DH 280 - Pain and Anxiety Control

Credit Hours: 2

Effective pain and anxiety control are essential components of the management of dental patients. This elective course will present 30 hours of didactic instruction required for a State of New York restricted certificate to administer local infiltration anesthesia and nitrous oxide/oxygen analgesia sedation during dental hygiene treatment procedures. Topics include a review of dental neuroanatomy, respiratory anatomy and physiology, pharmacology of local anesthetic drugs used in dentistry and nitrous oxide/oxygen sedation, proper administration techniques, patient assessment, legal, risk management and ethical issues. The clinical requirements for the infiltration anesthesia and nitrous oxide analgesia certificate can be completed in the elective Pain and Anxiety Control Clinic, DH281. Minimum passing grade is “C-.”

Course Outcomes
Upon completion of this course, the student will be able to:

explain the New York State law (NYSL) as it pertains to restricted certification of dental hygienist to deliver N2O/O2 sedation and local anesthesia;
utilize the health history and evaluation procedures to detect medically compromised patients and discern those conditions that place the patient at risk for local anesthetics, vasoconstrictors and nitrous oxide/oxygen sedation;
differentiate between the pediatric and adult respiratory and circulatory physiology and related anatomy;
describe the stages of drug-induced central nervous system depression through levels of anxiolysis, conscious sedation, deep sedation and general anesthesia;
define and describe psychological, physiological, and anatomic aspects of pain and anxiety at a level appropriate for the dental hygiene practice;
describe the pharmacology of agents used in inhalation sedation, local anesthesia, and vasoconstrictors, including drug interactions and incompatibilities;
define the indications and contraindications for use of inhalation sedation and local anesthesia;
explain the recommended dosages of local anesthesia and nitrous oxide analgesia;
discuss patient monitoring using observation with particular attention to vital signs and reflexes related to consciousness;
list the selection and preparation of the armamentaria and record keeping while administering various local anesthetic agents and nitrous oxide analgesia;
recognize and manage the complications and reactions to local anesthetic agents and nitrous oxide analgesia;
utilize proper infection control techniques with regard to local anesthetic and nitrous oxide analgesia and proper disposal of sharps;
describe the use of inhalation sedation equipment;
recognize the potential for health hazards of trace anesthetics and be able to propose techniques for limiting occupational exposure such as appropriate scavenging systems;
discuss the abuse potential and hallucinatory effects of nitrous oxide analgesia; and
describe and communicate the postoperative care of the patient and instructions to the patient.

Prerequisites: All required fall semester, second year courses in the Dental Hygiene curriculum must be passed.
Corequisites: All required spring semester, second year courses in the Dental Hygiene curriculum.
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