Behavior management for mentally disabled dental patients with painless Local anesthesia.

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When dental treatment of a mental handicapped patient takes place, the cooperation of the patient is necessary requirement. For this purpose, the administrating of an injection that does not cause pain is of significant importance.We researched various methods of venous and local anesthesia injection that potentially would not inflict pain. We used a 10% lidocaine iontophoresis for ten minutes as a topical anesthesia before carrying out 'painless' venous injections. After this procedure, a2% alkalinized lidocaine with a pH 7.4 as a cutaneus local anesthesia was administered to 25 adult volunteers. This method was tested on the dorsal vein of one hand. On the opposite hand's dorsal vein, we attached a 60% lidocaine tape for one hour and then compared the VAS values. The result : 75% of the volunteers felt less pain with the lidocaine tape method when compared with the iontophoresis method. The use of iontophoresis was also conducted clinically. All conditions were carried out indentical … More ly with the exclusion of the lidocaine, which was not adjusted to the pH 7.4. We tested 40 mentally handicapped patients. The McGrath Facial scale was determined to be an effective judge of pain. The result obtained showed that approximately 85% of the vpatients injected experienced no pain. This was reported in 1997 at the Dentistry for the handicapped's conference and in the journal of Clinical Pediatric Anesthesia. For the testing of painless local anesthsia, 25 volunteers were administered local anesthesia inside the oral mucosa. Two experiments were conducted and compared. In the first experiment a 60% lidocaine attached to the oral mucosa for 10 minutes followed by a 2% lidocaine injection. The second experiment, carried out as acontrol, called for a 2% lidocaine injection with an adjusted pH 7.4 to be administered after a 4% lidocaine paste iontophoresis was applied. The reduction of pain was accomplished with both nethods. However, some volunteers felt discomfort after the injection of the pH 7.4 local anesthetic. Less