Wolfson Flashcards
injury to 11
avulsion
suitable storage mediums for 11
in order
saliva
milk
physiological saline
water
radiograph to review 11
anterior periapical
8yo presents with mum, complains he frequently sucks his thumb
List the dental features of digit sucking
anterior open bite
proclined upper incisors
retroclined lower incisors
unilateral posterior cross bite
methods to break digit sucking habit
nailvarnish with bitter taste
URA with rake/crib
finger guards
positive reinforcement
35y.o. male, type 1, requires extraction of lower right 8
blood tests needed
HbA1c 48mmol/mol or below
extraction of lower 8
LA
IDB - inferior alveolar nerve and long buccal
flap design for 48 extraction
Distal relieving, crevicular incision partway across 7 and mesial relieving
35y.o. male, type 1, requires extraction of lower right 8
Pt begins sweating and begins to lose coconsciousness
2 likely reasons
hypoglycaemic attack
syncope/fainting due to stress or drop in BP
clinical signs of gingivitis
bleeding
redness/inflammed gums
hallitosis
clinical features of periodontitis
mobile teeth
gum recession
premature tooth loss
clincal attachment loss
pockets
bone loss
formation of black triangles
inflammation
Dx
necrotising ulcerative periodontitis
features of NUP
greyish/yellow slough
bleeding
bad smell and taste
inflammation
common risk factors for NUP
stress
bad OH
malnutrition
female
smoking
immunosuppressed
methods of assessing bridge failure
radiograph
pain/inflammation
stained/discoured
lisp
loose
cracked
reasons why a bridge may fail
inappropriate prep
occlusal trauma
poorly bonding
impinge supracrestal attachment
poor perio health
fractured abutment teeth
decay
types of luting cement
glass ionomer cement
ZOE
why not use RMGI for luting cement of post
needs light cured and post is too deep to achive an effective cure
what is this
foxs bite plane
used to check occlusal plane
what is this
willis gauge
measuring occlusal vertical dimension, freeway space and resting vertical dimension
what is this
high smile line
allow the lab to wax up the teeth in correct allignment as to not show too much gum
gte the pt to smile and mark it on
incisal plane
ask pt to relax and mark how much teeth
check by saying f
more in young then old
reduce block to this plane
what is this
centre line/midline
to position the central incisors and midline
from the philtron of the upper lip
get pt to look ahead at mirror with themselves and then stand behind to check
what is this
canine lines
measure how large the teeth should be and set canines
measure down from inner canthus of the eye
how can you make sure the anterior and posterior occlusal plane is level
ala tragal line (posterior) and interpupillarly line (anteiror)
use foxs occlusal plane
adv of self cure PMMA over light cure
faster (14mins Vs 4Hrs)
disadv self cure PMMA Vs light cure
more monomer left which could make it more irritable, porosity inc
liquid component of self cure PMMA
monomer
powder component of self cure PMMA
polymer
4 types of porosity
gaseous
granular
contraction
crazing
gaseous porosity
- Localised area, thicker parts, round and defined
- Air bubbles
- Vaporisation of monomer during processing - heat up too fast or high
granular porosity
- Thin sections, White and frosty appearance
- Incorrect polymer:monomer ratio, unreacted polymer
contraction porosity
- Throughout whole denture, whole shape
- Polymerisation shrinkage
- Insufficient pressure or inadequate packing
crazing porosity
- Mixing of monomer and polymer from different brands
- Results in cracks and weakened structure
luxator role
cutting PDL away from tooth
soft tissue retractoor
protect soft tissue, allow clearer operator field of view
elevators role
widen socket to aid placement of forceps and mobilise tooth
domestic abuse case
- Ask
- Non judgemental language
- ‘sometime when I see bruises like these it means the person is being hurt by someone – is this happening to you?’
- ‘ see you have some bruises – how did you get them?’
- Quite hard to get bruises there
- ‘is everything OK at home?’
- Validate
- Validate take the blame away from victim
- ‘you do not deserve to be hurt or hit no matter what happened’
- If someone is doing this to you, you do not deserve this
- ‘I am concerned about you safety’
- Provide some relief or comfort and help the victim to start to realise the seriousness of their situ
- Document
- Be specific and detailed
- Use the pt own words
- Name, location, witnesses that pt metioned
- Describe injuries in as much detail as possible
- Refer
- Pt to appropriate services
- Even if the pt doesn’t seem keen, you should still offer
- Do not attempy to deal with yourself
- Hi I am Niamh and I am a 3rd year dental student and I will be treating you today*
- How are you today?*
- How did you get in today?*
- Ask some social stations – work? Live alone? Kids?*
-
‘you do not deserve to be hurt or hit no matter what happened’
- If someone is doing this to you, you do not deserve this
- ‘I am concerned about you safety’
Heres a pen with Scottish Domestic Abuse helpline on it, when you feel ready you can contact them and they can give you more advice and help about this
angina but worse and lasting longer - could be
myocardial infarction
symptoms of MI
- Breathlessness
- Nausea/vomiting
- Tired/fatigue
- Dizziness/lightheaded
- Restlessness
- Pain/discofort pressure in chest/left arm/neck
- Jaw and back – radiating, crushing
- Sweating
- Anxiety
- Coughing/wheezing
possible medications that we can give if MI in chair
aspirin
oxygen
GTN spray
aspirin role for MI aid
- Reduce prostaglandin production
- Reduction in pain
- Reduction in platelet adhesion
- Reduction in clotting
- Thins blood
oxygen role in MI aid
- Helps pt if they’re having trouble breathing or feeling SOB
- Raises the oxygen content of the blood
GTN role in MI aid
- Reduces preload
- Dilates (coronary) arteries
- Easier for blood to pump around the body
- More oxygen and blood to heart
what is INR
international normalised ratio
used to check how long it takes for blood to clot
higher the INR the longer it will take for blood to clot - monitor the effects of warfarin
which two periods is it suitable to extract
INR 1.5 9/11/15-11/11/15
INR 3.5 2/12/15-4/12/15
need to be below 4 and within a 72hrs period
LA for pt with heart issue
Prilocaine 3% for any heart issues, has felypressin
(lignocaine plain if heart issue and pregnant as felypressin induces labour)
side effects of LA
- Allergic reaction (rash, tingling, breathing problems)
- Seizure
- Cardiac arrest
- Dizziness
- Headaches
- Nausea (vomiting)
- Blurred vision
- Twitching muscles
- Continuing numbness, weakness or pins and needles
- Lack of ability to recall actual tx
- Nerve damage
- Haematomas
- Quicker heart rate
where to inject for XLA 24
- Palate adj to upper left premolar on palatal side
- Disto buccal/distal to upper let premolar
how to check LA work
- Check by precussion of tooth (with handle)
- Probe to gingiva around tooth sulcus
- Q pt
lignocaine %
2% with 1:80,000 adrenaline
articaine %
4%
then plain or 1:100,000 or 200,000 or 400,000
prilocaine %
3% with felypressin (ocatpressin)
ortho activate appliance
uncoil - 1/4 turn away from midline
except roberts retractor which is coil
