Outcome 2 - Manipulate Amalgam & Bonding Agents used with it Flashcards

Question

Is Amalgam Resistant to Corrosion and Chemicals?

Answer 1

Surface and marginal corrosion is a factor with dental amalgam. However, there are polishing products and procedures which can lessen the deterioration and esthetic consideration of corrosion.

Answer 2

The expansion and contraction of dental amalgam is not ideal when compared to that of tooth tissues. The expansion and contraction factor of the metal amalgam is greater than the surrounding tooth structure when exposed to hot & cold environments. This can lead to stress on the surrounding tooth structure, and possible marginal leakage between restoration and tooth.

Answer 3

Because dental amalgam is metal, it is a thermal and electrical conductor. The oral environment can change as much as 30 degrees C within seconds if both hot and cold foods are being consumed. There may be thermal sensitivity within the tooth, as the metal conducts the temperature towards the pulp of the tooth.

Answer 4

A condition called ‘galvanism’ or galvanic shock may occur if the amalgam is touched by a dissimilar metal and there is transference of electrical charge.

Answer 5

Ethetically, dental amalgam is not ideal. The silver colour cannot be matched to tooth structure, which eliminates the use of this material in anterior restorative situations.

Answer 6

Dental amalgam is extremely easy to manipulate and will easily conform to any shape of cavity preparation. It is very pliable after trituration and remains easy to shape and carve for a reasonable amount of time.

Answer 7

Amalgam cannot adhere to tooth structure. With the advancement of dentin bonding agents, there can be a seal created between the amalgam and tooth structure, but a not a true adhesion or bonding situation.

Answer 8

Amalgam is tasteless and odorless and is not unpleasant once in the tooth preparation.

Answer 9

If the surface of the amalgam is smooth and polished, it is very easy to clean & maintain. However, if the amalgam restoration fractures or breaks down, it usually has to be fully replaced. It is difficult to add material to an exisiting restoration.

Answer 10

The cost of dental amalgam remains the most affordable of all restorative materials currently in use. The time efficiency of placement and finishing contributes to economic benefits to the patient.

Answer 11

Because mercury can have detrimental effects on human health and the environment, its consumption, use & disposal is regulated by Environmental Canada. Mercury can enter the body through inhalation of vapours, ingestion or absorption through the skin.

Answer 12

It becomes stable when mixed with the silver metal alloy, which reduces its detrimental effects. Extremely small amounts of mercury can be released in the moouth under biting pressure, but this is believed to be completely harmless to patients.

Answer 13

There have been a few cases of mercury allergies (less than 0.1% of patients), which must be considered when treatment planning.

Answer 14

The most significant concern regarding human health would be from the mercury vapour releaed during the handling of amalgam, which often impacts the dental healthcare worker more than the patient. Proper use of PPE and proper disposal will protect dental personnel from any toxic effects of the pure mercury.

Answer 15

Though the safety of dental amalgam as a restorative material continues to be controversial, both the ADA & CDA still support the use of it. Amalgam continues to be a safe, affordable and durable material for posterior retorations.

Answer 16

Amalgam capsules are supplied in single, double, or triple spill amounts, indicating how much mercury and subsequent alloy is present in each. The ratio is always 1:1, meaning that for each spill of mercury, there is an equal part of alloy by weight.

Answer 17

400 or 600 mg

Answer 18

800 mg If necessary, more than one capsule may be required for very large restorative procedures.

Answer 19

In plastic capsules that may or may not contain a pestle for mixing. Some amalgam capsules require activation to release the mercury into the alloy, others do not.

Answer 20

Varies by manufacturer, but ususally ranges from 5 to 20 seconds.

Answer 21

It will be dull, crumbly, and difficult to handle.

Answer 22

It will be excessively pliable and also difficult to handle.

Answer 23

Will apear cohesive, shiny, smooth and collected into a homogenous mass.

Answer 24

carefully opened, the amalgam dropped into an amalgam well and, if present, the pestel removed from the mass.

Answer 25

Part 4 of the Canadian Environmental Protection Act, 1999

Answer 26

All personnel involved in the handling of mercury and amalgam should be made aware of the toxic nature of these substances and should be instructed in safe handling practices.

Answer 27

- all mercury should be kept in tightly sealed containers -Container should be changed approx. every 6 months. If amalgam is not used often, change annually. These sponges contain an antibacterial agent and chemical to absorb mercury molecules. -Stored mecury and waste amalgam should be labeled, indicating the contents and hazardous nature.

Answer 28

- the dentist should use a rubber dam when removing and placing amalgam restorations. Waste amalgam accumulated on the rubber dam can be suctioned off by the DA - Empty amalgam capsules are placed in a Ziploc bag which is then placed into a container to be disposed of by a certified waste carrier -Scrap amalgam bits must be placed into a break-proof sealed container until ready for disposal by a certified waste carrier. - Op units must be equipped with disposable traps to catch waste amalgam from oral evacuation. These scrap amalgam are emptied into a sealed container and the traps are placed into Ziploc bags at the end of each amalgam procedure and then into a container for disposal by a certfied waste carrier. Use of gloves and mask when removing the suction traps for disposal - an amalgam separator must be installed in the compressor / suction unit to prevent amalgam from entering the sewer system

Answer 29

- do not dispose of scrap amalgam in the garbage -do not wash scrap amalgam down the drain -do not place scrap amalgam in the sharps container -do not give scrap amalgam to a scrap dealer who is not certified to transport hazardous wastes -do not rinse the traps and filters in the sink as amalgam particles will discharge into the sewer -do not throw disposable traps that contain amalgam particles into the garbage -do not place extracted teeth with amalgam fillings in the regular garbage. They should be disposed of in the "Scrap Amalgam" container to avoid incineration -Do not suction up unused particles of amalgam, instead place them in a break-proof sealed container

Answer 30

All amalgam trituration should be conducted in a ventilated area. This triturator should be equipped with a removable tray to catch any spilled mercury or amalgam. It should be cleaned each day to free all mercury and amalgam. During removal of amalgam restorations, dentists and D.A.s should wear a tight fitting oral-nasal mask capable of filtering out particulates. Gloves and protective eyewear must be worn. The use of a handpiece equipped with a cooling water spray prevents frictional heating of the amalgam and subsequent release of mercury vapor during removal of the restorations from the patient's mouth. All surfaces where mercury and amalgam are used should be free of cracks or corners where mercury can be trapped. Floors should be one piece with corners and abutting walls covered. Carpets should not be used in operatories because it is almost impossible to decontaminate them from a mercury spill. Further more, vacuuming of mercury from contaminated carpets can create a temporary severe inhalation hazard because the mercury, passing through the heated exhaust of the vacuum cleaner, is readily vaporized. Operatory chairs should be covered with a smooth vinyl upholstery material. Cloth coverings should be avoided. Excess amalgam should not be permitted to fall from the patient's clothing because it can contaminate operatory floors, dental chairs, and floors. Mercury contamination can be eliminated during handling of the metal if encapsulated pre-proportioned materials are used when the amalgam is being prepared. Manufacturer's recommendations with respect to maximum quantities of materials to be used in their triturators should be followed. Load your carrier from an amalgam well or a dappen dish

Answer 31

- clean up spills immediately using an approved mercury spill kit -never use bare hands to gather up spilled mercury -all materials used for picking up spills should be collected and stored for disposal

Answer 32

-If mercury or amalgam is accidentally touched with your hands, scrub them thoroughly using soap or detergent as soon as possible. -Smoking or eating should be prohibited in areas where mercury is used, and persons who have worked with mercury should not smoke or eat until they have washed. -Mercury may be absorbed from contaminated clothing. Lab coats, plastic aprons, or coveralls should be worn where clothing contamination is likely.

Answer 33

Soreness, inflammation or bleeding of the gums, loosening of teeth, metallic taste in the mouth Tremor or shaking of the hands, tongue, lips, head or extremities Change in personality; particularly if unusually irritable or excitable, if unusual difficulty is experienced in getting along with others, or if moods change frequently for no apparent reason Loss of appetite, weakness, digestive disorders, sore mouth, excessive salivation