Test Bank for Local Anesthesia for the Dental Hygienist, 1st Edition: Logothetis

Test Bank for Local Anesthesia for the Dental

Hygienist, 1st Edition: Logothetis

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Logothetis: Local Anesthesia for the Dental Hygienist
Chapter 06: Topical Anesthetic Agents

Test Bank

ESSAY

1. List common forms of topical anesthetics used in dentistry.

ANS:
Gel, spray, liquid, ointment, and one patch form

REF: Page 94 and Table 6-1

2. List the methods for delivery of topical anesthetic drugs.

ANS:
Cotton tip applicators, sprays, brushes, patches, blunted cannulas and/or syringes, and
single-dose applicator swabs

REF: Page 94

TRUE/FALSE

1. The over-the-counter product Anbesol with benzocaine can be safely used by all
family members.

ANS: F
Correct: Anbesol comes in a variety of strengths. One concentration cannot be used
safely by all family members.

REF: Page 97, Table 6-2

2. Although topical anesthetics are generally regarded as safe, if used improperly they
can produce adverse reactions that are fatal.

ANS: T REF: Pages 100, 102 and Box 6-2

3. A patient presents to your dental office the day after her dental appointment,
complaining of swelling and itching on the right side of her face. You should reassure
the patient that it is not possible that her symptoms are related to dental anesthesia.

ANS: F
Correct: Some allergic reactions occur up to 2 days after the anesthetic is given.

Copyright © 2012 by Mosby, an imprint of Elsevier Inc.

Test Bank 6-2

REF: Page 102

4. Benzocaine topical anesthetic exists almost entirely in its base form, making
absorption into circulation high.

ANS: F
Correct: Benzocaine topical anesthetic exists almost entirely in its base form, making
absorption into circulation low.

REF: Page 97

5. The published maximum dosage recommendation for the topical anesthetic

benzocaine is 200 mg.

ANS: F
Correct: The published maximum dosage recommendations for benzocaine have not
been established and do not exist.

REF: Page 97

6. Lidocaine is metabolized in the liver and excreted via the kidneys with less than 10%
remaining unchanged.

ANS: T REF: Page 98

7. The most commonly found form of lidocaine is in base form because it is water
soluble and can easily penetrate and be absorbed into the tissues.

ANS: F
Correct: The base form is poorly soluble in water and has poor penetration and
absorption abilities.

REF: Page 98

8. Tetracaine hydrochloride has a rather slow onset of action; however, it can last
approximately 45 minutes.

ANS: T REF: Page 98

MULTIPLE CHOICE

1. What is the name of a common ester topical anesthetic?

a. Lidocaine
b. Dyclonine hydrochloride

Copyright © 2012 by Mosby, an imprint of Elsevier Inc.

Test Bank 6-3

c. Prilocaine 2.5%
d. Benzocaine

ANS: D
Benzocaine is the name of a common ester topical anesthetic.

REF: Page 91

2. What is the name of a common ketone topical anesthetic?

a. Lidocaine
b. Dyclonine hydrochloride
c. Tetracaine hydrochloride
d. Benzocaine

ANS: B
Dyclonine hydrochloride is the name of a common ketone topical anesthetic.

REF: Page 91

3. What is the name of the most potent ester topical anesthetic?

a. 2.5% Lidocaine and 2.5% prilocaine cream
b. Dyclonine hydrochloride
c. Tetracaine hydrochloride
d. Benzocaine

ANS: C
Tetracaine hydrochloride is the name of the most potent ester topical anesthetic.

REF: Page 91

4. Which of the following are considered advantages for the use of topical anesthetic
agents?
1. Pain control
2. Stimulation of gag reflex
3. Can be purchased over the counter
4. Ease of use
a. 1, 4
b. 1, 3, 4
c. 1, 2, 3, 4
d. Some other combination

ANS: A
Pain control and ease of use are two advantages for the use of topical anesthetic agents.
Topical anesthetic agents can be used to reduce the patient’s gag reflex. The fact that
topical anesthetic agents can be purchased over the counter is not necessarily an
advantage when one considers the risk of toxicity.

Copyright © 2012 by Mosby, an imprint of Elsevier Inc.

Test Bank 6-4

REF: Page 92

5. Which of the following characteristics could contribute to the properties of an ideal

intraoral topical anesthetic?
a. Allergenic
b. Allow pain-free application
c. Dissolves readily at the site of application
d. Produces some systemic toxicity

ANS: B
Ideal properties of an intraoral topical anesthetic would include the pain-free application
of the agent.

REF: Page 93

6. What is the main difference in the mechanism of action between topical anesthetics
and injectable anesthetics?
a. Location of the blocking of nerve conduction
b. Increase of depolarization
c. Decrease of excitability threshold
d. All of the above

ANS: A
Topical anesthetics work by blocking nerve conduction at the surface of the skin or
mucous membrane.

REF: Page 93

7. To obtain the most benefit from the use of topical anesthetics, a fairly substantial
amount of topical should be placed on the cotton tip applicator. This amount mixes
with the saliva and may numb the tongue, soft palate, or pharynx.
a. Both statements are true.
b. Both statements are false.
c. The first statement is true; the second statement is false.
d. The first statement is false; the second statement is true.

ANS: D
Only a small amount of the gel or ointment on the applicator tip is necessary to achieve
the desired results. An excess amount mixes with the saliva and may numb the tongue,
soft palate, or pharynx, which usually leads to patient dissatisfaction of the whole
process.

REF: Page 94

Copyright © 2012 by Mosby, an imprint of Elsevier Inc.

Test Bank 6-5

8. Which of the following properties are advantages to topical anesthetics being in a

liquid form?
a. Provides anesthesia to a widespread area
b. Useful to decrease a patient’s gag reflex
c. Can be applied to site-specific areas with an applicator
d. All of the above
e. Some combination of the above

ANS: D
Liquids are great for providing anesthesia to a widespread area. They are especially
useful when trying to decrease a patient’s gag reflex, and the use of a liquid for a more
site-specific procedure requires an applicator.

REF: Page 94

9. Which of the following properties is an advantage of purchasing a single-dose unit of

a topical anesthetic?
a. Dose manageable
b. Cost-effective
c. Less cross-contamination
d. a and c
e. All of the above

ANS: D
Individual packaging of topical anesthetic is not only less messy; it also helps to prevent
possible cross-contamination and allows monitoring of the dosage being used.

REF: Page 95

10. What is a drawback to the use of an unmetered topical anesthetic spray?

a. Cost
b. Not dose manageable
c. Cross-contamination
d. Site-specific

ANS: B
Unmetered sprays are not recommended because they do not allow the operator control of
the amount of anesthetic dispensed.

REF: Page 95

11. Which topical anesthetic has warnings about the risk of methemoglobinemia?
a. Benzocaine creams
b. Benzocaine sprays
c. Tetracaine hydrochloride
d. Dyclonine hydrochloride

Copyright © 2012 by Mosby, an imprint of Elsevier Inc.

Test Bank 6-6

ANS: B
Warnings have been issued about the possibility of benzocaine sprays causing
methemoglobinemia.

REF: Page 95

12. Which of the following are considered advantages of the application of dental topical
anesthetics in a patch form?
a. Site-specific
b. Multiple choices
c. Cost-effective
d. All of the above

ANS: A
The advantage of patches over other methods of administration in that they can be placed
directly to desired sites. Patches available for intraoral topical anesthesia are limited.

REF: Page 95

13. Which of the following is/are true regarding topical anesthetics?

a. Allergic reactions can occur up to 2 days after the anesthetic is given.
b. Benzocaine and tetracaine are both amides, which increases their potential for
causing an allergic reaction.
c. If there were an allergic reaction, it is likely to present immediately at the time of
anesthesia.
d. All of the above
e. Some combination of the above

ANS: A
Allergic reactions can occur up to 2 days after the anesthetic is given.

REF: Page 94

14. Possible localized adverse effects of topical anesthetics could include which of the
following?
1. Stinging at the site of application
2. Tissue discoloration
3. Sloughing
a. 1, 2
b. 2, 3
c. 2, 3
d. 1, 2, 3
e. Some other combination

ANS: D

Copyright © 2012 by Mosby, an imprint of Elsevier Inc.

Test Bank 6-7

Possible localized adverse effects of topical anesthetics could include stinging at the site
of application, tissue discoloration and sloughing.

REF: Page 102

15. What is the reason that concentrations of topical anesthetic agents are higher than
those of their injectable counterparts?
a. Topical agents are not natural vasoconstrictors like injectable anesthetic agents.
b. They facilitate high plasma concentrations of topical anesthetic agents.
c. They facilitate diffusion of the topical anesthetic agent through the mucous
membranes.
d. With topical anesthetic agents, systemic absorption decreases.

ANS: C
The reason that concentrations of topical anesthetic agents are higher than that of their
injectable counterparts is to facilitate diffusion of the topical anesthetic agent through the
mucous membranes.

REF: Page 100

16. Which patients may be more susceptible to adverse effects to topical anesthetic
agents?
a. Children
b. Elderly
c. Medically compromised
d. All of the above

ANS: D
Children, elderly, and medically compromised individuals are more susceptible to the
adverse reactions to topical anesthetics.

REF: Page 100

17. Why does the local and systemic absorption of topical anesthetics increase the risk of
toxicity?
a. Topical anesthetics do not contain vasoconstrictors.
b. Topical anesthetics are formulated in high concentrations.
c. Topical anesthetics are absorbed quickly into the tissue and blood stream due to
vasodilation of the area.
d. All of the above

ANS: D
With the higher concentrations of the topical anesthesia and in the absence of
vasoconstricting abilities, the risk of local and systemic absorption increases with the use
of topical anesthetics.

Copyright © 2012 by Mosby, an imprint of Elsevier Inc.

Test Bank 6-8

REF: Page 100

18. What is the available concentration of Oraqix?

a. 5% lidocaine and 5% prilocaine
b. 2.5% lidocaine and 2.5% prilocaine
c. 14% Benzocaine, 2% butamben, and 2% tetracaine hydrochloride
d. 20% Benzocaine and 5% lidocaine

ANS: B
Oraqix is available for dental use in a 2.5% lidocaine and 2.5% prilocaine concentration.

REF: Page 100

19. What is the maximum recommended dose of Oraqix at one dental treatment session?
a. Two cartridges
b. Four cartridges
c. Five cartridges
d. Eleven cartridges

ANS: C
The maximum recommended dose of Oraqix at one dental treatment session is five
cartridges.

REF: Page 100

20. What FDA Category does Oraqix fall into?

a. Category A
b. Category B
c. Category C
d. Categories B or C, depending on the concentration used.

ANS: B
Oraqix falls into FDA Category B.

REF: Page 100

21. While at room temperature, Oraqix is in gel form in the cartridge. It will liquidate as
it reaches body temperature in the periodontal pocket.
a. Both statements are true.
b. Both statements are false.
c. The first statement is true; the second statement is false.
d. The first statement is false; the second statement is true.

ANS: B
While at room temperature, Oraqix is in liquid form in the cartridge. It will gel as it
reaches body temperature in the periodontal pocket.

Copyright © 2012 by Mosby, an imprint of Elsevier Inc.

Test Bank for Local Anesthesia for the Dental Hygienist, 1st Edition: Logothetis

Test Bank 6-9

REF: Page 100

22. What has the combined lidocaine/prilocaine cream been approved and effectively
used for?
a. Medical procedures
b. Dental procedures
c. Topical anesthetic for skin abrasions
d. All of the above

ANS: A
The combined lidocaine/prilocaine cream been approved and effectively used for medical
procedures.

REF: Page 99

23. Which of the following are best practices to follow when administering local
anesthesia of any kind in the dental office?
1. Review the patient’s health and dental history at all appointments.
2. Use the lowest concentration of anesthesia to satisfy clinical requirements.
3. Limit the area of application.
4. Know the concentration of the drug being used.
a. 2, 3, 4
b. 1, 3
c. Some other combination
d. All of the above

ANS: D
Best practices to follow when administering local anesthesia of any kind in the dental
office include: Review the patient’s health and dental history at all appointments; use the
lowest concentration of anesthesia to satisfy clinical requirements; limit the area of
application; and know the concentration of the drug being used.

REF: Pages 96, 102 and Box 6-3

Copyright © 2012 by Mosby, an imprint of Elsevier Inc.

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