Deck 14: Local Anesthesia for the Child and Adolescent

Question 1

The amount of topical anesthetic applied prior to local anesthetic injection should be factored into the total administered dose because it can infiltrate into the vascular system.

A) Both the statement and reason are correct and related.
B) Both the statement and reason are correct but NOT related.
C) The statement is correct,but the reason is NOT.
D) The statement is NOT correct,but the reason is correct.
E) NEITHER the statement NOR the reason is correct.

Answer 1

Both the statement and reason are correct and related.

Question 2

Which of the following agents is indicated for the reversal of soft tissue anesthesia?

A) Epinephrine 1:100,000
B) Phentolamine mesylate
C) Oraqix
D) Mepivacaine 3% plain

Answer 2

Phentolamine mesylate

Question 3

Treatment of soft tissue injury includes applying heat on the day of the injury.The following day ice may be applied.

A) Both statements are true.
B) Both statements are false.
C) The first statement is true;the second statement is false.
D) The first statement is false;the second statement is true.

Answer 3

Both statements are false.

Question 4

Which of the following does successful treatment of all patients depend upon?

A) Relief of pain
B) Relief of anxiety
C) Profound anesthesia
D) All options listed

Question 5

Supraperiosteal injection techniques are less clinically effective in mandibular primary molars compared to mandibular permanent molars due to the shorter roots of primary molars.

A) Both the statement and reason are correct and related.
B) Both the statement and reason are correct but NOT related.
C) The statement is correct,but the reason is NOT.
D) The statement is NOT correct,but the reason is correct.
E) NEITHER the statement NOR the reason is correct.

Question 6

For pediatric patients,each of the following contributes to increased risk of complications from local anesthesia except ONE.Which one is the EXCEPTION?

A) Concomitant use with opioid/sedatives during treatment
B) Immature organ function
C) Lowering MRD
D) Use of long duration local anesthetics

Question 7

Children between the ages of 6-9 may receive effective pain control,equivalent to the IA block,from buccal supraperiosteal infiltrations.Some extraction procedures can be accomplished utilizing mandibular supraperiosteal injections.

A) Both statements are true.
B) Both statements are false.
C) The first statement is true;the second statement is false.
D) The first statement is false;the second statement is true.

Question 8

Which of the following are useful strategies for behavioral management of children during provision of local anesthesia?

A) Show-tell-do communication
B) Utilizing a dental assistant to stabilize the child's head and hands
C) Discuss the process using the child's terminology
D) All options listed

Question 9

Which of the following is true regarding the use of mepivacaine 3% plain?

A) Provides short-acting pulpal anesthesia
B) Provides similar duration of soft tissue anesthesia as lidocaine 2% 1:100,000 epinephrine
C) Makes it easier to reach or exceed MRD than 2% lidocaine 1:100,000 epinephrine
D) Contains 50% more local anesthetic in a cartridge than 2% lidocaine 1:100,000 epinephrine
E) All options listed

Question 10

Most adverse drug reactions occur within 5-10 minutes of injection.Local anesthesia system toxicity initially manifests as excitation followed by depression of the cardiovascular system and to a lesser extent of the central nervous system.

A) Both statements are true.
B) Both statements are false.
C) The first statement is true;the second statement is false.
D) The first statement is false;the second statement is true.

Question 11

Which of the following decreases the possibility of LAST?

A) A standard scale to determine accurate body weight
B) Adhering to MRDs set by the AAPD
C) Anesthetizing only the quadrants currently being treated
D) All options listed

Question 12

For the overweight child all of the following are important considerations when providing local anesthesia EXCEPT one.Which one is the EXCEPTION?

A) Use lowest effective dose
B) Use Ideal Body Weight index
C) Consider lowering AAPD MRD
D) Calculate MRD based upon standard tables and Clark's Rule

Question 13

The PSA may be needed in some children because the thick zygomatic process may overlie the buccal roots of the second primary and first permanent molars.

A) Both the statement and reason are correct and related.
B) Both the statement and reason are correct but NOT related.
C) The statement is correct,but the reason is NOT.
D) The statement is NOT correct,but the reason is correct.
E) NEITHER the statement NOR the reason is correct.

Question 14

Bupivacaine is not recommended for children because it will increase the risk of soft tissue injury.

A) Both the statement and reason are correct and related.
B) Both the statement and reason are correct but NOT related.
C) The statement is correct,but the reason is NOT.
D) The statement is NOT correct,but the reason is correct.
E) NEITHER the statement NOR the reason is correct.

Question 15

All of the following describe situations when dental hygienists most often provide local anesthesia for pediatric patients EXCEPT one.Which one is the EXCEPTION?

A) When requested by the dentist who is providing restorative work
B) When the dental hygienist is licensed to provide restorative work
C) During nonsurgical periodontal therapy
D) When the patient has an appointment first with the hygienist and then with the dentist for restorative care.

Question 16

Self-inflicted soft tissue injury resulting from regional local anesthesia in the dental office is a significant and common local complication for children.The most common area of injury is the upper lip.

A) Both statements are true.
B) Both statements are false.
C) The first statement is true;the second statement is false.
D) The first statement is false;the second statement is true.

Question 17

Which of the following describes why the IA block has a greater success rate in children than adults?

A) The mandibular foramen is located more inferior in children than adults.
B) The soft tissue is thicker overlying the IA nerve.
C) Bone does not need to be contacted prior to deposition.
D) All options listed.

Question 18

Which of the following are preventive measures to decrease the occurrences of soft tissue injury?

A) Selection of agent with appropriate duration of action
B) Advise parent/caregiver about possible injury due to biting the lip,tongue,or cheek
C) Place cotton rolls in vestibule and warning stickers on the patient's head
D) Advise parent/caregiver to delay meals and hot drinks
E) All options listed

Question 19

One of the most common adverse reactions to local anesthesia is systemic toxicity.This is typically the result of administering the anesthetic agent over the patient's maximum recommended dose (MRD)or from inadvertent intravascular injections.

A) Both statements are true.
B) Both statements are false.
C) The first statement is true;the second statement is false.
D) The first statement is false;the second statement is true.

Question 20

All of the following are considerations regarding the use of palatal injections for children with only primary dentition EXCEPT one.Which one is the EXCEPTION?

A) The use of the C-CLAD will increase comfort
B) The NP block technique is identical to that described for adults
C) The GP block technique is identical to that described for adults
D) Prepuncture techniques increase comfort
E) Slow administration increases comfort