1. Local Anesthesia and Use of Rubber Dam in Pediatric Dentistry Maha ALSARHEED

2. Local Anesthesia in pediatric dentistry requires understanding of Child growth and development Behavioral management Physiologic pain and modulation Pharmacology of local anesthesia

3. Continued Children’s perception to pain varied with ages < 2 yrs- unable 2-10yrs- begin to distinguish >10 yrs- able to participate

4. Anesthesia in Children Topical Anesthesia (TA) Local Anesthesia (LA) General Anesthesia (GA)

5. Topical Anesthesia (TA) Its reduce the discomfort within the mucosal membrane TA is used to anesthetize 2-3mm depth of surface tissue when used properly A number of different preparation varying in the active agent and in concentration are available for intra-oral use TA provided as sprays, solutions, creams ointments and the mostly used in children is gel in different flavored

6. Local Anesthesia Definition A reversal temporary cessation of painful impulses from a particular region in the body Mechanism of Action LA agent penetrate the nerve cell membrane and block receptor site that control the influx of Na + associate with membrane depolarization

7. Local Anesthesia Agents Ethers Amides

8. Local Anesthesia properties LA properties vary as a function of intrinsic properties of the anesthesia agent and the regional anesthetic procedure employed

9. Operator technique

10. TECHINIQUES Maxillary Primary and Permanent Molar Anesthesia Maxillary Primary and Permanent Incisor and Canine Anesthesia Infraorbital block injection Nasal palatine block

11. Mandibular Tooth Anesthesia Papillary injection Intraligamentary injection

12. Complication of LA 1.Localized complications 2.2. Systemic complications Management of Complication 1.Prevention 2.Management

13. Conclusion Justification Calculate maximum safe dose for each patient Practice techniques Use vasoconstrictor Knowledge of the intrinsic properties of LA

14. Rubber Dam in Pediatric Dentistry Advantage of using Rubber Dam 1.Improving of child’s safety by reduced damage to the soft tissue and swallowing or inhalation items 2.Ensure a dry field by moisture control 3.Decrease operating time 4.Reduce stress and child become more quite and relaxed 5.Better view of the operating field by retracting of tongue, cheeks and gingival tissue 6.Enhance nasal breathing for N 2 O administration 7.Reduce risk of cross-infection

15. Contraindication in using Rubber Dam 1.Presence of fixed appliance 2.Recent erupted tooth 3.Child with upper respiratory infection, congested nasal passages or nasal obstruction 4.In rare case allergy to latex.

16. Method of application