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ADA Division of Science

Publications and source records attributed to ADA Division of Science.

3 recordsLinked to original sources

The key to profound local anesthesia: neuroanatomy.

BACKGROUND: To achieve profound dental local anesthesia, it is necessary for the dentist to have a thorough knowledge of the details of sensory innervation to the maxilla and mandible. Since the early 1970s, dentistry has experienced a resurgence of interest in the neuroanatomical basis of local anesthesia, resulting in numerous scientific reports on the subject. OVERVIEW: Current studies afford a more detailed knowledge of the branching of various divisions of the trigeminal nerve, the great sensory nerve of the head region. In this article, the authors provide an update of the peripheral distribution of the trigeminal nerve to enhance induction of safe and effective dental local anesthesia. CONCLUSIONS AND PRACTICAL IMPLICATIONS: An understanding of the potential variations in innervation should help the dentist improve his or her ability to induce profound local anesthesia.

Anesthesia, Dental↗

Avoiding complications in local anesthesia induction: anatomical considerations.

BACKGROUND: Dentists administer thousands of local anesthetic injections every day with few reports of serious complications. However, misjudging the anatomy involved during local anesthetic administration can result not only in inadequate or incomplete anesthesia, but in other complications such as paresthesia, bleeding or hematoma formation, or in serious systemic complications. OVERVIEW: The authors discuss anatomical considerations that dentists should keep in mind when administering local anesthetic injections. In particular, they discuss ways in which dentists can minimize the risk of nerve or vascular injury, as well as systemic complications. CONCLUSIONS AND CLINICAL IMPLICATIONS: Even the most experienced practitioner can benefit from a periodic review of the anatomy associated with local anesthesia. This article offers dentists the opportunity to consider needle placement with regard to location of nerves, blood vessels and glands, and to review injection protocols that can minimize the risk of complications.

Anesthesia, Dental↗

Manual versus powered toothbrushes: the Cochrane review.

BACKGROUND: In a report released in January 2003, The Cochrane Collaboration Oral Health Group provided a systematic review of the effectiveness of powered versus manual toothbrushes, which generated much interest in the popular press. METHODS: The Cochrane researchers developed and implemented search strategies for the Cochrane Oral Health Group's Trial Register, the Cochrane Central Register of Controlled Trials, MEDLINE and the Cumulative Index to Nursing and Allied Health Literature. They contacted manufacturers for additional information. Trials were selected if they met the following criteria: compared power versus manual toothbrushes, had a randomized design, drew participants from a general population without disabilities, provided data regarding plaque and gingivitis, and were at least 28 days in length. Reviewers evaluated only studies published in 2001 or earlier. Six reviewers from the Cochrane study independently extracted information in duplicate. Indexes for plaque and gingivitis were expressed as standardized values for data distillation. Data distillation was accomplished using a meta-analysis, with a mean difference between powered and manual toothbrushes serving as the measure of effectiveness. RESULTS: The searches identified 354 trials, only 29 of which met the inclusion criteria. These trials involved about 2,500 subjects and provided data for meta-analysis. The results indicated that only the rotating oscillating toothbrush consistently provided a statistically significant, although modest, clinical benefit over manual toothbrushes in reducing plaque and gingivitis. CONCLUSIONS AND CLINICAL IMPLICATIONS: Some powered toothbrushes with a rotation-oscillation action achieve a significant, but modest, reduction in plaque and gingivitis compared with manual toothbrushes.

Dental Plaque↗