Restorative Procedures 1 Flashcards
What is restorative dentistry?
When teeth are restored to their ideal structure.
What are the roles of a dental assistant?
- Be familiar with the procedure and anticipate the needs of the Dentist
- Prepare the set up for the procedure
- Provide moisture control
- Transfer instruments
- Provide proper mix of materials
- Perform and legal expanded functions
- Maintain patient comfort
- Maintain IPC
How to handle materials safely
MSDS sheets
be aware of adverse reactions
Examples of patient education
Explain the procedures to assist with calming and/ or educating the patient
Procedures for diagnosing decay
- Dental Explorer
- Radiographs
- Visual Appearance
- Indicator Dyes
- Caries Detection Devices
- Laser Caries Detector
Anxiety and Pain Control
The practice of various psychological, physical, and chemical
Examples:
1. Topical anesthesia
2. Local
3. Inhalation sedation
4. Antianxiety agents
5. Intravenous (IV) sedation
6. General anesthesia
7.
What is Anesthesia
types of topical/ local anesthetic
- gels
- wash
- spray
What are the different needle gauges
30 Gauge
this is used to anaesthetize
maxillary arch
#30 is thin and short
What are the 4 steps
Always use a new needle
Point the needle away fro you
Never touch the
what do you call the area in thee mouth that the topical/ local anesthetic is placed
Mucobuccal fold
How long does topical anesthetic last?
15 mins
How long does Local anesthetic last
2-4 hours
What is topical anesthesia
- Ointments
- Liquids
- Sprays
- Patches
This provides a temporary numbing effect on nerve endings
What is local anesthetic
- Local anesthesia temporarily blocks the normal
generation and conduction action of the nerve
impulses - Local anesthesia is obtained by injecting the
anesthetic agent near the nerve in the area
intended for dental treatment - Induction time is the length of time from the
injection of the anesthetic solution to complete
and effective conduction blockage
Chemical Composition of Local
Anesthetics
- Amides (local anesthetics)
- Esters (topical anesthetics)
Amide anesthetics are metabolized in the liver
Ester anesthetics are met
Time Span of Anesthetics
Induction – length of time between injection of the
anesthetic and complete conduction of blockage
Duration – length of time from induction until
reversal
Short acting – can last approximately 30 min
Intermediate acting – can last approximately 60 min
(most commonly used in general dentistry)
Long acting – can last approximately 90 min.
MDA 13th pg. 517
Complications and Precautions
Injecting into a blood vessel
- Can alter function of vital organs, mainly the heart. The
DDS will aspirate the syringe before injection
Infection
- Anesthetic agents may be delayed or prevented if injected into infection. Inflammatory infection LOWERS the PH, which interferes with anesthetic penetration. It can also possibly diffuse the infection
Toxic Reactions
- Localized reactions – contact dermatitis
- Systemic reactions – systemic toxicity can manifest in the central nervous system
Temporary Numbness
- Patient feels that their lip/tongue/cheek feels “fat”, may bite tissue inadvertently
Paresthesia
- Condition where numbness lasts after the local anesthetic has worn off. This can be caused by the following:
- Trauma to the nerve sheath during injection
- Bleeding into or around the nerve sheath
- Use of contaminated anesthetic solution
- Paresthesia can be temporary or permanent. Most cases are resolved in about 8 weeks.
Inhalation Sedation
- Nitrous oxide/oxygen (N2O/O2)
- Combination of gases inhaled to help eliminate fear and to aid relaxation
- Effects
- Non-addictive
- Onset is easy, side effects are minimal, and recovery is rapid
- Produces stage I anesthesia
- Dulls the perception of pain
Advantages of N2O/O2 Use
- Administration is simple and easily managed
- The services of an anesthetist or other special
personnel are not required - Excellent safety record
- Side effects are minimal
- The patient is awake
- Recovery is rapid
- Can be used with patients of all ages
Disadvantages of N2O/O2 Use
- Some patients may experience nausea or vertigo
- Patients who have behavioral problems may react in a negative way and act out those behavior issues
Nitrous Oxide Contraindications
- Pulmonary disorders
- Respiratory disorders
- Pregnancy
- Psychiatric
- Immune compromised
- Multiple Sclerosis
- Frequent marijuana or drug use
- Middle ear blockage
- Alcoholic or recoverin alcoholic
- Nasal Obstruction
- Emphysema
- Emotional Instability
remember 2-3
Nitrous Oxide Administration
- Ask patients to refrain from speaking or mouth breathing while nitrous is being administered
- There is no set dosage regimen as patients can react differently to treatment from one appointment to the next
- Assess the patient for dizziness, headache or lethargy once nitrous has been removed
How often should physiologic measurements be taken on IV sedation.
15 mins
What is general anesthesia?
A controlled state of unconsciousness with a loss of protective reflexes—including the ability to maintain an airway independently and to respond appropriately to physical stimulation or verbal command—that produces stage III general anesthesia
Documentation of Anesthesia
and Pain Control
Always document the following measures and
observations:
* Review of the patient’s medical history
* Preoperative and postoperative vital signs
* Vitals are also documented every 15 min in the patient chart during IV, general and oral sedation
* Patient’s tidal volume if inhalation sedation is being used
* Times at which anesthesia began and ended
* Peak concentration administered
* Postoperative time (in minutes) required for patient recovery
* Adverse events and patient complaints
Stage I
- Patient is relaxed and fully conscious. The patient
experiences a sense of euphoria and reduction in
pain. Vital signs are normal.
Stage II
- Excitement stage. Patient is less aware. Patient
may loose consciousness, vomit or become
unmanageable. Undesirable stage.
Stage III
- General anesthesia. The patient feels no pain or
sensation. Patient becomes unconscious. Can be
achieved only under the guidance of an
anesthesiologist in a controlled environment.
Stage IV
- Respiratory failure or cardiac arrest. If not quickly
reversed it can result in death.
Patient Preparation
Patient undergoes a preoperative physical exam and signed consent is completed.
Most appointments are scheduled in the early morning as the patient cannot eat or drink for 8 12 hours before the procedure
The patient must have someone to drive them home
Once the procedure is completed the patient is
monitored closely until normal reflexes return. The
patient should NOT be left alone while regaining
consciousness.
Black’s Classification
The standard classification system for notating carious lesions is the Black’s Classification System
We have six classifications
* Cavities are classified by surfaces involved
* Example: MO, MOD, MODBL
Class I Lesions
Occurs on pits and/or fissures, can also appear on the buccal or lingual
Easy small filling
Class II Lesions
Occurs on the posterior teeth only, involves the inter-proximal surface
two or more surface restoration
Class III Lesions
Anterior teeth only and involve a interproximal
surface only
Class IV Lesions
Interproximal surface and Incisal edge of anterior teeth only
Class V Lesions
Gingival third of lingual or buccal (facial) surface on any tooth
Class VI Lesions
Physical or chemical wear on the incisal or occlusal edge, on any tooth
Dental Caries
Can be called cavities or dental caries
Primary caries
- Occur on unrestored teeth
Recurrent or Secondary caries
- Occur around restorations: require
replacement
Rampant caries
- Widespread areas of caries occurring
simultaneously
Simple Carious Lesions
- involves only 1 tooth surface
Compound Carious Lesions
- involves 2 tooth surfaces
Complex Carious Lesions
- involves 3 or more tooth surfaces
