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Pain perception
The physical process of receiving a painful stimulus and transmitting the information through the nervous system to the brain
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Pain reaction
The personal interpretation and response to the pain message
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Factors that influence pain reaction
- Age
- Fatigue
- Emotional state
- Cultural behavior
- Ethnic behavior
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Pain control mechanisms
- Remove painful stimulus
- Block pathway of pain message
- Prevent pain reaction by raising threshold
- Depress CNS
- Use psychosedation methods
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What does NSAID's stand for
Non-steroidal anti-inflammatory drugs
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What are the actions of NSAIDS
- Inhibit generation of pain message
- Suppresses onset of pain
- Decreases pain severity
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What is dental fear
The body's response to an immediate threat
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Dental anxiety
- Nonspecific unease, apprehension or negative thoughts about what may happen durin an appointment
- Can also lead to the perception that a normally non painful stimulus is painful
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Phobia
Fear or anxiety that is irrational, persistent and unreasonable in relation to the actual threat
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Effects of fear on the body
- Flight or flight response
- Dilation of pupils
- Decrease in salivation
- Increase respiration
- Increased BP
- Increased heart rate
- Increased blood glucose
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Pain threshold
The point at which an uncomfortable stimulus is perceived as painful
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Pain tolerance
The amount of pain that is the most the individual can bear
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Vicarious learning
Occurs when anxiety is acquired by watching, listening to or reading about the experience of others
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What are the 2 major groups of dental local anesthetics
Ester & Amide Anesthetic Drug
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All currently used local injectable anesthetic agents are
Amides
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Characteristics of Ester
- Widely used in topical agents
- Higher incidence of allergic reactions
- Less effective and shorter duration
- Metabolized in blood plasma
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Charactersistics of Amides
- Low incidence of allergic reactions
- Potential for toxicity
- Metabolized by the liver
- Causes vasodilation of local blood vessels
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Symptoms of toxicity
- Blurry vision
- Dizziness of lightheadedness
- Shivering
- Drowsiness
- Diffuculty breathing
- Seizures
- Ringin in ears
- Headache
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A mild allergic reaction can include
Sweeling and raised welts on the skin that can itch and burn
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Factors affecting the absorption of drug
- Thickness of SS epithelial covering
- Degree of keratinization
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Topical Agents Amides
- Lidocaine & Lidocaine Hydrochloride
- Only amide used alone as topical
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Topical Agents Ester
- Benzocaine
- -7.5-20% formulations
- -Liquids, gel, ointment and spray
- -Low toxicity
- -May cause allergic reaction with prolonged use
- -Only topical anesthetic available OTC
- -Most widely used
- Tetracaine HCL
- -Longer effect, readily absorbed & more potential for toxicity
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What is the action of topical anesthetic
Desensitizes the mucous membrane by anesthetizing the terminal nerve endings
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What are the indications for use of non-injectable anesthesia
- Mild to moderate discomfort from scaling
- Needle phobic adults
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What are the contraidications for non-injectable anesthesia
- Allergy to amide
- Methomoglovinemia
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What are the 4 gel contents of Oraquix
- 2.5% Lidocaine & Prilocaine
- Poloxamers-thermosetting agents
- Ph adjuster-hydrochloric acid
- Purified water
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What is the initial onset & duration of the Lidocaine transoral patch
- Initial onset 21/2 -5 minutes
- Duration is 45 minutes
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Lidocaine ointment
- Initial onset 1-2 minutes
- Optimum application 3-5 minutes
- Duration is 15 minutes
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Tetracaine combined with other drugs
- Initial onset 2 minutes
- Duration 20-60 minutes
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Benzocaine
- Initial onset 30 seconds
- Optimum application 1-2 minutes
- Duration 5-15 minutes
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Oraquix
- Initial onset 30 seconds
- Duration 14-31 minutes
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