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ADBA Dental Anesth study materials
ADBA Dental Anesth study resources

ADBA Dental Anesth practice questions

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Question 1Written Examination (didactic knowledge of dental anesthesiology)

Which local anesthetic belongs to the ester class?

  1. Benzocaine Correct answer.
  2. Mepivacaine
  3. Lidocaine
  4. Articaine

Explanation

Ester local anesthetics are metabolized by plasma pseudocholinesterase and include benzocaine, procaine, and tetracaine. Articaine, lidocaine, and mepivacaine are all amide anesthetics metabolized primarily in the liver.

Question 2Written Examination (didactic knowledge of dental anesthesiology)

What is the primary mechanism by which local anesthetics produce reversible nerve blockade?

  1. Blocking calcium influx at the presynaptic terminal
  2. Stimulating GABA-A receptors on nerve membranes
  3. Blocking voltage-gated sodium channels from the intracellular side Correct answer.
  4. Enhancing potassium efflux during repolarization

Explanation

Local anesthetics bind the inner pore of voltage-gated sodium channels in their inactivated state, preventing sodium influx and blocking impulse propagation. This is a use-dependent, reversible block.

Question 3Written Examination (didactic knowledge of dental anesthesiology)

A 70 kg patient receives 4 cartridges (1.8 mL each) of 2% lidocaine with 1:100,000 epinephrine. Approximately how much lidocaine has been administered?

  1. 288 mg
  2. 144 mg Correct answer.
  3. 36 mg
  4. 72 mg

Explanation

A 2% solution contains 20 mg/mL, so each 1.8 mL cartridge holds 36 mg. Four cartridges deliver 4 × 36 = 144 mg of lidocaine.

Question 4Written Examination (didactic knowledge of dental anesthesiology)

Which maximum recommended dose of lidocaine with epinephrine is most consistent with standard dental guidelines for a healthy adult?

  1. 2.0 mg/kg
  2. 1.0 mg/kg
  3. 4.4 mg/kg
  4. 7.0 mg/kg Correct answer.

Explanation

For a healthy adult, the commonly cited maximum dose of lidocaine with epinephrine is approximately 7 mg/kg, not to exceed about 500 mg total. Lower limits apply to patients with significant cardiovascular or hepatic disease.

Question 5Written Examination (didactic knowledge of dental anesthesiology)

Epinephrine is added to a local anesthetic solution primarily to accomplish which effect?

  1. Reduce the risk of methemoglobinemia
  2. Prolong anesthesia and reduce systemic absorption Correct answer.
  3. Neutralize the acidity of the cartridge
  4. Increase the rate of anesthetic metabolism

Explanation

Vasoconstriction reduces local blood flow, slowing systemic uptake of the anesthetic and prolonging its presence at the nerve. This both extends anesthesia and lowers peak plasma concentrations.

Question 6Written Examination (didactic knowledge of dental anesthesiology)

A patient reports that a previous injection of an amide anesthetic caused hives and wheezing. Which statement best reflects appropriate management?

  1. The event should be evaluated as a possible true allergy before further amide use Correct answer.
  2. Allergy is unlikely and the reaction should be attributed to epinephrine
  3. The reaction is most likely vasovagal and the same drug may be repeated
  4. True amide allergy is common and any amide may be safely substituted

Explanation

True allergic reactions to amide anesthetics are rare, but a history of urticaria or bronchospasm warrants investigation before re-exposure. Most adverse events are psychogenic or vasovagal rather than immune-mediated.

Question 7Written Examination (didactic knowledge of dental anesthesiology)

Which nerve block is most appropriate for achieving pulpal anesthesia of the mandibular molars when a standard inferior alveolar nerve block fails?

  1. Nasopalatine nerve block
  2. Long buccal nerve block alone
  3. Gow-Gates or buccal infiltration with articaine Correct answer.
  4. Greater palatine nerve block

Explanation

When inferior alveolar block fails, alternative approaches include the Gow-Gates or Vazirani-Akinosi techniques, or buccal infiltration with articaine, which has enhanced bone penetration. These target the same nerve via different access.

Question 8Written Examination (didactic knowledge of dental anesthesiology)

Which structure is at greatest risk of inadvertent needle injury during a standard inferior alveolar nerve block?

  1. The parotid duct
  2. The maxillary artery
  3. The lingual nerve and vessels Correct answer.
  4. The facial nerve trunk

Explanation

During an inferior alveolar block, the needle passes near the lingual nerve and lingual vessels, which can be injured or injected. Prolonged lingual nerve paresthesia is a recognized complication.

Question 9Written Examination (didactic knowledge of dental anesthesiology)

A patient becomes pale, diaphoretic, and bradycardic shortly after an injection and then briefly loses consciousness. What is the most likely diagnosis?

  1. Vasovagal syncope Correct answer.
  2. Epinephrine overdose
  3. Anaphylaxis
  4. Local anesthetic systemic toxicity

Explanation

Bradycardia with pallor, diaphoresis, and transient loss of consciousness in the immediate post-injection period is characteristic of a vasovagal reflex. Anaphylaxis typically produces tachycardia and urticaria, while toxicity causes excitatory symptoms.

Question 10Written Examination (didactic knowledge of dental anesthesiology)

Which finding is an early sign of local anesthetic systemic toxicity?

  1. Hypertension with bradycardia
  2. Tinnitus and a metallic taste Correct answer.
  3. Respiratory depression without warning
  4. Flaccid paralysis

Explanation

Early central nervous system excitation from local anesthetic toxicity includes tinnitus, metallic taste, circumoral numbness, and visual disturbances. These precede seizures and later cardiovascular depression.

Question 11Written Examination (didactic knowledge of dental anesthesiology)

Which agent is most appropriate for topical anesthesia of the airway or mucosa in a patient with a documented ester allergy?

  1. Tetracaine gel
  2. Benzocaine spray
  3. Procaine solution
  4. Lidocaine spray Correct answer.

Explanation

Lidocaine is an amide anesthetic and is appropriate when ester allergy is documented. Benzocaine, tetracaine, and procaine are all esters and should be avoided.

Question 12Written Examination (didactic knowledge of dental anesthesiology)

Which patient factor most increases the risk of local anesthetic toxicity from a given dose?

  1. Recent antibiotic use
  2. Mild renal impairment
  3. Well-controlled asthma
  4. Hepatic impairment Correct answer.

Explanation

Amide anesthetics are metabolized hepatically, so hepatic impairment reduces clearance and raises plasma concentrations. Dose reduction should be considered in these patients.

Question 13Written Examination (didactic knowledge of dental anesthesiology)

Which statement about articaine is accurate?

  1. It contains a thiophene ring and is partly metabolized in plasma Correct answer.
  2. It is an ester anesthetic metabolized by plasma cholinesterase
  3. It is contraindicated for all mandibular blocks
  4. It has a longer half-life than bupivacaine

Explanation

Articaine is an amide anesthetic with a thiophene ring and an ester side chain, allowing partial plasma metabolism. This contributes to its short half-life and rapid clearance.

Question 14Written Examination (didactic knowledge of dental anesthesiology)

What is the primary purpose of aspirating before depositing local anesthetic during a nerve block?

  1. To confirm needle patency
  2. To warm the solution
  3. To detect intravascular needle placement Correct answer.
  4. To measure tissue resistance

Explanation

Aspiration identifies inadvertent entry into a blood vessel, allowing the clinician to reposition the needle before injecting and thereby reducing the risk of systemic toxicity.

Question 15Written Examination (didactic knowledge of dental anesthesiology)

Which nerve block provides anesthesia to the anterior two-thirds of the tongue?

  1. Chorda tympani branch of the lingual nerve Correct answer.
  2. Inferior alveolar nerve
  3. Long buccal nerve
  4. Mylohyoid nerve

Explanation

The lingual nerve, carrying taste fibers from the chorda tympani, supplies general sensation and taste to the anterior two-thirds of the tongue. It is anesthetized during an inferior alveolar block.

Question 16Written Examination (didactic knowledge of dental anesthesiology)

A patient with a history of methemoglobinemia should avoid which local anesthetic?

  1. Prilocaine Correct answer.
  2. Lidocaine
  3. Articaine
  4. Mepivacaine

Explanation

Prilocaine is metabolized to o-toluidine, which can oxidize hemoglobin to methemoglobin. Patients with methemoglobinemia or glucose-6-phosphate dehydrogenase deficiency should avoid it.

Question 17Written Examination (didactic knowledge of dental anesthesiology)

Which best describes the mechanism of action of epinephrine in local anesthetic solutions?

  1. Cholinesterase inhibition
  2. Direct sodium channel blockade
  3. Beta-adrenergic bronchodilation
  4. Alpha-adrenergic vasoconstriction Correct answer.

Explanation

Epinephrine acts primarily on alpha-adrenergic receptors in the vasculature to cause vasoconstriction. This reduces blood flow at the injection site and prolongs anesthesia.

Question 18Written Examination (didactic knowledge of dental anesthesiology)

Which patient is at greatest risk of a hypertensive reaction to a local anesthetic containing epinephrine?

  1. A patient with uncontrolled hyperthyroidism Correct answer.
  2. A patient with well-controlled hypothyroidism
  3. A patient taking a nonselective beta-blocker
  4. A patient with mild seasonal allergies

Explanation

Hyperthyroidism increases sensitivity to catecholamines, raising the risk of tachycardia and hypertension when epinephrine is administered. Careful dosing or a vasoconstrictor-free alternative may be considered.

Question 19Written Examination (didactic knowledge of dental anesthesiology)

Which local anesthetic has the longest duration of action and is often used for postoperative pain control?

  1. Prilocaine
  2. Articaine
  3. Mepivacaine without vasoconstrictor
  4. Bupivacaine Correct answer.

Explanation

Bupivacaine is highly protein bound and has the longest duration among commonly used dental anesthetics, making it useful for extended postoperative analgesia.

Question 20Written Examination (didactic knowledge of dental anesthesiology)

Which factor most increases the likelihood of a successful inferior alveolar nerve block?

  1. Using a larger gauge needle
  2. Injecting rapidly to increase pressure
  3. Accurate deposition near the lingula with adequate volume Correct answer.
  4. Injecting while the patient is supine

Explanation

Success depends on depositing solution near the inferior alveolar nerve as it enters the mandibular foramen, with sufficient volume to diffuse around the nerve. Rapid injection or needle gauge does not improve accuracy.

Question 21Written Examination (didactic knowledge of dental anesthesiology)

Which statement about the pterygomandibular space is correct in the context of the inferior alveolar nerve block?

  1. It contains the facial artery
  2. It contains the inferior alveolar nerve and vessels Correct answer.
  3. It is bounded anteriorly by the parotid gland
  4. It is located lateral to the ramus

Explanation

The pterygomandibular space contains the inferior alveolar nerve and vessels, the lingual nerve, and the mylohyoid nerve. The inferior alveolar block targets this space.

Question 22Written Examination (didactic knowledge of dental anesthesiology)

Which agent is most appropriate when a vasoconstrictor-free local anesthetic is required for a patient with severe cardiovascular disease?

  1. 3% mepivacaine plain Correct answer.
  2. 0.5% bupivacaine with 1:200,000 epinephrine
  3. 2% lidocaine with 1:100,000 epinephrine
  4. 4% articaine with 1:100,000 epinephrine

Explanation

Plain mepivacaine provides anesthesia without a vasoconstrictor, avoiding catecholamine exposure. Its duration is shorter than vasoconstrictor-containing solutions.

Question 23Written Examination (didactic knowledge of dental anesthesiology)

A patient develops sudden urticaria, wheezing, and hypotension minutes after an injection. What is the first-line pharmacologic treatment?

  1. Sublingual nitroglycerin
  2. Intramuscular epinephrine Correct answer.
  3. Oral diphenhydramine
  4. Intravenous furosemide

Explanation

Anaphylaxis is treated with intramuscular epinephrine as the first-line agent, along with airway support and oxygen. Antihistamines are adjunctive and do not reverse airway or vascular collapse.

Question 24Written Examination (didactic knowledge of dental anesthesiology)

Which statement best explains why local anesthetics are less effective in inflamed tissue?

  1. Acidic pH reduces the proportion of uncharged drug Correct answer.
  2. Inflamed tissue has more sodium channels
  3. Inflammation increases plasma protein binding systemically
  4. Inflammation increases nerve conduction velocity

Explanation

In inflamed tissue the extracellular pH is lower, increasing the fraction of charged local anesthetic and reducing diffusion across the nerve membrane. This can decrease the depth and duration of anesthesia.

Question 25Written Examination (didactic knowledge of dental anesthesiology)

Which nerve block is used to anesthetize the palatal tissue of the maxillary molars?

  1. Anterior superior alveolar nerve block
  2. Greater palatine nerve block Correct answer.
  3. Middle superior alveolar nerve block
  4. Inferior alveolar nerve block

Explanation

The greater palatine nerve supplies the palatal mucosa and glands of the posterior maxilla. Blocking it provides palatal anesthesia for molar procedures.

Question 26Written Examination (didactic knowledge of dental anesthesiology)

What is the primary reason for adding a vasoconstrictor to a local anesthetic solution?

  1. To increase the pH of the solution
  2. To speed systemic absorption of the anesthetic
  3. To reduce the risk of methemoglobinemia
  4. To prolong anesthesia and reduce bleeding Correct answer.

Explanation

Vasoconstrictors such as epinephrine constrict blood vessels, which decreases local blood flow, slowing systemic absorption and thereby prolonging the anesthetic effect and reducing surgical bleeding.

Question 27Written Examination (didactic knowledge of dental anesthesiology)

Which nerve block is used to anesthetize the buccal soft tissues of the mandibular molars?

  1. Inferior alveolar nerve block
  2. Mental nerve block
  3. Buccal nerve block Correct answer.
  4. Lingual nerve block

Explanation

The buccal nerve provides sensory innervation to the buccal gingiva and mucosa adjacent to the mandibular molars. A buccal nerve block is performed to anesthetize this area.

Question 28Written Examination (didactic knowledge of dental anesthesiology)

Which local anesthetic has the most rapid onset of action?

  1. Articaine Correct answer.
  2. Mepivacaine
  3. Procaine
  4. Bupivacaine

Explanation

Articaine has a rapid onset (typically 1–3 minutes) due to its high lipid solubility and low pKa, allowing rapid penetration of the nerve membrane. Bupivacaine and mepivacaine have slower onsets, and procaine is an ester with a relatively slow onset.

Question 29Written Examination (didactic knowledge of dental anesthesiology)

What is the maximum recommended dose of lidocaine with epinephrine for a healthy 70-kg adult?

  1. 70 mg
  2. 140 mg
  3. 500 mg Correct answer.
  4. 210 mg

Explanation

The maximum recommended dose of lidocaine with epinephrine is 7 mg/kg, up to a maximum of 500 mg. For a 70-kg adult, 7 mg/kg × 70 kg = 490 mg, which is rounded to 500 mg.

Question 30Written Examination (didactic knowledge of dental anesthesiology)

Which instrument is essential for administering a nerve block?

  1. A syringe with a 25-gauge needle Correct answer.
  2. A rubber dam clamp
  3. A dental mirror
  4. A periodontal probe

Explanation

Nerve blocks require a syringe with an appropriate needle (e.g., 25-gauge) to deliver the local anesthetic solution to the target nerve. The other instruments are not used for injection.

Question 31Written Examination (didactic knowledge of dental anesthesiology)

What is the primary purpose of using a topical anesthetic before an injection?

  1. To prolong the effect of the local anesthetic
  2. To sterilize the injection site
  3. To prevent systemic toxicity
  4. To reduce the pain of needle penetration Correct answer.

Explanation

Topical anesthetics numb the superficial mucosa, reducing the discomfort of needle penetration. They do not sterilize the site, prolong the effect of the injected anesthetic, or prevent systemic toxicity.

Question 32Written Examination (didactic knowledge of dental anesthesiology)

Which of the following is a sign of a successful inferior alveolar nerve block?

  1. Numbness of the lower lip and chin Correct answer.
  2. Numbness of the upper lip
  3. Numbness of the tongue
  4. Numbness of the palate

Explanation

An inferior alveolar nerve block anesthetizes the inferior alveolar nerve, which supplies the lower lip and chin (via the mental nerve). Numbness of the lower lip and chin is a reliable indicator of a successful block.

Question 33Written Examination (didactic knowledge of dental anesthesiology)

Which local anesthetic is most appropriate for a patient with a known allergy to amide anesthetics?

  1. Articaine
  2. Lidocaine
  3. Mepivacaine
  4. Procaine Correct answer.

Explanation

Patients allergic to amide anesthetics should receive an ester local anesthetic instead. Procaine is an ester and is therefore appropriate, whereas lidocaine, mepivacaine, and articaine are amides.

Question 34Written Examination (didactic knowledge of dental anesthesiology)

A patient with severe liver disease requires a local anesthetic. Which agent is safest?

  1. Prilocaine
  2. Lidocaine
  3. Bupivacaine
  4. Articaine Correct answer.

Explanation

Articaine is rapidly hydrolyzed by plasma esterases, so its elimination is less dependent on hepatic metabolism. In severe liver disease, amides that rely on hepatic metabolism (lidocaine, bupivacaine, prilocaine) may accumulate, making articaine a safer choice.

Question 35Written Examination (didactic knowledge of dental anesthesiology)

During an inferior alveolar nerve block, the needle contacts bone. What is the appropriate next step?

  1. Withdraw the needle slightly and aspirate Correct answer.
  2. Remove the needle and select a different site
  3. Inject the solution while in contact with bone
  4. Advance the needle further with pressure

Explanation

Contact with bone indicates the needle has reached the desired depth. The needle should be withdrawn slightly (about 1 mm) before aspiration and injection to avoid subperiosteal injection and to ensure the solution is deposited in the correct tissue space.

Question 36Written Examination (didactic knowledge of dental anesthesiology)

Which local anesthetic is associated with the greatest risk of cardiotoxicity if inadvertently injected intravascularly?

  1. Bupivacaine Correct answer.
  2. Lidocaine
  3. Prilocaine
  4. Mepivacaine

Explanation

Bupivacaine is more cardiotoxic than other local anesthetics because it binds strongly to cardiac sodium channels and dissociates slowly, leading to severe ventricular arrhythmias and cardiac arrest if injected intravascularly.

Question 37Written Examination (didactic knowledge of dental anesthesiology)

What is the recommended treatment for a patient who develops convulsions due to local anesthetic toxicity?

  1. Administer additional local anesthetic
  2. Administer a benzodiazepine and support ventilation Correct answer.
  3. Administer a beta-blocker
  4. Administer epinephrine

Explanation

Convulsions from local anesthetic toxicity are treated with a benzodiazepine (e.g., midazolam or diazepam) to terminate seizure activity, along with support of ventilation and oxygenation. Epinephrine, beta-blockers, and additional local anesthetic are not appropriate.

Question 38Written Examination (didactic knowledge of dental anesthesiology)

Which nerve block is contraindicated in a patient with a known allergy to sulfites?

  1. A block using plain articaine
  2. A block using plain prilocaine
  3. A block using a local anesthetic containing epinephrine Correct answer.
  4. A block using plain mepivacaine

Explanation

Local anesthetic solutions containing epinephrine often include sodium metabisulfite as a preservative. Patients with sulfite allergy may react to these solutions, so a sulfite-free alternative should be used.

Question 39Written Examination (didactic knowledge of dental anesthesiology)

What is the primary reason for using a self-aspirating syringe during a nerve block?

  1. To reduce the pain of injection
  2. To increase the speed of injection
  3. To allow the use of a larger needle
  4. To detect intravascular needle placement Correct answer.

Explanation

A self-aspirating syringe allows the clinician to aspirate easily before injection, which helps detect whether the needle tip is inside a blood vessel. This reduces the risk of intravascular injection and systemic toxicity.

Question 40Written Examination (didactic knowledge of dental anesthesiology)

Which local anesthetic is most appropriate for a patient with a history of malignant hyperthermia?

  1. Mepivacaine
  2. Lidocaine
  3. Articaine Correct answer.
  4. All amide local anesthetics are safe

Explanation

Malignant hyperthermia is triggered by volatile anesthetics and succinylcholine, not by amide local anesthetics. However, articaine is often preferred because it is rapidly hydrolyzed by plasma esterases, minimizing systemic exposure. All amide local anesthetics are generally considered safe, but articaine's rapid metabolism makes it a suitable choice.

Question 41Written Examination (didactic knowledge of dental anesthesiology)

Which of the following is a relative contraindication to the use of a local anesthetic with a vasoconstrictor?

  1. A history of penicillin allergy
  2. A history of asthma
  3. Controlled hypertension
  4. Uncontrolled hyperthyroidism Correct answer.

Explanation

Uncontrolled hyperthyroidism is a relative contraindication to vasoconstrictor use because epinephrine can exacerbate tachycardia and other symptoms. Controlled hypertension, asthma, and penicillin allergy are not contraindications.

Question 42Written Examination (didactic knowledge of dental anesthesiology)

What is the maximum recommended dose of mepivacaine for a 50-kg adult?

  1. 400 mg
  2. 300 mg Correct answer.
  3. 150 mg
  4. 500 mg

Explanation

The maximum recommended dose of mepivacaine is 6.6 mg/kg, up to a maximum of 400 mg. For a 50-kg adult, 6.6 mg/kg × 50 kg = 330 mg, which is rounded to 300 mg.

Question 43Written Examination (didactic knowledge of dental anesthesiology)

Which nerve block is most appropriate for anesthetizing the maxillary central incisors?

  1. Greater palatine nerve block
  2. Nasopalatine nerve block Correct answer.
  3. Inferior alveolar nerve block
  4. Mental nerve block

Explanation

The nasopalatine nerve block anesthetizes the nasopalatine nerve, which supplies the palatal tissues of the anterior maxilla, including the central incisors. It is often used in conjunction with local infiltration for complete anesthesia.

Question 44Written Examination (didactic knowledge of dental anesthesiology)

A patient develops a hematoma after an inferior alveolar nerve block. What is the most likely cause?

  1. Allergic reaction
  2. Injection into a blood vessel
  3. Needle trauma to a blood vessel Correct answer.
  4. Infection

Explanation

A hematoma occurs when a blood vessel is punctured by the needle, causing bleeding into the surrounding tissues. It is not caused by intravascular injection, allergic reaction, or infection.

Question 45Written Examination (didactic knowledge of dental anesthesiology)

Which local anesthetic is most likely to cause methemoglobinemia when used in excessive doses?

  1. Bupivacaine
  2. Lidocaine
  3. Prilocaine Correct answer.
  4. Mepivacaine

Explanation

Prilocaine is associated with methemoglobinemia because its metabolite, o-toluidine, oxidizes hemoglobin to methemoglobin. Excessive doses of prilocaine increase this risk.

Question 46Written Examination (didactic knowledge of dental anesthesiology)

What is the primary advantage of using a 30-gauge needle for an inferior alveolar nerve block?

  1. Increased patient comfort Correct answer.
  2. Faster onset of anesthesia
  3. Longer duration of anesthesia
  4. Reduced risk of intravascular injection

Explanation

A 30-gauge needle is thinner than a 25- or 27-gauge needle, which reduces tissue trauma and improves patient comfort during injection. It does not reduce the risk of intravascular injection, speed onset, or prolong duration.

Question 47Written Examination (didactic knowledge of dental anesthesiology)

Which local anesthetic is most appropriate for a patient with a history of severe cardiovascular disease who requires a vasoconstrictor-free solution?

  1. Articaine with epinephrine
  2. Bupivacaine with epinephrine
  3. Mepivacaine plain Correct answer.
  4. Lidocaine with epinephrine

Explanation

Mepivacaine plain is a vasoconstrictor-free amide local anesthetic suitable for patients in whom vasoconstrictors are contraindicated. The other options all contain epinephrine.

Question 48Written Examination (didactic knowledge of dental anesthesiology)

A patient with a history of bisphosphonate use requires a dental extraction. Which local anesthetic technique is preferred to minimize the risk of osteonecrosis?

  1. Greater palatine nerve block
  2. Intraligamentary injection
  3. Local infiltration Correct answer.
  4. Inferior alveolar nerve block

Explanation

In patients at risk for bisphosphonate-related osteonecrosis of the jaw, local infiltration is preferred over nerve blocks because it avoids trauma to the inferior alveolar nerve and reduces the risk of ischemia. Intraligamentary injection and nerve blocks may increase the risk.

Question 49Written Examination (didactic knowledge of dental anesthesiology)

Which of the following is the most appropriate initial management for a patient who experiences a seizure during a dental injection?

  1. Immediately administer epinephrine
  2. Protect the patient from injury and maintain the airway Correct answer.
  3. Administer a local anesthetic reversal agent
  4. Place the patient in a supine position and give oral fluids

Explanation

The initial management of a seizure is to protect the patient from injury, maintain the airway, and support ventilation. Administration of an anticonvulsant may follow if the seizure is prolonged. Local anesthetic reversal agents, epinephrine, and oral fluids are not appropriate initial steps.

Question 50Written Examination (didactic knowledge of dental anesthesiology)

What is the primary mechanism of action of local anesthetics?

  1. Activation of potassium channels
  2. Agonism at GABA-A receptors
  3. Blockade of voltage-gated sodium channels Correct answer.
  4. Inhibition of cyclooxygenase enzymes

Explanation

Local anesthetics prevent the generation and conduction of nerve impulses by blocking voltage-gated sodium channels in the neuronal membrane, thereby inhibiting the influx of sodium ions necessary for depolarization.