tips and tricks

-Notches on upper wax rims should not be parallel. This is so that the bite record can't slide left or right -Wax is a better bite recorder than PVS as you can control it easier and you can't see anything with PVS bite reg. -In the tooth try in stage for a remount or in a processed denture for a lab reline Dr. Smith applies wax to the upper plate. He softens a sheet of wax ~ 1.5x the AP length of the denture and places it in line with the posterior part of the denture. He then folds the wax over at the front and adapts the wax to the palate. A heated wax knife is used against the teeth to remove the labial wax at the buccal cusp tips and incisal edges. a flame is used to soften the wax over the occlusal surfaces and is placed in the patient's mouth to bite onto. -Wax rims should be adjusted to meet when the patient bites together. If there is contact prematurely then it is preferred to have this at the front. The small gap at the posterior will then be closed with wax in

Perhaps the most important factor related to the survivability of an endodontically treated tooth is the amount of coronal and radicular tooth structure that remains prior to restoration. This factor appears to be of paramount importance and will be considered in detail later in this chapter. The tooth structure that will be available following tooth preparation should be visualized and should be assessed for the provision of adequate retention and resistance form for the subsequent crown. Key to this factor is the presence of an adequate ferrule. The term  ferrule  describes the band of circumferential material that encircles the cervical area of a tooth restored with a crown. 18  As commonly used in dentistry,  ferrule  also refers to the dimension of remaining vertical tooth structure from the anticipated margin of the preparation to its coronal extent, which is available for encirclement by the crown. The "ferrule effect" serves to reinforce the remaining to

When using a rubber dam whilst preparing an interproximal cavity, apply some interdental wedges before the box prep to retract and protect the rubber dam as well as to separate the teeth to allow easier breakage of the contact. When using floss to take the interseptal dam under the contact, the dam should have the leading edge at the occlusal aspect of the contact point. i.e the septa of the dam should not be unched up and a single thcikness of the dam should pass through the contact at any point. If one floss through is enough to bring the whole dam down, lift the lingual end of the floss over the contact point and to the facial so that when you are pulling the floss out at the facial there is no contact with the papilla that may cause trauma. If multiple flosses are needed, bring the lingual end of the floss to the facial and refloss through the contact without removing the first strand of floss. The dam should be inverted around the necks of the teeth, at least in the area of th

Enamel is as hard as steel (But even steel products can wear). Cavity outline forms should be designed so that the margins avoid regions of heavy occlusal force. A deep fissure is formed by incomplete fusion of lobes of cuspal enamel in the developing tooth. The resulting narrow clefts provide a protected niche for acidogenic bacteria and the nutrients they require .  It is estimated that caries lesions are five times more likely to occur in occlusal fissures and two and a half times more likely to occur in buccal and lingual fissures than in proximal smooth surfaces. Although craze lines in the surface enamel are of little consequence, pronounced cracks that extend from developmental grooves across marginal ridges to axial surfaces, or from the margins of large restorations, may portend coronal or cuspal fracture. A crack defect is especially critical when the crack, viewed within a cavity preparation, extends through dentin or when the patient has pain while chewing . A cracked 

Do things properly the first time e.g Rubber dam. If you are going to use it and things go wrong such as the ligature is insufficient and doesn't hold the dam down properly. Don't think that's okay and keep going. Take the time to get it right before you keep going because it'll save you time in the long run.

-Polyether is hydrophyllic compared to PVS which is hydrophobic (Yes i knew that but...) this makes it easier to take an impression as Poly ether won't be displaced by saliva and also easier to pour up as it is less likely to form a void in stone. -We SHOULD be pouring up our own models -Bright teflon tape can be useful to fill screw holes instead of cotton wool - "breathe through your nose and tip your head forwards. If there is turbulence, an oxygen mask will drop fro, the ceiling" -concept of suction lower dentures (Special impression technique and secondaries and jaw reg in one appt. Aim to produce a BTC point where the cheek and tongue come over the denture to form a seal - Dr. Smith mixed an alginate and placed it in the lingual area of his lower poly ether impression to make pouring up easier. -Soaking the impression-model in hot water for 30 seconds can soften the compound and tray and make removal of the impression easier from the freshly poured up model -

Some pediatric tips from Dr. Bourke: 1. Be thoughful of the parents. They may be single mothers or fathers or same sex partners. 2. Caries can progress very fast in children. Early prevention is important as children can return in 6 months with rampant decay. 3. Parent;'s oral habits are important for the health of the child. Attitudes to dental health are passed down through the modelling of the parents. Bacterial colonisation occurs with tasting, kissing, cuddling by the parents. While the mother is pregnant, it is important to get her oral hygiene under control (Gingivitis and caries). It is important for the mother to keep a healthy diet to encourage proper tooth development of the child. They should be having the proper intake of vitamins, minerals, proteins etc to encourage the child's development. 4. It is important for the child to eat well as well. Restricting sweets can avoid the child getting a taste for sugary snacks. 5. Water is the best liquid for the child.

Lower molars with two mesial canals and/or 2 distal canals may overly each other in the working length PA. It is useful to have a protocol e.g Distal canal and Buccal canal PA then Lingual canal PA. The 2nd PA can recapture the distal canal if it is incorrect. Upper molars often have 2 MB canals (MB1/MBB, MB2/MBL). These may be overlaid by the palatal root. Therefore, a first PA with MB1 and MB2 and D with a 2nd PA to capture the Palatal canal may be useful.

An OPG can provide useful information when extracting multiple teeth with the benefit of lower radiation exposure than multiple PAs. However, A paralleling technique PA will provide the maximum level of quality of the root structure. This can be essential in treatment planning the extraction of roots with fine anatomy such as bulbous roots, curved root tips etc which may not be visible on an OPG. When using an OPG to gauge the difficulty of extractions take your time and look carefully under magnification. Look for proximity to adjacent teeth, Root shape and thickness, Size of restorations, proximity to vital structures.

Once clear vision and a stable fulcrum have been established, penetrate the mucosa to a depth of 1-2 mm (approximately the length of the bevel) with the bevel oriented  toward bone . A few drops of solution are usually deposited as needles are advanced because even gentle contact with the thumb on the front inner surface of the thumb ring will cause a few drops of anesthetic to be deposited ahead of the needle. Note that this does not require visibly advancing the stopper and no separate action is required other than to proceed slowly. The total volume administered in this manner should be less than 0.2 mL (the volume displaced by 1 stopper length). --- Despite performing this step (aspiration) correctly, it is still possible to have false negative aspirations  at times. This can occur when a bevel is in contact with a vessel wall. During an aspiration test, negative pressure can retract the vessel wall into the lumen of the needle blocking the flow of blood through the needle into

 Modifications to Local Anesthesia for Common Medical Conditions Condition Local Anesthetic Considerations Vasoconstrictor Considerations Modifications Diabetes None of Significance Epinephrine opposes the action of insulin Minute amounts used in dentistry do not raise blood levels significantly Use epinephrine with caution  when there is significant cardiovascular disease and/or uncontrolled diabetes. Glaucoma None of Significance Vasoconstrictors cause increased ocular pressure Avoid  vasoconstrictors Hypertension None of Significance Vasoconstrictors can increase the risk of hypertensive episodes however the  lack  of profound anesthesia can increase levels  of endogenous epinephrine Controversial topic Clinical  judgment  and medical  consult  advised Note : Uncontrolled hypertensives either should not be treated or treated with  caution , depending upon severity See  Table 10-1  ASA Physical Status Classification  Blood Pressure Guidelines f

I can't resist tips that use letters like this... An easy method to identify the classification of dental local anesthetic drugs is to observe that the word  amide,  as well as all names for these drugs, contain a letter "i" in the first and second syllable of the name. In contrast the word  ester  has no letter "i," nor does the first syllable for any of the ester drugs. Esters and amides do share the common ending "-caine." AM I  DES ESTERS L  i  do-caine Co-caine Bup  i  va-caine Pro-caine Mep  i  va-caine Benzo-caine Pr  i  lo-caine Tetra-caine Art  i  caine * Chloropro-caine Metabolism: primarily in the liver Metabolism: by cholinesterase *Articaine is primarily metabolized by cholinesterase. Also included was a neat explanation on the pharmacology of Local anaesthetics. Assume LA are weak bases in their neutral form (RN) which becomes charged with Hydrogen ions by the HCL acidified in the solutio