ASA Physical Status Classification SYSTEM

ASA I

Normal and healthy.  Little or no anxiety.  Little or no risk. 

ASA II

Mild to moderate systemic disease or are healthy ASA I patients who demonstrate a more extreme anxiety and fear toward dentistry.  Patients are able to walk up one flight of stairs or two level city blocks, but will have to stop after completion of the exercise because of distress. 

Examples: well-controlled NIDDM, epilepsy, asthma, and/or thyroid conditions; ASA I with a respiratory condition, pregnancy, and/or active allergies.

ASA III

Severe systemic disease that limits activity, but is not incapacitating.  Patients are able to walk up one flight of stairs or two level city blocks, but will have to stop enroute because of distress

Examples: angina, MI or CVA history, IDDM, CHF, COPD

ASA IV

Patients have severe systemic disease that limits activity and is a constant threat to life.  Distress is present even at rest.

Examples:  unstable angina, MI or CVA within the last six months, HTN, severe CHF or COPD, uncontrolled epilepsy, diabetes, or thyroid condition. 

STAGES OF HTN

	Systolic	Diastolic	Treatment Modifications
Normal	< 130 mm Hg	< 85 mm Hg	None
Stage 1	140 - 159	90-99	Inform pt, med referral
Stage 2	160 - 179	100-109	Med referral, selective tx
Stage 3	180 - 209	110-119	ER tx only, med referral
Stage 4	> 210	> 120	Immediate med referral

LOCAL ANESTHESIA

Injection	Injection Site	Affected Ares	Depth
ASA	C / 1P eminence	CI, LI, C (P)	16mm
MSA	MB fold of 2P	1/2P +  MB root of #3	A few mm
PSA	45/45/45 to 2M	Molars except MB #3	16 mm
Nasoplatine	Side of incisive papilla	1P-1P	A few mm
Greater palatine	Ant to foramen	Post hard palate	< 10 mm
IAN	Opp. P, Occ. plane	Mn teeth ant to M	10-25 mm
Long Buccal	Post to 3M, Occ. plane	Buccal of M	1-2 mm
Lingual	Opp. P, Occ. Plane	Ant 2/3 tongue, FOM, Li soft tissues	10-12 mm