Basic Guide to Dental Procedures

Carole Hollins

• Publisher: Wiley-Blackwell
• Year: 2015
• Print ISBN: 9781118924556
• eBook ISBN: 9781118924570
• Edition: 2
• Topic: Medicine
• Subtopic: Dentistry

Basic Guide to Dental Procedures, Second Edition provides an essential introduction to the core preventative and restorative treatments routinely carried out in the modern dental practice. Written as a guide for the whole dental team, 'before and after' colour photographs enable the reader to understand and explain the procedures to their patient with confidence. Each section is clearly structured to cover the reasoning behind the treatment described, the relevant dental background, the basics of how each procedure is carried out and any necessary aftercare information.

Key features include:

• Colour photographs throughout combined with concise text to highlight the crucial points of each procedure
• Suitable for the whole dental team, from office support staff to the dentist explaining procedures to a patient
• Thoroughly updated and revised in line with the substantial changes to the role and professional obligations of the dental nurse, including a new chapter detailing extended duties
• The new images of tray set-ups means it is an ideal companion for trainee dental nurses studying for the NEBDN OSCE exam

Chapter 1
Preventive techniques

Reason for procedure

Preventive techniques are aimed at preventing the onset of dental caries in teeth, to maintain the dental health of a patient.

The two procedures discussed are:

• Application of fissure sealants
• Application of topical fluorides – full mouth or specific teeth

Background information of procedure – fissure sealants

Any surface area of a tooth that cannot be cleaned easily by the patient can allow food debris, and ultimately plaque, to accumulate there and allow caries to develop by acting as a stagnation area. Patients usually clean their teeth by tooth brushing, flossing, the use of other interdental cleaning aids, mouthwashing, or any combination of these techniques.

The usual sites that can act as stagnation areas are the occlusal pits and fissures of posterior teeth (Figure 1.1), and especially the first permanent molars which erupt at around 6 years of age.

Figure 1.1 Molar tooth model showing occlusal fissure system

These teeth are particularly prone to caries because:

• They are the least accesible teeth for cleaning, being at the back of the young patient's mouth
• They erupt at an age when a good oral hygiene regime is unlikely to have been developed, so may be cleaned poorly by the patient
• Younger patients often have a diet containing more sugars than an adult, as the concept of dietary control will not be appreciated

Details of procedure – fissure sealants

The occlusal pit or fissure needs to be eliminated to prevent it acting as a stagnation area, and this is achieved by closing the inaccesible depth with a sealant material.

The materials used are either unfilled resins, composites, or glass ionomer cements, or a combination of these two materials (known as a compomer).

The usual instruments and materials that may be laid out for a fissure sealant procedure are shown in Figure 1.2.

Figure 1.2 Fissure sealant instruments and materials

Technique:

• The tooth is kept isolated from saliva contamination, as materials will not adhere to the tooth when it is wet
• Isolation techniques include the use of cotton wool rolls and low speed suction techniques using a saliva ejector (Figure 1.3)
• The occlusal fissures and pits are chemically roughened with acid etch to allow the microscopic bonding of the sealant material to the enamel
• The etch is washed off and the tooth is dried; the etched surface will appear chalky white
• Unfilled resin is run into the etched areas to seal the fissures or pits, and then locked into the enamel structure by setting with a curing lamp
• If any demineralisation of the fissure is present, one of the alternative materials listed above is used to replace the enamel surface

Figure 1.3 Tooth isolation techniques

Background information of procedure – topical fluoride

Other very difficult to clean areas of the teeth are the points where they have contact with each other in the dental arch – the interproximal (interdental) areas.

There are certain oral health products available specifically for cleaning these areas, such as dental floss and interdental brushes, but they require a certain amount of dexterity and determination by the patient to be used effectively.

All fluoridated toothpastes provide some protection of these areas from caries, but some patients require additional full mouth fluoride protection by the professional application of a topical fluoride varnish or gel.

They are:

• Children and vulnerable adults with high caries rates
• Physically disabled patients who are unable to achieve a ...

Table of contents

• Cover
• Title Page
• Copyright
• Table of Contents
• How to use this book
• Chapter 1: Preventive techniques
• Chapter 2: Oral hygiene instruction
• Chapter 3: Scaling and polishing
• Chapter 4: Diagnostic techniques
• Chapter 5: Tooth restoration with fillings
• Chapter 6: Tooth restoration with crowns, bridges, veneers or inlays
• Chapter 7: Tooth restoration with endodontic techniques
• Chapter 8: Tooth extraction
• Chapter 9: Tooth replacement with dentures
• Chapter 10: Tooth replacement with implants
• Chapter 11: Tooth alignment with orthodontic appliances
• Chapter 12: Tooth whitening
• Chapter 13: Extended duties of the dental nurse
• Assessment sheet
• Glossary of terms
• Index
• End User License Agreement