tips and tricks

NB: This is definitely not my idea We make putty stents for the palatal buildup of wear and trauma cases so why not do this for caries cases as well? Patients who present with large carious lesions that have the palatal shell intact or very near anatomical contour can have a putty stent made intraorally. If there are any defects or missing bits of tooth structure these can be mocked up in composite or even sealed with flowable or wax and an intraoral putty impression can be taken and trimmed. After the prep you have a putty stent that replicates the ideal palatal anatomy without a waxup! The same goes for wear cases etc. If the mockup is done intraorally with composite then the patient can appreciate the shade, shape and occlusion to approve before final adhesion. Once you have gotten everything perfect, you can take a putty stent of this mockup. This saves on lab time and costs but the human jaw is the most accurate articulator you can find and it may save of time with occlusal adju...

I'll start by putting forward a question to you: "Would you rather be missing your little toe or your front tooth?" Dental health is more important to your patients than we or they realise. Not just from a biological point of view but also a psychosocial, mental health and general health point of view. Loss of teeth ultimately leads to poorer function, aesthetics and declining self image. In this world of consumerism we find aesthetics becoming more of a priority and something that is traded upon like any commodity ranging from vouchers for veneers to bargain discounts on implants. I don't blame patients for being confused and sucked in by some of these gimmicks. I also do see where they are coming from when they neglect their oral health. However, it did initially confuse to me as a health professional and someone who has never had a significant oral or general health issue. Patients always seem to have the same excuses... -I've always had bad teeth -It...

In a working environment that puts high importance on personal protection equipment, we often forget about the protection that our ears need. High speed suction and handpieces can produce sounds over 85dB and up to 100dB which is within the range to produce damage to the delicate auditory sensory organs. This damage is preventable but irreversible. Therefore it is prudent that we tackle this problem early on in one's career very similar to poor posture. I use earplugs from the brand Earasers but you can see an audiologist to make custom in ear plugs that will dampen but not completely remove the noise of the dental operatory. I find that with these ear plugs my ears don't ring at the end of the day as they would without them however without regular hearing tests I would not know if this is making a noticeable difference. Signs of damaged hearing include tinnitus, sound distortion, difficulty interpreting complex sounds especially higher tones and the enunciation of S, Z and...

Don't ever forget that Root surface caries is a bitch to treat . The individual chemical makeup of dentine makes it uniquely predisposed to catastrophic caries. -The more apically you look, they thinner the dentine is before it reaches the pulp. It also means that any loss of tooth structure due to prep will result in a larger percentage loss of cross sectional area. Therefore the same amount of tooth structure lost on the root will result in a higher risk of catastrophic fracture -This is a site patients often neglect to clean. the reason the recession appeared in the first place was likely influenced by poor oral hygiene, once the dentine is exposed the bacteria can get to work dislodging the mineral in the exposed root surfaces. root concavities suck as between molar and premolar roots are exquisitely hard for patients to clean without the proper instruction -Dentine has a critical pH of 6.5 as opposed to 5.5 for enamel so any caries on dentine will be faster progressing a...

This is a message for those dental students entering the big wide world. Take it easy. There is no rush to be the biggest and the best. On a daily basis we are exposed to flash and fancy dentistry but you have to realise that this isn't what most people do day in and day out. Menial tasks such as checks and cleans and simple restorative are the bulk of most if not all general dental practices. Get good at the simple stuff first . Focus on your bread and butter dentistry in getting efficient, high quality dentistry going and focus on the fancy stuff later. What is more important and impressive than doing high quality fine tuned prosthodontic work is to give painless injections, managing patient expectations and providing a comfortable and stress free appointment. In the end, no matter how fancy your work is, the patient has to like you to return and give you repeat business. It is all well and good to have high aspirations, but don't rush into things at 100km/h. And never think ...

Thee places that patients have the most difficulty with handling intraoral films are any lower films due to lack of space and proximity to the sensitive tissue of the floor of mouth and upper posteriors due to gagging. I believe I've already made a post about managing gagging with impressions and intraoral films so this will focus of xrays of the lower teeth. The most common film including the lower teeth is the bitewing. This is an excellent tool to screen for interproximal caries, subgingival calculus and bone loss. Compared to a lower PA radiograph it is fairly well tolerated. Situations where it is not tolerated are gaggers, obese (who have significant increase in tongue size), and nervous patients who have increased muscle tone during procedures and are less likely to follow your instructions. There are 2 options of films each with their own pros and cons: -Thin PSP or analogue films: These tend to have sharper edges and have more issues in the feeling of cutting the fl...