[MUSIC] Hello, I'm Doctor Helen Giannakopoulos. I'm an Associate Professor of Oral Maxillofacial Surgery and Pharmacology. And the director of Post Doctoral Oral Maxillofacial Facial Surgery Residency program. I will be presenting on dental local anaesthesia. Dental local anaesthesia usually involves the trigeminal nerve or cranial nerve V. The trigeminal nerve is what's responsible for providing the majority of the sensory innervation from the teeth, bone and soft tissues of the oral cavity. First, it is necessary to understand how local anesthetics work. They decrease the permeability of the ion channel to sodium ions, thereby, nerve impulses cannot be conducted in a region that has been injected with a local anesthetic. Local anesthetics can be classified accordingly by their chemical structure into two major categories, esters and amides. Due to their significant pharmacologic advantages over their earlier ester counterparts, amides soon became and have remained the standard local anesthetic type and are the most widely used anesthetics in dentistry. Local anesthesia can be administered via local infiltration or via a nerve block. In local infiltration, small nerve endings are flooded with local anesthetic. With a nerve block, local anesthetic solution is deposited close to a main nerve trunk. Maxillary anesthesia techniques, depending on the area, these include local infiltration, anterior superior alveolar, middle superior alveolar, posterior superior alveolar, greater palatine, and nasopalatine nerve blocks. With mandibular anesthesia, also depending on the area, these include local infiltration, inferior alveolar, mental and long buccal nerve blocks. The armamentarium needed to administer local anesthesia includes a dental syringe, needle and cartridge. This is a syringe that is used specifically in dentistry and its subspecialties. The basic injection technique is as follows. Step one, communicate with the patient. Step two, load the syringe and check the flow of the local anesthetic. Step three, position the patient. Step four, dry the tissue. Step five, apply topical local anesthetic. Okay. >> Mm-hm. >> It will help with the injection. Bite down on that for me. Step six, retract the tissue. Okay. Okay, you'll feel a small pinch. Stay open just like you are. Step seven, insert the needle. Step eight, aspirate. Step nine, slowly deposit the anesthetic solution. And step ten, withdraw the syringe.