Universitat Internacional de Catalunya
Anaesthesia in Dentistry
Other languages of instruction: Catalan, English
If the student is enrolled for the English track then classes for that subject will be taught in the same language.
Teaching staff
STUDENT hours.
Thursday afternoons by appointment via e-mail.
Lecturer responsible: Jordi Prats Armengol jprats@csc.uic.es
Coordinating lecturer: Dr Elvira Ferrés Amat eferresamat@csc.uic.es
Introduction
Anaesthesia in Dentistry, Pain Control and Anxiety is a subject that is taught at the end of the first year.
Its aim is to instruct the student in the handling of material for anaesthesia and asepsis and to provide knowledge of the drugs used and the domain of the main techniques. The skills taught will help students reduce patient anxiety and perform odontostomatological treatments with the absence of pain.
Pre-course requirements
Anatomy and physiology. Knowledge of tracts and cranial nerve function, namely the V and VII cranial nerves, and anatomic structures of the face and neck. For appropriate performance, both the techniques and the loco-regional anaesthetic block require knowledge of the anatomic relationships.
Pharmacology. Knowledge of the locus of action and pathways of drug metabolism.
Principles of asepsis and sterilisation.
Objectives
A. Theoretical objectives
1. To provide dental students with the theoretical, anatomical, physiological and pharmacological knowledge necessary for performing an oral anaesthetic block.
2. To know and master the instruments and their proper handling.
3. To know and master the techniques most frequently used for local anaesthesia in dentistry.
4. To know all the possible complications and their treatment domain and the limitations of local anaesthesia.
5. To know the anaesthesiology techniques that can be used for dental treatments with the help of an anaesthesiologist.
6. To understand the patterns of pharmacological pain treatments.
B. Manual and practical skills:
1. To enable the student to properly handle the instruments and equipment through a secure Sterile Technique.
2. To provide the necessary training to perform the various techniques of local and oral loco-regional anaesthesia.
3. To enable the student to select the appropriate anaesthetic technique for each patient and the planning of the therapy.
4. To provide the knowledge for ergonomic planning, supplies and the equipment that is required for each case.
5. To train students in the models of analgesia in clinical use, individualising treatment regimens to each patient.
Competences/Learning outcomes of the degree programme
- 08 - Knowing how to share information with other healthcare professionals and how to work as part of a team.
- 14 - Being aware of the general processes of the illness, including infection, inflammation, alterations in the immune system, degeneration, neoplasm, metabolic alterations and genetic disorders.
- 18 - Being aware of, critically evaluating and knowing how to use sources of clinical and biomedical infomation in order to obtain, organise, interpret and communicate scientific and healthcare-related information.
- 20 - Obtaining and creating a medical record containing all the relevant information.
- 35 - Knowing the scientific principles of sterilisation, disinfection and the antiseptics necessary to prevent cross-infection in dental practice
- 38 - Being aware of clinical and laboratory-based procedures and diagnostic tests, knowing their reliability and diagnostic viability and being competent in interpreting the results
- 39 - Recognising oral normality and pathology, as well as the evaluation of semiological data
- 58 - Knowing the general pathological characteristics of the illnesses and disorders that affect organic systems
- 61 - Knowing the pharmacological grounding for the various anaesthetic techniques, both local and general, as well as the role of sedation and general anaesthesia in terms of managing dental patients
- 62 - Conocer y manejar las emergencias y urgencias médicas más frecuentes en la práctica odontológica y en las técnicas de reanimación cardiorrespiratoria básica
- 63 - Having knowledge of human nutrition, particularly the connection between nutritional habits or diet with the maintenance of good health and the prevention of oral and dental diseases
- 73 - Applying loco-regional anaesthetic techniques
Learning outcomes of the subject
The knowledge acquired in this course will enable the student to make rational use of anaesthetic drugs and to know the characteristics and conditions for each patient and treatment schedule. Similarly, it should enable the student to appropriately implement the techniques of local and loco-regional oral cavity anaesthesia. Students must also learn to provide reassurance to the patient in order to reduce anxiety.
- 3.01 - Identify the most important characteristics of the different groups of medicines: pharmacological activity, mechanism of action, indications, dosage, contraindications and adverse effects.
- 3.02 - Using information sources of Pharmacology
- 3.07 - Obtain and develop a medical history that includes all relevant information
- 3.08 - Perform a general physical examination and registration of vital signs
- 3.15 - Know the different techniques of anesthesia that can be used in dentistry
- 3.16 - Master the techniques of loco-regional anesthesia in the oral and maxillofacial region
- 3.17 - Know the treatment of complications of loco regional anesthesia
- 3.26 - Recognize and make a correct use of oral surgery instruments
Syllabus
A. THEORETICAL CREDITS. THEME BLOCKS.
Block I. The basic principles of anaesthesia.
1. Introduction and concepts.
1.1. Anaesthesia. Anaesthesiology.
1.2. Anaesthetic techniques.
1.3. Local and loco-regional anaesthesia.
1.4. History of local anaesthesia.
1.5. Anaesthesia techniques in dentistry.
2. Neurophysiology of pain.
2.1. Nociceptors and their channels.
2.2. Peripheral nerve anatomy.
2.3. Physiology of peripheral nerves.
Unit 3. Pain pathways from the oral tissues.
3.1. Anatomy of the V cranial nerve.
3.2. Innervation of the teeth.
3.3. Painful stimulation of the tooth.
3.4. Periodontal painful stimulation.
3.5. Innervation of the orofacial region.
Block II. Pharmacology of local anaesthetics.
4. General pharmacology.
5. Pharmacology of local anaesthetics.
6. Pharmacology of vasoconstrictors.
7. Clinical application of local anaesthetic solutions.
Block III. Instruments and supplies.
8. The syringe.
9. The needle
10. The cartridge.
11. Complementary additional material.
12. Preparation of instruments and equipment.
Block IV. Techniques of local anaesthesia in dentistry.
13. Pre-anaesthetic evaluation of the patient.
14. Local anaesthesia in dentistry.
14.1. Topical anaesthesia.
14.2. Infiltrative anaesthesia.
14.3. Regional anaesthesia field-mounting.
14.4. Block anaesthesia-conduction block.
14.4.1. Intraoral techniques.
14.4.2. Extraoral techniques.
14.5. Pressure anaesthesia (no needle injection).
14.6. Electronic dental anaesthesia (EDA).
15. Basic injection technique.
16. Maxillary anaesthesia.
16.1. General.
16.2. Incisors and canines.
16.3. Premolars.
16.4. Molars.
16.5. Conduction blocks.
17. Mandibular anaesthesia.
17.1. General.
17.2. Incisors and canines.
17.3. Premolars.
17.4. Molars.
17.5. Conduction blocks.
18. Other anaesthesia techniques in dentistry.
18.1. Injection.
18.1.1. PDL injection.
18.1.2. Intrapulpal injection.
18.1.3. Other techniques.
18.2. Topical anaesthesia.
18.3. Pressure anaesthesia (no needle injection).
18.4. Electronic dental anaesthesia (EDA).
19. Local anaesthesia in different fields of stomatology.
19.1. Oral surgery.
19.2. Periodontology.
19.3. Dental therapeutics.
19.4. Prostheses.
19.5. Paediatric dentistry.
19.6. Geriatric patients.
Block V. Failure and complications of local anaesthesia.
20. Failure of anaesthesia.
20.1. Anatomical variations.
20.2. Physiological variations.
20.3. Technique or suitable doses.
21. Local complications.
22. Systemic complications.
22.1. Psychogenic complications.
22.2. Toxigenic complications.
22.2.1. Overdose.
22.2.2. Reduced tolerance.
22.3. Hypersensitivity or allergy.
22.4. Pharmacological interactions.
Block 6. Methods for controlling anxiety.
23. Management of the patient.
23.1. Protocols for reducing anxiety.
23.2. Premedication.
Block 7. Anaesthesiology. Techniques.
24. Sedation.
24.1. Sedation with nitrous oxide.
24.2. Intravenous sedation.
24.2.1. Conscious sedation.
24.2.2. Deep sedation.
25. General anaesthesia.
25.1. Types.
25.2. Types.
25.3. Complications.
25.4. Post-anaesthesia resuscitation.
26. Medical emergencies in anaesthesiology.
26.1. Taking vital signs.
26.2. CPR.
26.3. Protocol for the management of resuscitated patients
.
Block 7. Pain pharmacotherapy.
27. Analgesia.
27.1. Overview of pain medications.
27.2. Opioid analgesics.
27.2.1. Types. Clinical use of opioid analgesics.
27.3. Non-opioid analgesics.
27.3.1. NSAIDs.
27.3.2. Analgesics-antipyretics.
27.3.3. Clinical use of non-opioid analgesics.
28. Clinical management of patients with acute pain.
28.1. Protocols for painkiller use.
28.2. Gastroprotection on NSAID treatment.
28.3. Coadjuvants drugs.
Teaching and learning activities
In person
1. Lectures.
Theoretical basic knowledge in schematic form and with a wealth of supporting graphical material. A slot (20 minutes) is dedicated to questions, clarification or extension of concepts at the end of the lecture, as required by the student (it may be used as a brief seminar).
2. Pre-clinical practical sessions
In the laboratory, in the classroom and, when possible, at the University Dental Clinic with phantoms, in these practical sessions we will implement practical knowledge and handling of instruments and equipment, ergonomics, asepsia, patient monitoring, attitude towards the patient and anaesthesia. Students will need to perform procedures with local and loco-regional anaesthesia on phantoms under the supervision of the lecturers.
3. Problem-based learning
A clinical situation will be presented which will be used to introduce a new topic or for reviewing and evaluating the student’s knowledge.
4. Exercise.
A written project will be submitted which complements the theory classes and is based on the topics covered in class. Topics will be proposed to the lecturer for assessment. The written work should contain a minimum of 10 pages (A4), not to exceed 15 pages. Students shall use Microsoft Word and Arial font, size 12 pt. Students will have two weeks prior to the final exam to complete the project. Groups may be formed of up to two students. The project should include, attached, a copy of the referenced articles (a minimum of four – two must be in English).
Alternatively, a communication poster may be submitted; it must follow the same guidelines as the written work.
5. Guided teaching
Guided teaching aims to foster students’ personal work and delve into various aspects of the agenda. The proposal for this course is:
To prepare open questions for “self-examination”.
Contact details will be provided to answer any questions that may arise during the process.
6. Formation RCP
| TRAINING ACTIVITY |
| Lecture or presentation given by the lecturer or professor describing the course content. This lecture is held in one room and is aimed at all the students enrolled on the course. This teaching methodology includes the use of audiovisual resources to help describe the content of the course. Students can interact or actively participate in this session. Autonomous learning for exams, library work, complementary reading, solving problems, resolving cases and filling in exercises etc. Time assigned to evaluate theoretical and practical exams, as well as presentations etc. Case based learning for the analysis and resolution of clinical cases in class. This is a group activity which allows students to hold discussions under the guidance of a lecturer or professor. Practical classes taught in pre-clinical dental laboratories. Seminar-workshop involving specific supervised sessions with participation from the lecturer/professor, students and experts in this area. These seminars are aimed at groups of between 25 and 50 students. Autonomous learning by students to prepare for seminars, readings, projects or clinical cases. Individual attention for students either alone or in groups in order to oversee their projects, presentations or study. |
Evaluation systems and criteria
In person
The final evaluation shall be as follows:
Final examination…………………70%
Practical examination……………………………20%
Exercise………………………………..5%
RCP...................................5%
Final examination:
The final exam will include theory and multiple choice questions (five options with a single correct answer). An incorrect response will subtract 0.20 points from the total.
Assessment of practical sessions:
Evaluation will take place on a continuous basis and include practical sessions by assessing the following parameters:
Knowledge of anatomy applied to oral local anaesthesia.
Knowledge of the drugs used in stomatological solutions and their clinical presentations.
Technical knowledge and sterile material, ergonomics and handling of instruments and equipment.
Local anaesthesia techniques and their applications in dentistry.
Clinical use of drugs for the control of pain and anxiety.
Prevention and management of complications of anaesthesia in dentistry.
After two absences the practical sessions will be considered as having been failed and the student will be required to sit a practical examination.
Evaluation of the exercise:
The written work will be evaluated on the basis of:
Presentation.
Structuring.
Thematic content.
Bibliography.
Guided teaching:
This will be reviewed regularly through responses to the lecturer’s questions on a “self-examination” basis.
Bibliography and resources
1. Recommended bibliography.
Dionne/Phero/Becker
Management of pain and anxiety in the dental office.
Saunders. 2002.
Malamed, S.F.
Manual de Anestesia Local
5ª Elsevier. Mosby. Madrid. 2006.
2. Reference bibliography.
Berini-Aytes/Gay-Escoda Anestesia odontológica 2ª Ed. Ediciones avances médico-dentales, S.L.. Madrid. 2000.
Jastak JT/Yagiela JA/Donaldson D Local anesthesia of the oral cavity WB Saunders. Philadelphia. 1995.
Lipp Anestesia local en odontologia Espaxs. Barcelona.1998 (Llibre + video)
Malamed Medical emergencies in the dental office 4ª Ed. Mosby-Year Book Inc. St Louis. 1999.
Miller Anestesia(2 vols.) 4ª Ed. Harcourt Brace. Madrid. 1998.
Snell Neuroanatomía clínica4ª ed. Ed. Médica Panamericana.Buenos Aires. 1.999.
Evaluation period
- E1 22/05/2025 A03 12:00h
- E1 22/05/2025 A01 12:00h
- E1 22/05/2025 A02 12:00h