1 Flashcards
1
Q
C/O ask
A
bleeding gums
bad breath
sensitivity
mobility
spacing
receding gums
pain
2
Q
HPC
guide
A
SOCRATES
3
Q
SOCRATES
A
S ite
O nset
C haracter
R adiation
A ssociation
T ime course
E xacerbate/relief
S everity
4
Q
PDH ask
A
regulat attender or only when in pain?
Tx today or previously for presenting complaint?
age of restorative work/dentures?
LA given before? issues?
OH habits?
5
Q
MH ask
A
- DJ HEART BBT
- CVS, CNS, Resp, GIT, Genito-urinary, Vascular, Immune, Endo, Dermatology
- long term conditions (current or past)
- medications
- allergies
- currently fit and well?
- seeing doctor for anythiing?
- any past hospital in stays?
6
Q
DJ HEART BBT
A
DJ HEART BBT
D iabetes
J aundice
H igh BP
E pilepsy
Rh Fever
TB
BBV
B leeding tendency
7
Q
FH ask
A
presenting conditions or others?
Periodontitis? (gum disease)
Cancers?
8
Q
SH ask
A
smoking - how long and how many, vape
alcohol - how much per week- unit
diet - snacking, sugars in teas, fizzy drinks
9
Q
E/O exam
A
- assess when walk into room
- limp
- check TMJ
- clicking, deviation on opening, history of locking
- check lymph nodes
- neck, cheeks, submandibular and behind ear
- check cracked lips
- asymmetry
- check masseter and temporails
10
Q
I/O exam
A
- any lumps, bumps, swellings
- lips, tongue, cheeks, had and soft palate, floor of mouth, oropharynx
11
Q
Dental exam
A
- missing teeth
- abnormalities: PE, crowding, diastema
- Restorations
- type
- number
- distribution
- carious
- #
- leaked
- attrition, abrasion, erosion
- distribution and severity
- endo
- occlusion - abnormalities
12
Q
periodontal exam
A
visual
- supra gingival plaque and calculus deposits
- hyperplasia, recession, gigival erythma
Probing
- BPE then 6PPC (3 or 4)
- BOP distibution
- plaque retentive factors
- sub-gingival calculus
- furcation involvement
- mobility
TTP
13
Q
DRS ABC
A
D anger
R esponse
S hout for help
A irways
B reathing
C irculation
14
Q
Response
check
A
gently shake and ask can you hear me?
no response -> shout
15
Q
Airways
check
A
if blocked finger sweep and/or aspiration
gentle head tild and jaw thrust as long as no chance of neck or vertebral injury
16
Q
breathing
check
A
ear to mouth and look at chest to see if rise and fall
10 seconds
17
Q
circulation
check
A
assess 10 seconds by listening, feeling for air with cheek and looking for chest movement, while at same time feeling for carotid pulse
18
Q
what to say to helper in CPR defib situation
A
phone for ambulance - inform cardiac arrest, exact location inc floor and contact number
fetch a defibrilator and bag-valve mask and oxygen
chest compressions with two hands, 5-6cm deep at 120bpm
2 breaths given from BVM with good seal after 30 compressions, repeat
defib - get help to do compressions whilst you set up
19
Q
paeds BLS
A
SSSABCR
Safety
Stimuli response (don’t shake <2 year olds)
Shout for help (ambulance, bag-valve)
Airways (pinkie sweep)
Breathing (If not breathing, give 5 rescue breaths before continuing – no tilt chin lift)
Circulation (Brachial pulse in infants, if <60bpm then begin compressions
- Just above bottom of sternum with 2 thumbs to 1/3 of the A-P depth
- At a rate of 120bpm and a ratio of 15 compressions to 2 breaths)
Reassess after 1 minute
- With children a carotid pulse can be taken & the head tilt chin lift manoeuvre is OK*
- Compressions are done with 1 han*
20
Q
paeds if choking
A
For an infant:
- Alternate between lying face down along arm downwards with head supported and give 5 sharp slaps to the back to encourage coughing
- Lying face up give 5 sharp upward facing compressions to the sternum.
For a Child:
- Lean over knee, support chest and give 5 sharp slaps to the back
- Alternate with 5 upwardly rotating abdominal thrusts.
21
Q
angina
A
chest pain due to ischaemia (lack of blood flow; lack of O2) of the heart muscle
characterised by retrosternal chest pain or discomfort (tightness/heaviness) that may radiate to the arms, shoulders and neck
22
Q
stable angina
A
chest pain/discomfort that often occurs with activity or stress and is relieved by rest
23
Q
unstable angina
A
lack of blood flow and oxygen that may lead to a heart attack
refer to GMP or ambulance
24
Q
Myocardial infarction
A
heart attack occurs when blood flow to a part of you heart is blocked for a long enough time that part of the heart muscle is damaged or dies
differs from angina in that pain is more severe and persistent, not relieved by rest and can cause death of heart muscle
25
Tx for angina/MI in dental chair
stop tx and sit upright
oxygen 15L via non-rebreathing mask
GTN spray (if BP \<70mmHs as if weak they may collapse)
Aspirin 300mg crushed/chewed
get urgent help if angina persists or if MI
26
how to tell if angine leads to MI
A airways Clear
B breathing - Tachypnoea (rapid, shallow)
C chest pain/Pulse inc/BP inc/ tachycardic
D Varies depending on extent
E anxiety/nausea/vomiting
27
7 emergency drugs
* Oxygen
* Salbutamol
* Midazolam
* Adrenaline
* GTN spray
* Aspirin
* Glucagon
## Footnote
*Only Stunning Men Are Getting Actural Girls*
28
Oxygen
emergency med
give 15L/min to anyone who is feeling unwell
29
Salbutamol
emergeny med
give two 100microgram actuations to anyone with a wheeze
In severe asthma case up to ten actuations should be delivered into a bag-valve-mask and given to the patient
Stridor may be caused by a foreign body in the airway – salbutamol should not be given.
30
Midazolam
emergency med
squirt **10mg into the buccal sulcus** of person having repeated or prolonged seizures (epileptics who have changed their medication)
31
Adrenaline
emergency med
**½ an ampule of 1:1000 parts adrenaline (0.5mg)** should be given as an **IM injection** using the Z-plasty admin route disruption technique to someone with a life-threatening anaphylactic shock
* If the condition is worsening, the injection can be repeated in the other leg.
2 needles: First may be blunt from drawing liquids – painful injection
32
GTN spray
emegency med
**Two actuations** can be given **sublingually** to patients suffering from an acute stable angina attack
The condition should also resolve with rest and will normally present on exercise.
If the condition does not improve then they may be having an MI or unstable angina (see aspirin)
33
Aspirin
emergency med
**300mg** to be taken **crushed or chewed** by persons having a myocardial infarction
They should be referred immediately to hospital.
34
Glucagon
emergency med
**1mg intramuscular injection** to patients suffering a hypoglycaemic coma (Type 1 Diabetics)
Will reduce all glucose stores from the liver
As soon as conscious should be given sugar in a quickly absorbable form.
35
INR stands for
international normalised ratio
36
Warfarin
action
inhibits coagulation by vitamin K anatgonism (listed under coumarins)
37
INR extraction minimum
4
38
warafarin interactions
* Antibiotics (Metronidazole increase effect)
* Carbamazepine inhibits
* Don’t use NSAIDS (ibuprofen)
* Antiplatelet effect will increase Bleeding time (inc effects)
39
how to dx Sjorgens when pt presents with dry mouth?
* Dry eyes and mouth clinical exam
* Blood tests for Anti-La antibody first
* Also Anti-Ro and ANA
* Histopathology assessment of a labial secondary salivary gland biopsy
* Radionucleotide assessment into a salivary duct, Imaging.
40
complications of Sjorgens
* dry mouth
* burning mouth
* difficulty swallowing and speaking
* increased risk of oral infection and caries
* difficulty with denture retention
* long-term risk of salivary lymphoma
41
5As of smoking cessation
Ask
Advise
Assess
Assist
Arrange
42
Ask in smoking cessation
smoker? how many per day? when first cigarette of the day? how many years?
want to stop? interested in stopping? interested in help?
43
Advise in smoking cessation
aware of health benefits of quitting?
single most effective way of improving health status
past failures will improve chances this time round as not easy to do
lung cancer and heart disease, oral cancer, gum disease and stained teeth
44
Assess in smoking cessation
desire to stop smoking?
help must be offered
45
Assist in smoking cessation
negotiate a stop date
review previous failed attempts and anticipate problems, suggest enlisting family and friends
inform of NRT availability and NHS Stop Smoking Service
46
Arrange in Smoking cessation
arrange follow up
arrange NHS SSS referral (one to one or group), monitor, support and encourage at future dental appointments
47
reversible pulpitis
Mild inflammation to pulp: *Caries, exposed dentine, defective restoration*
Tooth may respond more than normal to certain stimuli such as **heat and sweet**.
* Stimuli tend to produce a **sharp pain (A delta)** that **resolves within 5-10 secs after the stimuli removed**.
_Cause of inflammation (eg caries) is removed -\> pulp-dentine complex will return to normal_
48
irreversible pulpitis
| (symptomatic or asymptomatic)
**Dull aching pain lasts minutes or hours**
* Worse at night or when lying down due to an increase in intra pulpal pressure
* Symptoms may be initiated by temperature changes
Min radiograph changes til advanced – If it is then PDL widening
**Removal of the causal factor does not lead to pulpal regeneration**
If left untreated will become necrotic.
_Treatment: RCT/XLA_
49
necorsis
blood supply non existent
Asymptomatic before it extends to Periodontium
* Negative to EPT & cold sensitivity
* TTP positive
* Radiographic PDL thickening & PA lucency
Tx: XLA/Endo
50
acute necrotising ulcerative gingivitis ANUG
tx
debridement, oxidising mouthwash, CHX mouthwash, OHI
drugs
* metronidazole 200mg 3xday 3-5 days
* amoxicillin 250mhg 3xday 7-10 days
* oxidising hydrogen peroxide mouthwash
51
ANUG predisposing factors
stress
smoking
poor OH
*young and immunocompromised*
52
acute necrotising ulcerative periodontitis ANUP
tx
* metronizadole 200mg 3-5days
* chlorohexidine digluconate (bisguanide)
* 0.2% 10ml = 20mg; twice a day
53
chlorohexidine
bisguanide mouthwash
0.2% 10ml twice daily
substantivity 12 hours
dicatonic action
* one cation binds to the pellicle coated teeth
* other bactieral cell membrane
* low concentration - increase permeability
* high concentration - precipitation of cytoplasm and cell death
54
55
upper anterior straight forceps
13-23
56
upper universal forceps
14, 15, 24, 25
57
upper molar forceps
beak to cheek
6 back
58
lower universal forceps
35 - 45
59
lower molar forceps
left and right sets
6s back
60
cowhorn forceps
useful for browken down lower molars
squeeze out
61
bayonet forceps
upper 8s
help reach back
have roots version too
62
elevators
loosen PDL, widen space for easier forcecp access
63
luxators
tear PDL
sharp
64
when to stand behind pt for extraction
only loower right molars (right handed operator)
65
3 types of elevators
couplands
cryers
warwick james
66
post op extraction instructions
Don’t rinse for several hours, or not til the next day. Don’t be vigorous when you do
* Rinse the next day with hot salty water & gently swirl around 4 times a day for a minute
Avoid trauma. Don’t explore the socket with finger/tongue
Avoid hot food day of extraction. Eat on the other side of the mouth
Avoid excessive exercise
Avoid smoking/drinking on day of extraction
Brush as normal
Advice on bleeding
* if bleeds bite on damp gauze 20 mins & bleeding should stop
* If bleeding doesn’t stop then contact GDH&S or hospital(A&E)
May have slight discomfort so take pain killers before the LA wears off.
* Take whatever you normally take and continue as instructed on packet
If any problem contact GDH&S (dry socket; sutures removed)
67
post op pain killer caution with
* Elderly
* Peptic ulceration/GORD
* Pregnant
* U16 (Reye’s)
* Renal/cardiac/hepatic impaired
* Asthmatics (unless had before)
* History of NSAIDs hypersensitive
* Taking other NSAIDs
* On long term steroids (gastric ulcers)
* Warfarin
liver or kidney disease - need reduced dose
alcohol dependence - caution
68
ibuprofen prescription
200 or 400mg tablets 3-4 times per day after food
* Do not take more than 6 tablets (2.4g) in 24 hour.
follow box
69
paracetamol prescriptions
500mg tablets 1 or 2 tablets every 4 hours
* Do not take more than 8 tablets (4g) in 24 hours
follow box
70
co-codamol composition
paracetamol with 8 or 30g codeine
71
what to record from LA vile
batch number and expiry date
72
LA for high BP or heart problems
adrenaline free
prilocaine with felypressin
73
prilocaine with felypressin
vasoconstrivtive effect?
contains synthetic vasoconstrictor so effects of anaesthetic will last
* don't use lidocaine w/o adrenaline - no vasoconstrictor so effects won't last
74
if pt on Beta Blocker what LA to use
adrenaline free or limit quantity (3 cartridges max)
75
pt on anti-depressant tri-cyclics LA
adreanaline free or limit quantity
76
normal LA circumstances (standard)
2.2ml 2% lidocaine 1/80,000 adrenaline
77
EDTA solution role
irrigant
15%
removes smear layer
78
3 irrigant examples
EDTA 15%
sodium hypochlorite 0.5-6%
chlorohexidine 0.2%
79
sodium hypochlorite irrigant role
disinfects and dissloves pulpal remnants, disrupts organic portion of the smear layer
0.5-6%
80
chlorohexidine irrigant role
0.2%
disinfects canal
81
S files work in
coronal and mid root area
2/3 WL
S1, S2
82
order of files in endo
K files 10, 15, 20 to resistance
S1, S2 to WL with brushing motion
apical shaping with S files
F1, F2, F3 etc to WL
83
F1 diameter and taper
20
7%
84
F2 diameter and taper
25
8%
85
F3 diameter and taper
30
9%
86
F4 diameter and taper
40
6%
87
F5 diameter and taper
50
5%
88
paper points
job
ensure the canal is dry before medicating or obturating
89
examples of intervisit endo medication to prevent infection
* ultracal/hypocal/dycal
* non-setting CaOH
90
example of intervisit medication for hot, infected pulps to reduce inflammation
Ledermix
Corticosteroid and antibiotic mixture
91
GP points
obturation material
cold lateral compation or thermafill techniques
needs AH Plus sealer
92
Riva is
GI
93
Relyx is
RMGI
94
Vitrebond/vitremer is
RMGI
95
Kalzinol/sedanol is
ZOE (used in primary as RCT as its resorbable)
96
obturation materials options
GP points with AH Plus sealer
Resilon (resin based) with different sealer
97
Mouthwash for children
225ppm for 7+
98
if 5mg/kg F ingested
give milk and observe
reached potentially lethal dose
99
if 5-15mg/kg F ingested
milk and go to hospital
100
if over 15mg F ingested
go to hosptial for cardiac monitoring and IV calcium gluconate
101
max safely tolerated dose F
1mg/kg
102
certainly toxic dose F
32-54mg/kg F
| (5-10g toothpaste in 75kg)
103
potentially lethal dose F
5mg/kg
104
factiors influencing caries risk
* Diet
* Plaque control
* Fermentable carbohydrate intake
* Fluoride use
* Medical history
* Social history – siblings’ caries/deprivation
* Clinical evidence – DMFT/ortho/dentures/no FS
* Saliva volume and quality
105
6month to 6 year old toothpaste (unless high risk)
1000ppmF
| (smear for \<2)
106
toothpaste for:
\>6 low risk
\>3 high risk
1450ppmF toothpaste
107
toothpaste for:
\>10 high risk
28000ppmF
108
toothpaste for:
\>16 high risk
5000ppmF
109
moisture control technqiues for paeds
dental dam
cotton wool rolls
Dry Guard (parotid sheath)
tongue retractor
aspirator
saliva ejecter
110
Caries risk assessment looks at
* MH
* OH (plaque control)
* clinical assessmeent
* diet
* fluoride
* FH - siblings caries
* SH
* saliva
111
Splinting times and possible construction
primary teeth
dento-alveolar fracture
reposition and splint 3-4 weeks
112
Splinting times and possible construction
permanent teeth
concussion
none
113
Splinting times and possible construction
permanenent teeth
subluxation
2 weeks flexible
114
Splinting times and possible construction
permanenent teeth
intrusive and extrusive luxation
reposition and 2 weeks flexible
115
Splinting times and possible construction
permanenent teeth
avulsion
replantation and 2 weeks flexible
116
Splinting times and possible construction
permanenent teeth
lateral luxation
reposition and 4 weeks flexible
117
Splinting times and possible construction
permanenent teeth
root fracture apical 2/3
replantation and 4 weeks flexible
118
Splinting times and possible construction
permanenent teeth
root fracture coronal 1/3
replantation and 4 months flexible
119
Splinting times and possible construction
permanenent teeth
dento-alveolar fracture
reposition and 4 weeks rigid
120
diet diary
3 days: Everything eaten & when.
Choose 1 weekend day and 2 week days.
121
radiographic report includes
1. Type of radiograph
2. Grade of x-ray (A - diagonitically acceptable or N - not)
3. What teeth you can see
4. What you can see on the teeth
* e.g: RCT, PCC
* Bone levels
* Caries
* Defective restorations
* PA pathology
122
radiographic film holders
red
bitewings
123
radiographic film holders
yellow
posteiror periapical for image of a complete tooth including the root
124
radiographic film holders
blue
anterior periapical for complete anterior tooth including the root
125
radiographic film holders
green
endo for ID working lengths
126
film size for bitewings
2 for permanent teeht
0 for deciduous
127
anterior PA and endo films size
0
128
posteiror PA and endo film size
2
129
fitting an ortho appliance
1. Right pt; Right appliance
2. Appliance matches prescripton
3. Sharp edges
4. Integrity of wire (CoCr)
5. Fits in mouth w/o blanching
6. Posterior retention
7. Anterior retention
8. Tighten finger springs – Activates active component *(Always receive active component in passive form)*
1mm tooth movement per month
9. demonstrate correct procedure for removing and insertion of appliance, get pt to show you
10. book review appointment 6 weeks
130
how to check retention
Flyovers then arrowheads
* High flyover – “gum stripper”
* Arrowheads – wire into gums at undercut
131
pt instruction when get ortho appliance
1. Will feel big & bulky – you will get used to it
2. May be mild discomfort – this indicates it is working
3. Will impinge on speech – practise reading out loud
4. You may drool a lot especially first 24 hours
5. Wear all the time – ESP mealtimes
6. Clean after every meal. Remove & store for contact & active sports
7. Non-compliance significantly increases treatment time
8. Avoid hard sticky foods & fizzy drinks
9. Be cautious with hot food & drinks
10. Emergency contact number
132
Correcting Overbite & Moving canines palatally
ARAB
A:
* 13 and 23 buccal canine retractors 0.5mm HSSW & 0.5mm tubing – strength & rigidity
R:
* Adams clasp 0.7mm HSSW 16 and 26
* Southend clasp 0.7 HSSW 11 and 21
A: …..
B:
* Self cure PMMA
* FABP
* 6.5mmm O/J so 9.5mm FABP
133
anterior cross bite
ARAB
A:
* Z-spring 0.5mm HSSW
R:
* 16 and 26 Adams clasp 0.7mm HSSW
* 14 and 24 Adams 0.7mm HSSW
A: ……
B:
* Self cure PMMA (Heat cure also available – monomer allergy)
* FPBP
134
posterior cross bite
ARAB
A:
* Midline palatal screw
R:
* 16 and 26 Adams clasp
* 14 and 24 Adams clasp HSSW
A: ….
B:
* Self cure PMMA
* FPBP – will keep teeth apart while movement is ongoing
135
distalising canine (make space/close space)
ARAB
A:
* 13 and 23 palatal finger spring + guard 0.5mm HSSW
R:
* 16 and 26 adams clasps 0.7mm H.S.S.W
* 11 and 21 Southend Clasp .7 H.S.S.W
A: …..
B:
* Self cure PMMA
If clasps being placed on primary teeth then its 0.6 H.S.S.W
136
lab card for primary impressions
Impressions in alginate or impression compound
Pour in 50:50 plaster/stone
Please construct upper and lower custom trays in light cured PMMA, non-perforated, with upper 2mm spacing and lower 1mm spacing (close fitting) , intra oral handles and finger stops
137
lab card for master impresions
Impressions in addition silicone or polyether
Please pour in 100% dental stone and construct wax rims for jaw registration
Return rims on casts.
138
lab card for jaw reg
Please mount casts in registration and set teeth for wax trial
Return wax trial dentures on mounted casts. Specific instructions: Diastemas
139
lab card for wax re-trial
Re-Trial:
remount casts and make specified changed for second trial.
140
lab cards for finishing after wax trial
please wax up for finish and process in heat cured acrylic resin
141
maxillary primary support for denture
hard palate
maxillary tuberosities
142
maxillary secondary support for denture
alveolar ridge
rugae area
buccal shelves
143
post dam location on maxillar
along vibrating line;
in front of palatine fovea and through the hamular notches
144
areas of relief on maxillary denture
incisive papilla and palatine torus
labial and buccal frena are muscle attachments and shouldn't be encroached on
145
mandibular denture primary support areas
buccal shelf
pear shaped pad
146
mandibular denture secondary support
buccal and lingual slopes of alveolar ridge
147
areas of relief for mandibular denture
lingual, buccal and labial frena (lingual is mylohyoid muscle)
148
area utilised for retention in mandibular denture
lingual pouch
149
boxed imp tray
(partially) dentate
150
non-boxed imp tray
edentulous
151
impression materials
alginate
impression compound
agar
extrude/Virtual
impregum
152
alginate is
irreversible hydrocolloid
153
agar is
reversible hydrocolloid
154
extrude/virtual is
PVS (addition silicone)
155
impregum is
polyehter
156
impression compound is
non-elastic
157
transfer lines for jaw reg
* **High smile line –** can get an idea of how much tooth will show when smiling
* **Centre line** – the midline of the teeth matches the midline of the patient’s face
* **Canine line** – dictates the size of tooth to be used.
* **Residual alveolar line** – so that the teeth are set in such a way above the lower residual ridges that the contacts are on this line
* **Alveolar contour line** – because if the teeth are set on a slope then the denture may be displaced during function
* **Rim profile** – to ensure adequate lip support
158
jaw registration data
OVD
Centre line
Canine line
High lip line
Occ plane
Arch-form width (width-lip support)
* Profile of upper rim trimmed by dentist is transferred onto the occlusal plane guide (clear Perspex sheet)
* provide the arch form for setting teeth.
* Centre of the lower ridge is transferred onto the occlusal plane guide
* Centre line is transferred onto the casts and the occlusal plane guide.
* Canine lines marked at the level distal to the incisive papilla on the cast.
* Contour of occlusal rim is marked to show the flat area of the ridge where teeth should be placed.
159
denture hygiene
instructions to pt
Instructions to patient
Insertion and removal
Advice re pain
Denture cleansing advice
160
denture cleansing advice
alkaline hypochlorites
e. g. Dentural and **Milton**
* Don’t leave cobalt chromium dentures for longer than 10 mins as they can corrode.
**Superior cleaning properties**
**Effective dissolution of plaque**
**Stain removal properties**
**Bacterial and fungicidal properties**
* Possible bleaching of acrylic resin
* Residual taste after use (rinse)
161
denture cleansing advice
effervescent peroxides
e.g. Steradent and Boots effervesant original
Powder of tablets
**Rapid in action and simple to use**
* Problems can arise if very hot water used with denture, it can cause bleaching
**Additional mechanical cleansing action**
Bubbles created by the release of Oxygen which may dislodge debris
162
first thing to do when receive any appliance
always check right prescription for right pt and right cast
163
things to put on prosth prescription
* stage
* time and clinic needed for
* disinfected
* special tray - spacer? perforated? handle?
* material to be used
* positions of rests and clasps need to match drawing
* rest seats need marked
* indicate path of insertion
check casts for
* overtrimmed
* broken
* stuck together
* drag
* air bubbles
164
fixed prosth troubleshotting
* state teeth to be used as pontics
* how much tissue to be recovered? large amount of resorption needed?
* type material to be used
* stating 'resin retained' not enough
* type of bridge
* cantilever
* fixed-fixed
* fixed-cantilever
* check prescription and cast - need right teeth present
* inc lower cast - occlusion
* shade for teeth and features? translucent edge for incisors?
165
ortho prescription troubleshotting
* check drawing and prescription match
* gauge of wire
* 0.7mm HSSW for retentive
* 0.5mm HSSW for active
* buccal canine retractors need I.D tubing
* FABP needs to be O/J + 3mm
166
crown prescriptions
primary impressions
please pour upper and lower primary impressions in 100% dental stone for study casts
167
crown prescriptions
mounting casts with facebow
please mount upper castss and transfer onto av. value articulator using facebow registration
articulate lower cast to upper in ICP and fabricate custom incisal table
168
mini sickle
red
* double-ended point scaler with two cutting edges on each blade
* Buccal and lingual embrasure surfaces supra-gingivally and in the pocket orifice
169
columbia currette
4R-4L
red
* A double-ended universal curette with 2 cutting edges on each blade
* Sub-ging scaling anywhere in the mouth. Limited access to deep pockets.
170
gracey currette 1-2
grey
* A double-ended curette, each blade having a single cutting edge
* Fine/deep sub-gingival scaling of upper and lower anterior teeth
171
gracey currette 7-8
green
* A double-ended curette, each blade having a single cutting edge
* Fine/deep sub-gingival scaling of buccal/lingual surfaces of posterior teeth
172
gracey currette 11-12
orange
* A double-ended curette, each blade having a single cutting edge
* Fine/deep sub-gingival scaling of mesial surfaces of posterior teeth
173
gracey currette 13-14
blue
* A double-ended curette, each blade having a single cutting edge
* Fine/deep sub-gingival scaling of the distal surfaces of posterior teeth
174
hoe scaler 134-135
yellow
* A double-ended instrument
* Gross supra- and sub-gingival scaling mainly on buccal and lingual surfaces.
175
hoe scaler 156-157
red
* A double-ended instrument
* Gross supra- and sub-gingival scaling mainly on mesial and distal surface
176
teeth 43-33 scaling labial and lingual
position
7 o clock
177
teeth 44-48 buccal
scaling position
9 o clock
178
teeth 34-38 lingual scaling position
9 o clock
179
teeth 14-18 buccal scaling position
9 o clock
180
teeth 44-48 lingual scaling position
11 o clock
181
teeth 34-38 buccal scaling position
11 o clock
182
teeth 13-23 labial and palatal scaling position
11 o clock
183
teeth 14-18 palatal scaling positon
11 o clock
184
teeth 24-28 buccal and palatal scaling position
11 o clock
185
social hand washing
plain/antimicrobial soap & water or alcohol based hand gel if hands not visibly soiled.
Used for removing transient organisms
186
hygienic hand wash
Liquid soap and water and then alcohol gel or antimicrobial soap or antiseptic hand cleanser
* removing transient micro-organisms and reducing resident micro-organisms
6 step soap and water followed by alcohol gel or just alcohol gel if visibly clean, before and after patient contact before seeing pt and donning PPE
187
surgical scrub
Longer and more thorough hand washing that includes lower arms
Hibi scrub often used
antiseptic hand cleansers
(liquid soap and water followed by ABHR)
188
decontamination
hand washer
Washing visible blood off i.e forceps etc
189
decontamination
disinfect
anything that has touched the pt
190
decontamination
sterilise
anything that has crossed mucous membrane
191
measuring capacity
4 things
* Does the patient have a broad understanding of the procedure, its benefits and risks?
* Do they have knowledge of any alternatives available?
* Are they able to retain this information for a reasonable time?
* Are they able to make a decision and communicate this choice? (Consider residual capacity)
192
remember about capacity
Capacity fluctuates and is specific to each action/decision.
Patients may have capacity for some things but not others. It is NOT all or nothing.
assess each time
193
Adult's with Incapacity Act 2000 (Scotland)
5 key
* benefit
* minimum intervention
* present and past wishes
* consultation with relevant others
* encourage residual capacity
194
MMSE
used for
mini-mental state exam
Diagose dementia & help assess prognosis & severity
* 27/30 is normal
What is the date? Time? PM? 3 things & repeat back
195
donning PPE
apron
mask
visor
ABHR
gloves
196
doffing PPE
gloves
ABHR
visor
mask
apron
197
AGP Donning
carried out in AGP room before pt arrives
* Single use disposable gown
* FFP3 mask - straps adjusted and nose adjusted to ensure seal
* Disposable hat -all hair tucked in
* Visor over
* Nitrile gloves
* Sterile gloves over the cuffs of gown
198
AGP doffing
when pt left the AGP room
* Sterile gloves dispose
* Nitril gloves - can be retained for cleaning if needs
* Sanitise hands
* Neck, waist pull gown off and roll in - dispose
* Hand gel
* Visor and hat removed
* FFP3 mask doffed outside of aerosol room - sanitise hands, remove mase by handling sides and straps and sanitise
199
please construct a URA to reduce OJ 22, 21, 11, 12 and reduce OB
*4s extracted and canines moved distal previously*
Active components
* 22,21,11,12 Robert’s retract 0.5mm HSSW + 0.5mm ID tubing
Retention
* Posterior retention
* 16+26 Adam’s clasps 0.7mm HSSW
Stops
* 13+ 23 mesial stops 0.7mm HSSW flattened (stops canines relapsing these are passive components)
Anchorage
* Good and bad moving 4 teeth but all have small roots and moving same direction
Base plate
* Self cure PMMA with flat anterior bite plane OJ+3mm
200
Aim: please construct a URA to retract buccally placed 13 and bring 23 in the line of arch and reduce OB
Active components
* 13 buccal canine retractor 0.5mm HSSW with 0.5mm ID tubing
* 23 palatal finger spring and guard 0.5mm HSSW
Retention
* Posterior retention
* 16+26 Adam’s clasps 0.7mm HSSW
* Anterior retention
* 11+21 southend clasp 0.7mm HSSW
Anchorage
* Good only moving 2 teeth
Base plate
* Self cure PMMA with flat anterior bite plane OJ+3mm
