INBDE (Integrated National Board Dental Examination) Practice Exam

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Most local anesthetics used in dentistry today are classified as?

Secondary amines
Tertiary amines
Quaternary amines
Primary amines

The correct answer is: Tertiary amines

Most local anesthetics used in dentistry today are classified as tertiary amines because they contain three carbon atoms attached to the nitrogen atom in their chemical structure. Tertiary amines are more lipid-soluble compared to primary and secondary amines, allowing them to easily cross lipid barriers such as cell membranes to reach their target site of action. In contrast: - Primary amines have only one carbon atom attached to the nitrogen atom. - Secondary amines have two carbon atoms attached to the nitrogen atom. - Quaternary amines have a fourth group attached to the nitrogen atom, making them less able to penetrate cell membranes and therefore less effective as local anesthetics in dentistry.