response to drug based on time of day 
B)  Allows diffusion into spongy bone 
C)  Soft tissue restriction to flow of anesthesia 
D)  Expected variation 
E)  Accessory to mandibular incisors
F) Drug tolerance
G) Divided nerve
H) Unexpected variation
I) Hard tissue restricting flow of anesthesia
J) Accessory innervation to mandibular teeth

Question 19

Match the following:
-Mylohyoid nerve

Accepted Answer

A)  Response to drug based on time of day 
B)  Allows diffusion into spongy bone 
C)  Soft tissue restriction to flow of anesthesia 
D)  Expected variation 
E)  Accessory to mandibular incisors
F) Drug tolerance
G) Divided nerve
H) Unexpected variation
I) Hard tissue restricting flow of anesthesia
J) Accessory innervation to mandibular teeth 
A)  Response to drug based on time of day 
B)  Allows diffusion into spongy bone 
C)  Soft tissue restriction to flow of anesthesia 
D)  Expected variation 
E)  Accessory to mandibular incisors
F) Drug tolerance
G) Divided nerve
H) Unexpected variation
I) Hard tissue restricting flow of anesthesia
J) Accessory innervation to mandibular teeth

Question 20

Aberrant innervations are unexpected anatomical variations.

Accepted Answer

A) True 
 B)False

Exam 16: Troubleshooting Inadequate Anesthesia

Match the following: -Aberrant innervation

Fibers from the greater palatine nerve may provide accessory innervation to the palatal roots of maxillary molars.

The ________ injection technique requires penetration through the periosteum and cortical plate before injecting anesthetic solution.

Match the following: -Intraosseous injection

A pH below 3.3 can lead to failure of anesthesia because the solution is too acidic.

Which of the following factors is most likely to correspond to anesthetic failures?

Which statement is true regarding tachyphylaxis?

Which of the following does not typically have an effect on the ability to achieve profound anesthesia?

Match the following: -Fascial planes

PDL injections can overcome nearly all of the challenges that occur due to accessory and aberrant innervation.

Mepivacaine plain solutions may be useful for reinjection following the use of lidocaine 2% with epinephrine for all of the following reasons except

Following a PSA nerve block of tooth 2 it is determined that the palatal root is inadequately anesthetized. Discuss two possible causes and three possible solutions the clinician should consider.

Dental hygiene procedures require less duration of anesthesia than restorative procedures.

________ can deflect anesthetic solution away from ideal deposition sites, resulting in inadequate anesthesia.

The Gow-Gates is successful in providing anesthesia of mandibular molars in the presence of accessory innervation from the mylohyoid or lingual nerves because

Needle bevel orientations are not considered critical to the success of any injection.

The higher the gauge of a needle, the greater its ________ and deflection in tissues.

Match the following: -Dense bone

Match the following: -Mylohyoid nerve

Aberrant innervations are unexpected anatomical variations.

Perspectives on Local Anesthesia for Dental Professionals

Fundamentals of Pain Management

The Neuroanatomy and Neurophysiology of Pain Control

Pharmacology Basics

Dental Local Anesthetic Drugs

Vasoconstrictors in Dentistry

Dose Calculations for Local Anesthetic Solutions

Topical Anesthetics

Local Anesthetic Delivery Devices

Patient Assessment for Local Anesthesia

Fundamentals for Administration of Local Anesthetic Agents

Injections for Maxillary Pain Control

Injections for Palatal Pain Control

Injections for Mandibular Pain Control

Supplemental Techniques and Adjunctive Strategies

Local Anesthesia Complications and Management

Insights for the Fearful Patient

Insights From Pedodontics

Insights From Specialties: Oral Surgery, Periodontics, and Endodontics

Fundamentals for the Administration of N2O-Oxygen Sedation

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