LOCAL ANESTHESIA for the DENTAL
HYGIENIST Second Edition Exam 2026
Questions and Answers
Acetylsalicylic Acid (Aspirin) - Correct answer-ASA
antipyretic - Correct answer-reduces fever (Tylenol, aspirin)
Epinephrine is naturally secreted by the adrenal glands and the sympathetic nerve
fibers. The hormone can be obtained via extraction from the adrenal glands of
cattle and sheep, or it can be made in a laboratory. Synthetic production of
epinephrine entails the reaction of catechol and chloroacetyl chloride. - Correct
answer-
antipyretic - Correct answer-reduces fever (Tylenol, aspirin)
In 1842, it was reported that William Clarke administered ether, via a towel, to a
woman as one ofher teeth was extracted by a dentist. - Correct answer-
Tagamet (cimetidine) decreases hepatic blood flow and inhibits hepatic metabolism
of amides, particularly lidocaine, by competing for binding to hepatic oxidative
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,enzymes, and therefore increases half life of the amide anesthetic, augmenting the
risk for toxic overdose. - Correct answer-
Morphine - Correct answer-narcotic drug derived from opium, used to treat severe
pain
Horace Wells, a dentist, first tried nitrous oxide for dental pain control after
attending several "laughing gas" parties. - Correct answer-
He practiced on himself by using nitrous oxide, which he considered safer than
ether, and had a fellow dentist extract his tooth.He felt nothing during the
extraction and discovered nitrous oxide to be an effective anesthetic. - Correct
answer-
Halothane, a safe and stable chemical for inhalation anesthesia, was introduced in
1956. - Correct answer-
Halothane (Fluothane) - Correct answer-halogenated hydrocarbon volatile liquid
anesthetic with good maintenance
The first local anesthetic, cocaine, was isolated from coca leaves by Albert
Niemann and Francesco Di Stefano in Germany in the 1860s. - Correct answer-
Cocaine was first used as a local anesthetic in 1884 by Karl Koller, who
demonstrated the use during painless ophthalmological surgery. - Correct answer-
©COPYRIGHT 2025, ALL RIGHTS RESERVED 2
,In 1905, the ester procaine (Novocaine) was created in Germany and, when mixed
with a proportion of epinephrine, was found to be effective and safe - Correct
answer-
Procaine took a long time to produce the desired anesthetic result, wore off
quickly, and was not as potent as cocaine. Additionally, many patients were allergic
to procaine because procaine is an ester that has a high potential for allergic
reactions. - Correct answer-
In the 1940s, a new group of local anesthetic compounds, the amides,were
introduced. The initial amide local anesthetic, lidocaine, was synthesized by the
Swedish chemist Nils Lofgren in 1943. - Correct answer-Lidocaine revolutionized
pain control in dentistry worldwide, because it was both more potent and less
allergenic than procaine. In the succeeding years, other amide local anesthetics
(prilocaine in 1959, bupivacaine and mepivacaine in 1957) were introduced.
These new amide local anesthetics provided the dental practitioner with an array of
local anesthetics for pulpal anesthesia that could last from 20 minutes
(mepivacaine plain) to 3 hours (bupivacaine with epinephrine) - Correct answer-
In 1969, Rusching and colleagues prepared a new drug, carticaine, which differed
from the previous amide local anesthetics - Correct answer-Renamed articaine in
1984, the drug was derived from thiophene and thus contained a thiophene ring in
©COPYRIGHT 2025, ALL RIGHTS RESERVED 3
, its molecule instead of the usual benzene ring. Articaine became available in 2000
for marketing in the United States in a 4% 1:100,000 epinephrine formulation.
Today, lidocaine remains the most popular anesthetic used in dentistry in the
United States; however,articaine is increasing in its popularity and is a close
second to lidocaine.Many patients do not understand the distinction among the
agents and still ask for Novocaine, which is no longer available in dentistry. -
Correct answer-
levonordefrin (Neo-Cobefrin) - Correct answer-Vasoconstrictor
1/6th as strong as EPI
Mostly act on Alpha receptors (75%) Beta (25%)
Less systemic effects than EPI
Max Dose in ALL Pt's = 1mg/appt = 11 cartridges
2% carbocaine with 1:20,000 Levonordefrin
inact - Correct answer-To bring into action or a state of activity.
Pain threshold pertains to the point at which a sensation starts to be painful and
discomfort results. This threshold varies among individuals and may be altered by
©COPYRIGHT 2025, ALL RIGHTS RESERVED 4
HYGIENIST Second Edition Exam 2026
Questions and Answers
Acetylsalicylic Acid (Aspirin) - Correct answer-ASA
antipyretic - Correct answer-reduces fever (Tylenol, aspirin)
Epinephrine is naturally secreted by the adrenal glands and the sympathetic nerve
fibers. The hormone can be obtained via extraction from the adrenal glands of
cattle and sheep, or it can be made in a laboratory. Synthetic production of
epinephrine entails the reaction of catechol and chloroacetyl chloride. - Correct
answer-
antipyretic - Correct answer-reduces fever (Tylenol, aspirin)
In 1842, it was reported that William Clarke administered ether, via a towel, to a
woman as one ofher teeth was extracted by a dentist. - Correct answer-
Tagamet (cimetidine) decreases hepatic blood flow and inhibits hepatic metabolism
of amides, particularly lidocaine, by competing for binding to hepatic oxidative
©COPYRIGHT 2025, ALL RIGHTS RESERVED 1
,enzymes, and therefore increases half life of the amide anesthetic, augmenting the
risk for toxic overdose. - Correct answer-
Morphine - Correct answer-narcotic drug derived from opium, used to treat severe
pain
Horace Wells, a dentist, first tried nitrous oxide for dental pain control after
attending several "laughing gas" parties. - Correct answer-
He practiced on himself by using nitrous oxide, which he considered safer than
ether, and had a fellow dentist extract his tooth.He felt nothing during the
extraction and discovered nitrous oxide to be an effective anesthetic. - Correct
answer-
Halothane, a safe and stable chemical for inhalation anesthesia, was introduced in
1956. - Correct answer-
Halothane (Fluothane) - Correct answer-halogenated hydrocarbon volatile liquid
anesthetic with good maintenance
The first local anesthetic, cocaine, was isolated from coca leaves by Albert
Niemann and Francesco Di Stefano in Germany in the 1860s. - Correct answer-
Cocaine was first used as a local anesthetic in 1884 by Karl Koller, who
demonstrated the use during painless ophthalmological surgery. - Correct answer-
©COPYRIGHT 2025, ALL RIGHTS RESERVED 2
,In 1905, the ester procaine (Novocaine) was created in Germany and, when mixed
with a proportion of epinephrine, was found to be effective and safe - Correct
answer-
Procaine took a long time to produce the desired anesthetic result, wore off
quickly, and was not as potent as cocaine. Additionally, many patients were allergic
to procaine because procaine is an ester that has a high potential for allergic
reactions. - Correct answer-
In the 1940s, a new group of local anesthetic compounds, the amides,were
introduced. The initial amide local anesthetic, lidocaine, was synthesized by the
Swedish chemist Nils Lofgren in 1943. - Correct answer-Lidocaine revolutionized
pain control in dentistry worldwide, because it was both more potent and less
allergenic than procaine. In the succeeding years, other amide local anesthetics
(prilocaine in 1959, bupivacaine and mepivacaine in 1957) were introduced.
These new amide local anesthetics provided the dental practitioner with an array of
local anesthetics for pulpal anesthesia that could last from 20 minutes
(mepivacaine plain) to 3 hours (bupivacaine with epinephrine) - Correct answer-
In 1969, Rusching and colleagues prepared a new drug, carticaine, which differed
from the previous amide local anesthetics - Correct answer-Renamed articaine in
1984, the drug was derived from thiophene and thus contained a thiophene ring in
©COPYRIGHT 2025, ALL RIGHTS RESERVED 3
, its molecule instead of the usual benzene ring. Articaine became available in 2000
for marketing in the United States in a 4% 1:100,000 epinephrine formulation.
Today, lidocaine remains the most popular anesthetic used in dentistry in the
United States; however,articaine is increasing in its popularity and is a close
second to lidocaine.Many patients do not understand the distinction among the
agents and still ask for Novocaine, which is no longer available in dentistry. -
Correct answer-
levonordefrin (Neo-Cobefrin) - Correct answer-Vasoconstrictor
1/6th as strong as EPI
Mostly act on Alpha receptors (75%) Beta (25%)
Less systemic effects than EPI
Max Dose in ALL Pt's = 1mg/appt = 11 cartridges
2% carbocaine with 1:20,000 Levonordefrin
inact - Correct answer-To bring into action or a state of activity.
Pain threshold pertains to the point at which a sensation starts to be painful and
discomfort results. This threshold varies among individuals and may be altered by
©COPYRIGHT 2025, ALL RIGHTS RESERVED 4