Aerosol-Generating Procedures and Simulated Cough in Dental Anesthesia.

Dental professionals are at an increased risk for exposure to the severe acute respiratory syndrome coronavirus 2 with aerosol-generating procedures (AGPs), and dental anesthesia practices have additional risks due to airway management procedures. The purpose of this pilot study was to examine the extent of splatter on dental personnel that may occur with AGPs and coughing in a dental anesthesia practice. A Dentoform model was fitted into a dental mannequin and coated with Glo Germ to detect splatter during simulated dental AGPs produced with use of a high-speed handpiece, an ultrasonic scaler, and an air-water syringe, all in conjunction with high-volume suction. A simulated cough was also created using a ventilator programmed to expel Glo Germ within the velocity and volume parameters of a natural cough with dental personnel in their customary positions. A UV light was used after each procedure to systematically evaluate the deposition of Glo Germ splatter on each person. After AGPs were performed, splatter was noted on the face, body, arms, and legs of the dentist and dental assistant. The simulated cough produced more extensive splatter than AGPs; additional Glo Germ was seen on the shoes, the crown of the head, and the back of the dental personnel. Therefore, it is recommended that full personal protective equipment consistent with AGPs be used and changed between patients to reduce the risk of contamination and infection for dental personnel and patients.

Real-time ultrasonographic visualization for guided inferior alveolar nerve injection.

OBJECTIVE: The purpose of this study was to develop a methodological technique for the ultrasonographic visualization of the inferior alveolar nerve (IAN) using a novel hockey stick-shaped 8- to 15-MHz transducer in volunteers, followed by simulated IAN scanning and injection in cadavers. STUDY DESIGN: In 20 volunteers, bilateral scans of the IAN nerve were performed with a systematic technique. We recorded times to scan each side and sonographic visibility of the IAN. In 3 cadavers, bilateral scans of the IAN were performed, followed by simulated injection with dye. RESULTS: The IAN was visible in all 40 scans. Mean scanning times were 19.6 seconds (range: 4-54 seconds) for the left side and 30.5 seconds (range: 6-116 seconds) for the right side. In 5 cadaver injections, dye was correctly deposited onto the IAN with the ultrasound technique. CONCLUSIONS: We hypothesize that ultrasound-guided IAN block may be feasible in humans using our technique.

Oral sedation: a primer on anxiolysis for the adult patient.

The use of sedatives has established efficacy and safety for managing anxiety regarding dental treatment. This article will provide essential information regarding the pharmacology and therapeutic principles that govern the appropriate use of orally administered sedatives to provide mild sedation (anxiolysis). Dosages and protocols are intended for this purpose, not for providing moderate or deeper sedation levels.