Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

DENTAL NURSING revision dec 7th exam > DN10 - provide chairside support during non-surgical endodontic treatment > Flashcards

DN10 - provide chairside support during non-surgical endodontic treatment Flashcards

You may prefer our related Brainscape-certified flashcards:
Nursing Pharmacology flashcards NCLEX-RN® flashcards Nursing Mental Health flashcards Nursing Fundamentals flashcards Nursing Safety & Infection flashcards Nursing Adult Health flashcards NCLEX-PN® flashcards Nursing Management of Care flashcards Nursing Pediatrics flashcards Nursing Maternity flashcards
1
Q

BEFORE THE PROCEDURE

A
  • correct identification of the patient
  • correct identification of the procedure
  • knowledge of the records and images required by the operator for the procedure
  • knowledge of the correct setting up of the area for the procedure
  • knowledge of the instruments, materials and equipment that may be required for the procedure
  • knowledge of the actions to take if the dental nurse is unable to fully prepare for the procedure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

THE RECORDS TO BE SET OUT:

A
  • notes written at the previous appointment or when the decision was made to carry out the particular procedure
  • medical history form, to be checked to highlight any potential concerns - for example, is a certain local anaestetic required, or does the patient have an allergy to latex
  • consent form, indicating that the patient has given valid consent to the procedure
  • radiographs of the relevant tooth - these will allow the operator to plan the procedure and the technique used and to show any potential difficulties such as curved roots or lateral canals on the tooth involved
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

PULPECTOMY

A

conventional root canal therapy, involving the removal of all the pulp from the tooth and its replacement with a root-filling material

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

PULPOTOMY

A

removal of the coronal pulp only, leaving the radicular pulp intact

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

PULP CAPPING

A

sealing of a small coronal pulp exposure, with no removal of pulp contents

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

INSTRUMENTS FOR PULPECTOMY:

A
  • broach
  • gates glidden drill
  • reamer
  • file
  • irrigation syringe
  • metal ruler
  • apex locater
  • spiral paste filler
  • lateral condenser, or finger spreader
  • irrigation solution
  • antiseptic paste
  • paper points
  • cresophene
  • lubricating gel
  • gutta-percha points (GP points)
  • sealing cement
  • restorative materials
    RUBBER DAM:
  • rubber dam sheet
  • rubber dam punch
  • clamps
  • clamp forceps
  • rubber dam frame
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

INSTRUMENTS FOR PULPOTOMY:

A

same as pulpectomy, the only additional material required for the technique is a calcium hydroxide lining material which is placed over the radical pulp and allowed to set before covered with a base material and then a permanent restorative material

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

INSTRUMENTS FOR PULP CAPPING:

A

same as pulpectomy, the only additional materials are calcium hydroxide liner and a device to act as the “cap” over the exposure site. many operator use items such as a section of a glass ionomer class v matrix for this purpose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

BROACH

A
  • PLAIN BROACH to help locate the entrance of the root canal

- BARBED BROACH to remove (extirpate) the pulpal contents from the canal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

GLATES GLIDDEN DRILL

A

alternative to a plain broach to locate and access the root canal entrance. some operators also use them to enlarge the root canal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

FILE

A

HAND OR ROTARY - to enlarge the canal in its actual shape laterally, smooth the root canal walls, and remove any residual debris from them

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

IRRIGATION SYRINGE

A

blunt-ended with a side bevel, to irrigate and wash out debris from the root canal without injecting the syringe contents through the root apex. soloution used include chlorhexidine, sodium hypochlorite and local anaesthetic solution

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

METAL RULER

A

used with a file in palce, to work out the full length of each root canal by comparing to a periapical radiograph view of the tooth to the established working length

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

REAMER

A

HAND OR ROTARY, to enlarge the root canals in a circular shape laterally, down to the root apex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

APEX LOCATER

A

to determine the working length electronically

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

SPIRAL PASTE FILLER

A

used with the slow dental handpiece to spin sealant material into the root canal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

LATERAL CONDENSER OR FINGER SPREADER

A

used to condense the root-filling points laterally into each root canal, so there is no space remaining for microorganism to return. not required if root-filling material used is inserted while hot and flowable

18
Q

RUBBER DAM SHEET

A

a sheet of latex (green) or non-latex (purple or blue) rubber-like material that is used to seperate the tooth from the rest of the oral cavity.

19
Q

RUBBER DAM PUNCH

A

the instrument ised to punch a hole through the rubber dam so that the tooth undergoing the procedure is visible to the operator.

20
Q

CLAMPS

A

various shaped metal gripping devices which are palced around the tooth to hold the rubber dam tightly in place, so that the tooth is kept isolated form the rest of the mouth

21
Q

CLAMP FORCEPS

A

this instrument is used to gold the clamp securely while it is placed over the tooth with the dam material beneath it

22
Q

RUBBER DAM FRAME

A

a plastic or metal U-shaped frame which holds the dam material taut across the oral cavity, so that the tooth remains isolated an any irrigation fluids can be collected more easliy

23
Q

IRRIGATION SOLUTION

A

used during root canal preparation to lubricate the instruments and wash out any debris

24
Q

ANTISEPTIC PASTE

A

non-setting and containing antiseptic anti inflammatories, this paste is used to dress infected root canals for a time before root filling - an example is ledermix paste

25
Q

PAPER POINTS

A

tapered paper points of various diameters that are used to absorb unwanted moisture from withing the root canal and to apply medicaments into the canal

26
Q

CRESOPHENE

A

medical grade creosote used to dress infected root canals for a time, soaked onto paper points before insertion

27
Q

LUBRICATING GEL

A

for use with engine files and reamers to ensure the instruments do not snag on the canal walls and snap during use - an example is glyde

28
Q

GUTTA-PERCHA POINTS (GP POINTS)

A

tapered rubber points of various diameters that are used to fill the root canal system and that follow the same colour-coded width system as files and reamers

29
Q

SEALING CEMENT

A

setting cement used to aid the insertion of the GP points and to seal off any residual spaces in the root canal, some contain antisepticd and anti-inflammatories

30
Q

RESTORATIVE MATERIALS

A

used to restore the tooth to full function and appearance after root filling

31
Q

THE FINAL PREPARATION THAT THE DENTAL NURSE MUST CARRY OUT BEFORE STARTING PROCEDURE AND POINTS TO BE CLARIFIED?

A
  • have all routine medications been taken as requested, including any prescribed antibiotics?
  • if the procedure is being carried out under any form of concious sedation technique, has the patient complied with all of the relevent additional points as requested?
  • if the patient is a child or a vulnerabe adult, are they in attedance with a suitable adult escort, to look after and see them safetly home after the procedure?
  • if the patient is frail or excessively nervous, are they in attendance with a suitable adult escort for the same purpose
  • has the patient (or guardian) read and understood any pre-treatment information provided - are there any further questions?
  • has the patient (or guardian)been given enough information to provide valid consent for the procedure, and has that consent been given?
    when it becomes apparent that one or more of these points have not been followed, the dental nurse must report the matter to the operator immediately, and allow them to discuss the situation further witht he patient - the responsibility lies with the operator.
32
Q

DURING THE PROCEDURE

A
  • preparation of the patient
  • assistance during the administration of local anaesthesia, where necessary
  • assistance during the placement of rubber dam, where necessary
  • identification and correct handling of the instruments, material and equipment throughout the procedure
  • adequate provision of moisture control and tissue retraction throughout the procedure, where necessary
  • monitoring and support of the patient
33
Q

PREPARATION OF THE PATIENT:

A
  • help them to remove their coat if necessary and hang it up
  • assist them into the dental chair - they may need physical support, for example, or the chair raising or lowering
  • apply their rquired PPE:
    • safety glasses - these need to be tinted if the curing light is to be used to set materials
    • protective bib
    • some patients like to have a tissue in hand too#
  • monitor the patient for signs of anxiety, and notify the operator as necessary
  • reassure the patient in a calm and friendly manner - many appreciate the opportunity of a hand to hold at this point, although this action can be passed to an escort/guardian if appropriate
34
Q

ASSISTANCE DURING THE ADMINISTRATION OF LOCAL ANAESTHETIA:

A
  • noisy clattering of metallic items can be particularly unnerving for patients, so items must be handled proficiently at all times
  • the local anaesthetic cartridge is loaded into the syringe correctly, with the cap end at the bottom where the needle will be applied
  • if an aspirating technique is to be used, any screw-in plunger is locked into the cartridge bung before the needle is added
  • the needle is screwed on to the threaded end of the syringe, with the guard in place
  • on removal of the topical anaesthetic, the needle guard is loosened but left over the needle and the loaded syringe is offered to the operator
  • as the operator recieves the syringe, the dental nurse keeps hold of the loosened needle guard so that it becomes unsheathed as it is transferred over
  • the guard is then placed in the re-sheathing device, ready for the operator when the anaesthetic procedure is completed
  • successive cartridges are handed to the operator as required during the administration procedure
  • when the administration is complete, the equipment is re-sheathed by the operator without being handled by the dental nurse
35
Q

IDENTIFICATION AND CORRECT HANDLING OF THE INSTRUMENT DURING PULPECTOMY PROCEDURE:

A
  • the tooth is ISOLATED from the rest of the mouth, usually by the application of rubber dam, but good aspiration and the use of cotton wool rolls will also suffice in some cases
  • ACCESS is gained to the pulp chamber, either through the occlusal surface of a posterior tooth or the palatal/lingual surface on an anterior tooth, using the air turbine hanpiece and appropriate diamond burs
  • the root canal entrance is opened, using the slow handpiece and stainless steel burs or a gates glidden drill, and the pulp tissue is located using a plain broach or the drill
  • pulp tissue is EXTIRPATED using a barbed broach
  • the root canal is debrided and widened using files and/or reamers, and PREPARED to recieve the root filling
  • copious IRRIGATION AND LUBRICATION are used to avoid the possibility of fine instruments becoming jammed and then snapping within the canal
  • the canal is dried thoroughly using paper points
  • an apex locator or a diagnostic radiograph is used to determine the correct MEASUREMENT of the root canal length to be filled
  • once this is known and the canal has been suitably widened, it is fully OBTURATED using GP points and a suitable sealant material
  • the sealent material can be spun into the canal using a spiral paste filler, or the points can be coated first and then inserted into the canal
  • occasionally, silver points are used instead of GP, but these can only be used successfully in straight canals as they will not follow root curvature
  • the access cavity is sealed with a conventional filling material so that the tooth is RESTORED to its normal function
36
Q

IDENTIFICATION AND CORRECT HANDLING OF THE INSTRUMENT DURING PULPOTOMY AND PULP CAPPING PROCEDURES:

A
  • good moisture control to avoid contamination of the exposure site with saliva, especially if the operator is working without rubber dam
  • provision and passing of sterile cotton wool balls (pledgets) which are apllied to the root canal stump or the exposure site to control bleeding
  • some operators use these soaked in local anaesthetic soloution to take advantage of the vasoconstrictor in achieving haemostasis
  • mixing of calcium hydroxide paste to seal the pulp stump, and use of the curing light to set the material where necessary
  • assistance with placing the “cap” device iover the exposure site, during pulp capping
  • mixing of base material and assistance in its application
  • assistance during the restoration of the tooth
37
Q

ADEQUATE PROVISION OF MOISTURE CONTROL AND TISSUE RETRACTION

A

MOISTURE CONTROL - removal of moisture (saliva, blood, irrigation solution) from the operative area so that adequate vision is possible by the operator and so that the patient is not choking on a mouthful of fluid, using:
- wide-bore aspirator for fast fluid removal, as well as some soft tissue retraction
- saliva ejector beneath the rubber dam, which may need repositioning from time to time
- use of cotton wool rolls and pledgets for precise moisture control around and within the tooth
IRRIGATION - from the air turbine handpiece during the pulp access procedure, to avoid heat damage to the tooth, as well as irrigation of the root canal during instrumentation
TISSUE RETRACTION - to avoid damage to the soft tissues from burs and drills, and to provide good vision for the operator using:
- flanged wide-bore aspirator tips to retract the cheek, lips or tounge
- special cheek retractors, although these tend to be reserved for extractions or minor oral surgery procedures
- mouth mirror to retract the tounge or lips and to reflect light and thus illuminate the operative field
- if rubber dam is in place, the need for tissue retraction is greatly reduced

38
Q

MONITORING AND SUPPORT OF THE PATIENT:

A

the dental nurse must remain calm, friendly and helpful throughout , by taking the following general actions:

  • providing support during mouth rinsing
  • holding a patients hand if requested to do so
  • alerting the operator immediately if they suspect a patient can actually feel pain
  • constantly reasurring patients in a calm and even tone, and repeatedly encouraging them
  • avoiding the use of fearful phrases
  • once the procedure is over, congratulating the patient and reassuring them again
  • wiping and blood and debris from a patients face before discharge
  • removing their PPE when it is safe to do so
  • assisting them from the surgery area when the operator indicates that they can leave
39
Q

AFTER THE PROCEDURE:

A
  • check that they have been sufficiently cleaned of blood and debris
  • check they feel well enough to go home
  • give the relevant postoperative instructions if requested to do so, in relation to allowing the local anaesthetic to wear off and avoiding the use of the tooth as necessary
  • check whether the operator requires a further appointment to be made, and organise the making of the appointment - this may involve notifying reception to make the appointment or actually making it while the patient is still present
    immediately after the procedure has been completed, all dirty PPE should be removed and placed in the hazardous waste sack.
    the abilities required by a competent dental nurse to provide support after the procedure include the following:
  • hand over the patient to reception for discharge
  • complete the patients records
  • decontaminate the surgery and instruments
40
Q

DECONTAMINATE THE SURGERY AND INSTRUMENTS

A
  • all sharps are carefully disposed of in the sharps box - this includes local anaesthetic needles and all endodontic hand instruments that may have come into contact with pulp tissue
  • all autoclavable items are placed in a washer-disinfector unit or an ultrasonic bath and are decontaminated thoroughly before being placed in the autoclave for sterilisation
  • all contaminated waste is placed in hazardous waste sacks or sharps bins
  • all surfaces are disinfected using the correct solotion

DENTAL NURSING revision dec 7th exam (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions