Foreword -- Editors and authors -- Dedication -- Introduction: a short history of local anaesthesia -- Pain and impulse conduction 1 -- 1.1 Pain receptors -- 1.2 Nerve impulse transmission -- 1.2.1 The structure of the peripheral nerve -- 1.2.2 Impulse formation -- 1.2.3 Impulse conduction and transfer -- 1.2.4 Modulation of the impulse -- 1.3 Perception of pain -- 1.4 Nociception in the orofacial area -- 2 Anatomy of the trigeminal nerve -- 2.1 Introduction -- 2.2 The central part of the trigeminal nerve -- 2.2.1 Origin -- 2.2.2 Trigeminal nuclei -- 2.3 The peripheral part of the trigeminal nerve -- 2.3.1 Ophthalmic nerve -- 2.3.2 Maxillary nerve -- 2.3.3 Mandibular nerve -- 2.4 Deep areas -- 2.4.1 Pterygopalatine fossa -- 2.4.2 Infratemporal fossa and pterygomandibular space -- Pharmacology of local anaesthetics 3 -- 3.1 Classification -- 3.2 Pharmacodynamics -- 3.3 Pharmacokinetics -- 3.3.1 Physical-chemical characteristics -- 3.3.2 Diffusion -- 3.3.3 Mode of action of local anaesthetics -- 3.3.4 Protein binding -- 3.3.5 Onset time and duration of action -- 3.3.6 Local elimination -- 3.3.7 Systemic elimination -- 3.4 Additives to local anaesthetics -- 3.4.1 Vasoconstrictors -- 3.4.2 Preservatives -- 3.5 Additives to topical anaesthetics -- General practical aspects 4 -- 4.1 Use of local anaesthetics -- 4.2 Indications and contraindications -- 4.3 Instruments -- 4.3.1 Cartridges -- 4.3.2 Needles -- 4.3.3 The syringe -- 4.4 Topical anaesthesia -- 4.5 Position of the patient and dentist -- 4.6 Verification of effectiveness -- Local anaesthesia in the upper jaw 5 -- 5.1 Introduction -- 5.2 Incisors and canines -- 5.2.1 Anatomical aspects -- 5.2.2 Indication -- 5.2.3 Technique -- 5.3 Premolars -- 5.3.1 Anatomical aspects -- 5.3.2 Indication -- 5.3.3 Technique -- 5.4 Molars -- 5.4.1 Anatomical aspects -- 5.4.2 Indication -- 5.4.3 Technique.

5.5 The impacted third molar of the upper jaw -- 5.5.1 Anatomical aspects -- 5.5.2 Indication -- 5.5.3 Technique -- 6 Local anaesthesia in the lower jaw -- 6.1 Introduction -- 6.2 Incisors and canines -- 6.2.1 Anatomical aspects -- 6.2.2 Indication -- 6.2.3 Technique -- 6.3 Premolars -- 6.3.1 Anatomical aspects -- 6.3.2 Indication -- 6.3.3 Technical aspects -- 6.4 The direct and indirect technique -- 6.5 Molars -- 6.5.1 Anatomical aspects -- 6.5.2 Indication -- 6.5.3 Technique -- 6.6 Third molars in the lower jaw -- 6.6.1 Anatomical aspects -- 6.6.2 Indication -- 6.6.3 Technique -- Additional anaesthetic techniques 7 -- 7.1 Maxillary nerve block -- 7.1.1 High tuberosity anaesthesia -- 7.1.2 Greater palatine foramen block -- 7.2 Infraorbital nerve block -- 7.3 Nasopalatine nerve block -- 7.4 Mental nerve block -- 7.5 Gow-Gates technique -- 8 Local anaesthesia for children -- 8.1 Introduction -- 8.2 Experience of pain and fear in children -- 8.2.1 Security and support -- 8.2.2 Preparation for anaesthesia -- 8.2.3 Child-friendly procedure -- 8.2.4 Warning -- 8.3 Techniques -- 8.3.1 Topical anaesthesia -- 8.3.2 Infiltration anaesthesia -- 8.3.3 Mandibular block anaesthesia -- 8.3.4 Intraligamental anaesthesia -- 8.3.5 Microprocessor-controlled anaesthesia -- 8.3.6 Amount of anaesthetic fluid for children -- 8.4 Observation of the child -- 8.5 Complications of mandibular block anaesthesia -- 9 Local complications -- 9.1 Needle breakage -- 9.2 Pain during administration -- 9.3 Insufficient anaesthesia -- 9.4 Excessive spread of anaesthesia -- 9.5 Iatrogenic damage and self-inflicted damage of anaesthetised tissues -- 9.6 Persistent sensitivity disorders -- 9.7 Skin paleness ('blanching') -- 9.8 Tissue necrosis -- 9.9 Haematoma formation and trismus -- 9.10 Infection -- 10 Systemic complications -- 10.1 Introduction -- 10.2 Vasovagal collapse.

10.3 Hyperventilation syndrome -- 10.4 Toxicity -- 10.4.1 Effects on the central nervous system -- 10.4.2 Cardiovascular effects -- 10.4.3 Treatment of toxic reactions -- 10.5 Systemic effects of vasoconstrictors -- 10.6 Allergic reactions -- 10.6.1 Immediate hypersensitivity reactions -- 10.6.2 Delayed hypersensitivity reactions -- 10.6.3 Treatment of allergic reactions -- 10.6.4 Strategy for suspected allergy -- 10.7 Prevention of side effects -- 11 Patients at risk -- 11.1 Introduction -- 11.2 Cardiovascular disease -- 11.3 Hypertension -- 11.4 Cerebrovascular accident -- 11.5 Increased bleeding tendency -- 11.6 Liver diseases -- 11.7 Diabetes mellitus -- 11.8 Hyperthyroidism -- 11.9 Hypoproteinaemia -- 11.10 Pregnancy -- 11.11 Use of medication -- 12 Legal aspects of local anaesthesia -- 12.1 Judges and courts -- 12.2 Competency to give local anaesthesia -- 12.2.1 General and local anaesthesia given by the dentist -- 12.2.2 Local anaesthesia given by paramedics -- 12.3 Liability -- 12.3.1 A damaged nerve following anaesthesia: informed consent -- 12.3.2 No anaesthesia given, faulty injection or insufficient anaesthesia -- 12.3.3 Application of anaesthesia and general medical complications: record-keeping -- 12.3.4 Insufficient caution during injection -- 12.4 Avoiding legal problems in the use of local anaesthesia -- Index.