ANESTHESIOLOGY
OPERATOR PREFERENCE OF RETRACTION METHOD DURING ANESTHESIA DELIVERY
Bernadette Alvear Fa 1a *, Shika Gupta 1b, Mouchumi Bhattacharyya 2c
1
Department of Integrated Reconstructive Dental Sciences, School of Dentistry University of the Pacific Arthur A. Dugoni San Francisco, CA 94103, USA
2
Department of Mathematics, University of the Pacific, Stockton, CA 95211, USA a
DDS, Assistant Professor, Director of Local Anesthesia b
DDD, Assistant Professor c
Professor of Statistics
Cite this article: Alvear Fa B, Gupta S, Bhattacharyya M. Operator preference of retraction method during anesthesia delivery. Stoma Edu J. 2016; 3( 1): 10-15.
ABSTRACT
Received: March 9, 2016 Received in revised form: April 22, 2016
Accepted: April 24, 2016 Published online: March 09, 2016
Introduction: Dental Health Care Providers( DCPs) traditionally use finger retraction or mirror retraction when delivering local anesthesia. Needlestick injuries( NSIs) occur as hand retracting mucosa is likely to experience injury during dental anesthesia delivery. The aim of this paper is to examine a clinical split mouth study comparing two retraction methods and DCP’ s retraction preference during delivery of dental anesthesia. The clinical implications from this study impact the practitioner’ s risk of experiencing an NSI. Methodology: The IRB approved study( clinical trials ID: NCT02414620) compared the comfort and ease of the retraction method used while delivering an anterior superior alveolar( ASA) injection bilaterally. Surveys given to participants asked about comfort and ease of use of retraction methods, as well as preferred method of retraction during anesthesia delivery. Chisquare tests of goodness-of-fit were conducted to investigate whether there was a significant difference in the proportion of respondents that chose the various categories within one criterion. Results: 62 DCPs participated in the study and no reported NSIs. Data from the DCPs report significance( p value < 0.001) in comfort comparing retraction methods when providing anesthesia. Regarding preference of retraction, 22 prefer mirror, 29 preferred device, and 3 preferred their finger. Regarding ease of retraction used, 30 chose mirror, 18 device, and 10 chose finger. Conclusion: Our hypothesis and clinical implication were confirmed. More studies need to be conducted regarding the benefits of using a fingerless retraction method and its effectiveness in dental anesthesia. Keywords: dental anesthesia, dental injection technique, dental armamentarium.
1. Introduction
Dental Health Care Providers( DCPs) traditionally use finger retraction or mirror retraction when delivering local anesthesia. 1-3 Existing dental anesthesia curriculums and educational programs have not emphasized techniques other than using the finger for retraction of mucosa. 4-7 Literature presents cases of needlestick injuries( NSIs) when finger is used to retract mucosa to deliver anesthesia. 8, 9 Innovations towards dental anesthesia delivery have progressed throughout the years. 1, 4, 10-13 In addition, various instruments exist both in clinical practice and on the market to aid in retraction( cheek retractor, tongue depressor etc). 1, 14-16 In 2010, a device was approved for purchase in the United States for use during dental anesthesia delivery( Fig. 1). This device is a cordless, rechargeable, handheld system that delivers pulsed micro-oscillations to the injection site. The disposable retraction tips consisting of two rubber prongs with an illuminating LED light appropriate for the generation 2 model can be assembled onto the device prior to use. If the DCP applies too much pressure, the device will automatically shut down the oscillating pulses until an appropriate handle and pressure is applied. 17 The aim of this paper is to examine a clinical split mouth study comparing two retraction methods and DCP’ s preference during delivery of dental anesthesia. Our hypothesis is that introducing a new device will provide an alternative method to aid in retraction during delivery of dental anesthesia. The clinical implications from this study
* Corresponding author: Assistant Professor Bernadette Alvear Fa, DDS, Director of Local Anesthesia Department of Integrated Reconstructive Dental Sciences, School of Dentistry University of the Pacific Arthur A. Dugoni 155, 5th Street, San Francisco, CA 94103, USA Tel / Fax:( 415) 749 3373, e-mail: balvear @ pacific. edu
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