Anesthesia

View from the Chairside: An Anatomical Approach to Endodontic Access

Anecdotally, this great presentation happened as a coincidence. Dr. Andrew Moncarz was featured in Dr. Paul Belzycki’s recent clinical presentation as the treating endodontist who completed the root canal for the patient. To record the segment, Dr. Moncarz prepared a fantastic presentation on the approach he follows to achieve endodontic access. I thought the information was very pertinent and important that I suggested we would share it in a separate post. And, thankfully Dr. Moncarz agreed.  Here is a compilation of tips, advice and thoughts presented by Dr. Andrew Moncarz, Endodontist in Toronto. He received his DDS from U of ...

Read More »

What are the adverse effects and complications of local anesthetics?

Highlights In this short presentation, Dr. Aviv Ouanounou discusses the possible adverse effects of administering local anesthetics. Psychogenic reactions include most commonly syncope, as well as hyperventilation, nausea, and changes in heart rate and blood pressure. Allergic reactions are usually very rare and if they occur, they are usually related to the ester type of local anesthetics. Paresthesia is a complication that may occur following the administration of local anesthesia. It usually resolves within 6-8 weeks. It is thought that 4% solutions of local anesthetic may have higher risk of causing paresthesia. Hematomas are also another complication. They will commonly ...

Read More »

What You Need to Know about Local Anesthetics

Highlights Dr. Aviv Ouanounou returns to speak to the Oasis Discussions audience. In this short video, Dr. Ouanounou provides an overview of local anesthetics which are commonplace in every dental office. Local anesthetics are hydrophilic with an amide (most common) or ester (less common) linkages. Topical anesthetics belong to the ester group. These drugs stop action potential propagation by blocking sodium channels. Onset and duration of anesthetic are affected by: pH and pka of the drug and tissues, concentration of the drug, area of administration, nerve morphology. Local anesthetic agents are generally very safe; however, they can induce psychogenic effects ...

Read More »

Phentolamine: What is it & how to use it?

Dr. John O’Keefe explored the use of Phetolamine with Dr. Joonyoung Ji, dental anesthesia specialist in Ottawa, ON.  Indications  Dental procedure – Adults – Reversal of local anesthesia, Soft-tissue and pulp tissue: 0.2 mg for every 1/2 cartridge of  1:100,000 epinephrine containing local anesthetic administered, 0.4 mg for every 1 cartridge of 1:100,000 epinephrine containing local anesthetic administered, and 0.8 mg for 2 cartridges of 1:100,000 epinephrine containing local anesthetic administered; location(s) and technique(s) (infiltration or block injection) should be the same as used for the local anesthetic/vasoconstrictor. Dental procedure – Pediatric – Reversal of local anesthesia, Soft-tissue and pulp tissue: (6 yr and older or ...

Read More »

CE Showcase ASM 2017: Oral Sedation for Dentistry: Clinical “How-to” Concepts and Current Controversies

It was a pleasure to meet and speak with Dr. Mel Hawkins for this interview. Generously, he prepared these slides to tell our audience what his session on sedation will be about during ASM 2017. I hope you enjoy the conversation. Chiraz Guessaier, CDA Oasis Manager Highlights During the session pharmacokinetics/pharmacodynamics of oral sedation will be reviewed, including the difference between duration and halflife and importance of the first pass effect. Emphasis will be on the benzodiazepines. “How might a dentist incorporate and/or improve an office sedation protocol?” “Monitoring, complications, reversal, safety and a suggested pediatric regimen are all included ...

Read More »

Focusing the Medical History When Administering Nitrous Oxide

In this short video, Dr. Joonyoung Ji speaks to Dr. John O’Keefe about the absolute and relative contraindications for the use of nitrous oxide guide by the dental clinician. Highlights Nitrous oxide is often used to allay patient fears and anxiety that may occur during dental treatment. However, it should be used only after a thorough medical history by the dentist. Absolute contraindication Pregnancy Bowel obstruction Bleomycin Recent surgery in closed spaces such as eyes or middle ear Relative contraindications Pulmonary hypertension Intracranial pressure Folate deficiency Predisposition to nausea and vomiting In some instances, modifications can be made for patients ...

Read More »

Local Anesthetics for the Patient Suffering from Methemoglobinemia

Dr. Joonyoung Ji speaks with Dr. John O’Keefe about the risks of administering local anesthetics to patients suffering from methemoglobinemia. Highlights Scenario A patient has a scope performed in a hospital setting and benzocaine was used to numb the area before inserting the scope. Subsequently, the patient developed methemoglobinemia. The patient’s physician has now advised that all “-caine-type” anesthetics must be avoided in this patient for all dental work. Management Context is important to determine why a scope was performed and how the situation that developed was managed. Often, in medical settings the amounts of local anesthetics that are used ...

Read More »

The Dental Office Medical Emergency Kit

Dr. Joonyoung Ji, Dental Anesthesia specialist in Ottawa, provides useful and important information about the must haves in the dental office medical emergency kit.  Highlights Emergency kits are a necessity in every dental office but, there are basic elements practitioners must consider. Kits must be easily accessible Kits must be stocked appropriately and organized An action plan should be in place and the team should know how to administer the medications Expiration dates and reordering information should be kept handy The RCDSO mandates that all dental offices have 6 emergency drugs available in each office: Oxygen Epinephrine Salbutamol (Ventolin) Nitroglycerine ...

Read More »