[Music] hi students today we're going to be explaining about the placement of topical anesthetic first you always want to make sure you start off with your ppe which is going to be your mask your gloves your face shield and your lab coat you always want to start off by asking the patient their previous medical history or any changes as anything that they are taking medically can you know be affected by the topical or by the anesthetic that will be placed after the topical so it's very important to review that before you start any procedure first thing you want to do when you sit down a patient and after you ask them their medical history is you're going to grab a 2x2 and you are going to dry off the area for this example we will say that we are doing an mod filling on tooth number two so you'll want to dry off right in that vestibule area right above tooth number two get it nice and dry next thing you'll do is you will pick up your cotton tip applicator and your topical and a stick so topical anesthetic can have many different flavors this one here is strawberry smells like strawberry and tastes like strawberry so you want to grab just a good amount you don't want to grab too much so this right here is a pretty good amount so you will close that immediately up once you have the topical on the cotton tip applicator you will make sure to place it right above tooth number two in the vestibule you don't want to smear it or smudge it you'll just put it right there you always want to make sure that the stick part of the cotton tip applicator is going towards the midline and out of the mouth not towards the back of the mouth once you are done placing the topical you will always add that 2 by 2 to the outside of that cotton tip applicator on the cheek side just so that way the cheek is protected and can collect any additional saliva some of that topical isn't flowing through their mouth and they're swallowing it as it tends to make patients a little bit nervous because it can make the tongue and the throat go a bit numb according to the modern dental assisting textbook it does say that you want to leave it for 15 to 30 seconds however in the world real world you usually place it for a bit longer um just due to the dentist not being in the room or not ready yet and it doesn't hurt to get that patient just a little more comfortable for that injection when you are done placing you will remove this out of the mouth and then the dentist will come in to place the anesthetic in this example we are going to show how to place topical anesthetic on a mandibular tooth so it will be the exact same procedural steps first you will grab a 2 by 2 and you will dry off the retro molar pad right behind the distal of the last molar so that's going to be right over here you want to dry that off really good once it's dried you'll pick up that um that cotton tip applicator and you will place it right back there right behind the distal at the last molar from there you will add the two by two back on top of the retromolar pad have that patient close and then the stick will be coming towards the midline of the mouth once again you always want to keep it towards the midline and not to the back same thing you'll leave it for about two to five minutes typically it is doctor preference like i said before the textbook does say 15 to 30 seconds however in the real world you will leave it for about two to five minutes okay continuing on from our topical we're going to continue with number two number two for the anesthetic would be our blue needle this is your shorter needle and this is an anesthetic carbule and our anesthetic syringe got to be careful with this because inside of here is a little harpoon that's very sharp when we are placing our anesthetic carpool inside of the anesthetic syringe you place your hand here your finger and your thumb are on top of the little wings your little finger goes above the circle and you push up with your thumb and you pull down with your little finger just a slight movement like that it will push this up on your anesthetic carpel there's two different sides there's a little rubber stopper which goes towards the harpoon and there's a little gold or silver top with a little plastic part in the middle where the needle goes so this gets pulled down and this goes inside of here and right in there and then you can let go again so pull down and this goes inside and just like that our needles have a protective plastic cover on the back we normally just twist and pull there's the bottom of our needle that goes into the top of the syringe i'm going to just put that inside of here and gently screw that on kind of push just a little bit and then we gently harpoon it you're going to hit the bottom that locks this into place so this doesn't wiggle anymore now this is prepared for our doctors to give our anesthetic shots as a dental assistant we do not do that only doctors and some hygienists can do that for the anesthetic shot on number two for the mod we would use our needle capper if you have one you would put that on to the needle to make it nice and safe you would turn this to your doctor take as the doctor grabs the other side you would take the needle cap off for the doctor then the doctor could go ahead and place anesthetic the safest way to recap your needle is with a needle capper you never want to place your needle onto the top without a needle capper so make sure you're very safe with that to show how to place the anesthetic onto the the teeth the blue needle is for each maxillary tooth for number two the shot would be let's go ahead and put that on pull this off and just to show there's number one and number two we would go directly the doctor would be directly above number two it's called infiltration they give a shot above each individual tooth on the maxillary then they would cover the cover back up when they are done they either place the syringe back onto the tray or they'll give it to us after the treatment is done we discard our carpools and our needles in a sharp container they're normally red the only thing that goes into into these is any kind of glass containers for our sharps needles matrix bands anything sharp that could harm us i'm going to take the needle capper off i'm going to gently unscrew my needle very gently holding right here where nothing can poke or scratch me and i'm going to take that directly off and put it directly into my sharps container here i'm going to pull back this part of the syringe and the carpel is going to come out i'm going to put that directly in there sometimes the little stopper stays you just gently pull it off and it comes right up once that's done just lay it down this is now dirty also so that goes into your dirty side of your sterilization okay so coming from our topical this time we're going to use our long needle which is for a nerve block we're going to use on tooth number 30 mod so i'm going to show you how to put the anesthetic syringe together with that again this is our anesthetic syringe our little harpoon in there be careful this is your anesthetic carpool it has a little rubber stopper has normally a little gold or silver top and a little plastic part on the middle where the needle goes and this is our long needle for our nerve block on the mandibular so what i'm going to do first is hold my syringe my thumb here my finger here i'm going to pull up and push down at the same time take my little rubber stopper put it in and then let go i'm going to set that down i'm going to gently pull off the cap of my needle and i'm going to put my needle right into the front of the syringe i'm going to push just a little bit and gently screw it on don't push too hard be careful go slow all right now i'm going to harpoon it to set it now that's locked in ready to give to our doctor we have different types of diff uh needle cappers offices might have many more than these this is just a rubber one goes right on top of this helps pull our needle off needle cap or off and if it gets poked you're safe gently put that on again you're never going to put this needle on with your hands without being protected take that off i'm going to put this right into here this one holds it i'm going to put that into there and you'll hear it click right in that way we have the lid onto the needle nice and safe so we're going to go over here to where number 30 is number 30. we're going to do an mod when we give a nerve block we are going to give the anesthetic shot behind tooth number 32 if they had it it would be in the corner of the mouth way back here the retro molar pad the doctor would have the needle off we as assistants will never do this just for a demonstration the doctor would come in and the shot would be back here they give a little bit there and then sometimes they give a long buckle shot here on the side by the tooth this will numb everywhere from 32 to 25. they will be numb on their tongue they will be numb from this tooth all the way over to 25 the side of their tongue and the whole quadrant will become numb from that anesthetic shot doctor will check before they start the procedure and it shouldn't take very long to get down about five minutes once we're done and we have given the patient the anesthetic shot and we're all done with the procedure filling is all done again this goes into our sharp bucket take this off very slowly once you're handling a needle it's very slow take your time we don't want to get poked gently just unscrew it hold right there i'm holding them together going to go into our sharp bucket come down here come right out because they just fall right out this is our anesthetic cartile into the sharps bucket again this will go on our dirty side because it's now contaminated you