Dental demolition Flashcards
Dental demolition is very common. Give some reasons why?
- Heavily restored teeth
- Prev failure of rest
- Small occluso-gingival height
- High occlusal loads
Why do you need to consider operator safety and how is this done?
- Porcelain fragments flying everywhere along with grotty restorations and debris
- Wear adequate eye protection (visor)
- For failed posts and sharp metal edges consider surgical glove wear and appropriate handling - pot sharps injury
What things in pt safety should you consider for demolition of teeth?
- Eye protection
- Airway protection via dental dam and superfloss
- Suction
What is the basic technique for demolishing indirect restorations?
- For cutting porcelain use Course diamond
- For metal cutting use Gold cutting bar
- Cut whole way up buccal surface using enamel chisel
- Operator and pt safety
- High vol suction for any porcelain fragments
What do you need to warn pt prior to demolishing indirect rest like bridge or crown?
- Do not know the state of the core underneath the crown due to radiographic washout
- We may demolish the bridge or crown and the tooth may be deemed unrestorable and need to come out
- Fully consent the pt for these risk
What two materials are good at removing gutta percha?
- Eucalyptus and Turpentine oil
- Use conventional files, GT files , GG burs to remove
When removing a post, what things do you need to consider?
- Possibiliyt of fracture
- Assess of remaining tooth
- Is it easy to remove (length, taper/surface)
- Need to contingency plan for fracture
- Any other pathology ass with tooth
very difficult and required Time , Perseverance - can use fine extraction forceps
What is a failing dentition?
A dentition where deteriorating teeth, restorations or oral health or a combination of issues means a loss of adequate basic oral functions such as mastication and acceptable aesthetics is inevitable if untreated.
A failing dentition is sometimes a terminal dentition
What prevention advice can we giev to avoid failing dentition?
- Basic Oral health messages
- Individualised oral hygiene instruction
- Individualised dietary advice
- Individualised fluoride regime
- Individualised habit advice & management/referral to other health & social care professionals advice/safeguarding issues
- Information provision & documentation in the records
- Assess response to preventive and oral health measures before embarking on advanced treatment
List the effective communication you need to do in managing failure
Effective listening
Honesty & transparency
Taking into account patient’s wishes
Addressing difficult issues – oral hygiene, habits, failing restorations, previous treatment, fixed solution > removable solution
Seeking advice
Giving patient’s a reality check
Documenting discussions
Being assertive & compassionate
Time & patience
Avoiding patient led treatment
Have a holistic approach to treatment
What is the Protocol for giving bad news acronym?
