DHYG 326 Pain Management I: Local Anesthesia (3 credits)
Course Description
Surveys physiology and pharmacology of dental local anesthesia, elements of pre-anesthesia patient assessment, and devices and injection techniques commonly used in dentistry. Students learn techniques in peer-labs on each other.
Course Content
Evolution of local anesthesia and armamentarium in dentistry including the origins and principles of chemical pain control, key developers and timelines, and benchmark local anesthesia products.
History of use of local anesthetics by dental hygienists.
Pain control concepts and fundamentals of pain management.
Neuroanatomy and neurophysiology of nerve membranes, nerve impulse initiation, conduction and propagation, and pain control concepts.
Neurophysiology of the cranial nerves responsible for sensory and motor functions in the head, neck, and orofacial complex.
Pharmacological basis of dental local anesthetic drugs, vasoconstrictors, and topical anesthetics.
Pharmacological properties of common dental anesthetic drugs to include onset, absorption, vasodilatation properties, duration of action, distribution, metabolism, and excretion
Clinical significance of the pharmacokinetics and pharmacodynamics of local anesthetic agents
Pharmacological properties impacting the clinical effectiveness of local anesthetic agents
Theoretical basis for effects of local anesthetic agents in humans and perspectives on local anesthesia for dental professionals.
Drug factors required for dose calculations to include vasoconstrictors, limiting drug, multiple drugs, and drug MRDs
Establishing and calculating maximum recommended dosages of local anesthetics related to use in dentistry.
Armamentarium, local anesthetic delivery devices and clinical supplies for local anesthesia administration to include components of delivery devices and drug cartridges.
Safe and effective handling, use, and maintenance of dental anesthetic syringes to include manual, safety and computerized delivery devices.
Pre-injection patient assessment and treatment planning for local anesthesia and management of local and systemic complications related to local anesthetic injections.
ASA classifications for assessment of patient medical status prior to administration of local anesthetics.
Relative and absolute contraindications to dental local anesthetic agents
Local and systemic effects of local anesthetic agents on the central nervous system, cardiovascular system, peripheral vasculature and respiratory system.
Anatomy relevant to the administration of local anesthetics by injection for maxillary, palatal, and mandibular pain control in dentistry.
Key injections landmarks of bony structures, soft tissues, and muscles associated with anatomical barriers to successful anesthesia
Vessels and nerves of the orofacial complex relevant to dental injections to include arteries, veins, branches and pathways of CN-V (trigeminal) nerve and CN-VII (facial), and structures innervated by each.
Indications for local anesthesia in dental and dental hygiene practice.
Potential drug interactions with local anesthetic agents.
Signs and symptoms of adverse reactions to local anesthetics to include toxicity, allergy, and idiosyncrasy.
Management of complications and medical emergencies related to local anesthetic administration and anesthesia.
Clinical manifestations of mild to moderate to high levels of local anesthetic toxicity.
Technique implicated complications related to local anesthetic administration
Fundamentals of administration of local anesthetic agents and basic steps for administering dental injections for maxillary, palatal, and mandibular pain control in dentistry.
Exposure control and safety guidelines for handling needles, drug cartridges, and syringes.
Student Outcomes
- Integrate facts and concepts related to neurophysiology, pharmacology, pharmacokinetics and pharmacokinetics, and mechanism of action in to the safe selection of dental local anesthetic agents and accurate calculation of drug doses.
- Recognize anatomical facts and concepts related to common dental local anesthetic injection techniques in the orofacial complex including bony and soft tissue landmarks, muscles, vasculature, and pathways of the facial and trigeminal nerves.
- Communicate patient health factors impacting drug selection, the safe administration of dental local anesthetic drugs and prevention of adverse events to dental and healthcare professionals, and patients.
- Demonstrate clinically acceptable armamentarium management and injection techniques for safe and effective administration of dental local anesthetic agents.
- Manage common local and systemic adverse events and potential medical emergencies related to the use of local anesthesia in dentistry.
Degree Outcomes
This course is part of the Bachelor of Applied Science in Dental Hygiene Degree. Please refer to the Dental Hygiene Competency Map for detail of the Program Competencies this course addresses. Each competency is identified at a level of skill by the terms Introductory (I), Developing (D), or Competent (C). The map also shows the alignment between each Program Competency and the Pierce College Core Ability(ies).
Core Abilities
Critical, Creative and Reflective Thinking: Graduates will evaluate, analyze, synthesize, and generate ideas; construct informed, meaningful, and justifiable conclusions; and process feelings, beliefs, biases, strengths, and weaknesses as they relate to their thinking, decisions, and creations.
Lecture Contact Hours 20
Lab Contact Hours 20
Clinical Contact Hours 0
Total Contact Hours 40
Potential Methods
In-class discussion - participation rubric
Weekly online discussion topics - blackboard blog rubric
Written final examination - multiple choice
Student lab activities – clinical injection technique evaluation criteria
ePortfolio
Clinical (Acceptable, Improvable, Standard Not Met) AIS Evaluation Criteria and/or Pierce College Global Rubrics
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