Session outcomes — Anaesthesia & instrumentation (summary)
What you should be able to do
- Understand LA techniques and doses as they apply to oral surgery.
- Understand LA pharmacology + dosing strategies relevant to oral surgery.
- Describe instruments required for simple exodontia.
LA: practical competence checklist
- Plan coverage: tooth + alveolar bone + circumferential gingiva (incl. palatal/lingual tissues)
- Distinguish pressure vs pain: warn patients they’ll feel pushing/pulling/pressure
- Troubleshoot inadequate anaesthesia
- Technique miss (e.g., IANB/lingual)
- Infection/inflammation (low pH)
- Accessory innervation (e.g., mylohyoid → consider lingual supplementation)
Dosing: “what matters most” table
| Situation | Why dosing matters | Practical strategy |
|---|
| Routine restorations / simple exos | Usually 1–2 carpules | Rarely dose-limiting |
| Clearances / multi-quadrant extractions | Higher total LA volume | Calculate max, consider staging/quadrants |
| Small / frail / adolescent patients | Lower safe total dose | More conservative planning + timing |
Core instruments for simple exodontia (scannable)
- Luxators
- Thin blade for PDL severing along long axis; wedging force
- Aim: less adjacent-tooth contact, less bone trauma
- Elevators
- Used for lever/wedge/wheel-and-axle mechanics (depending on design)
- Must avoid using adjacent teeth as fulcrum unless planned for extraction
- Forceps
- Correct beak selection + apical pressure to help expand socket
- Must seat apically and control forces to reduce crown/root fracture risk
Safety essentials
- Maintain control to prevent instrument slip (soft tissue injury risk)
- Beginners: avoid uncontrolled lingual/palatal luxation (high injury risk)