Dental pain

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Preventive and postoperative analgesia using opioids and/or NSAIDs should be employed in all animals undergoing dental procedures. This chapter discusses Indications for analgesia, describes the basic analgesic routine for various common presentations, and provides guidance on the use of local anaesthesia, including techniques for infiltration anaesthesia and regional nerve blocks.

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7.9 A dental local anaesthetic needle and syringe. The empty device, the ampoule with local anaesthetic agent and the needle. An 18 G needle is also depicted to demonstrate how fine the dental needle is. The device assembled and ready for use.
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7.10 Technique for infiltration anaesthesia. A small amount of local anaesthetic is deposited into the gingiva and alveolar periosteum in the region of the tooth that needs to be desensitized. The anaesthetic agent diffuses into the tissue to have local effect on the nerve. The location for buccal desensitization of an upper incisor is shown on a cadaver. It is often necessary to place anaesthetic agent palatally as well. The location for palatal desensitization of an upper incisor is shown on a cadaver.
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7.11 The intraoral approach to the mandibular block involves palpating the mandibular foramen intraorally and directing the needle to that area using an oral approach. The easiest way is to slide the needle along the medial aspect of the ventral mandible, with the syringe held parallel to the hemi-mandible to be blocked. When the point of the needle is close to the foramen, move the syringe barrel over to the premolar region of the contralateral side to give better access to the area around the foramen. The needle should be close to the bone of the ventral mandible to avoid inadvertently blocking the lingual nerve. The calculated dose is deposited.
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