tips and tricks

The greater palatine artery provides blood supply to the posterior palate. There is accessory supply to much of the head and neck so cutting this artery will not result in any long term issues and it is often ligated. Most arteries in the head and neck can be ligated with no consequences due to the density of accessory supply. Exceptions include the internal carotid artery. Surgery around the palate including upper posterior extractions, periodontal surgery on posterior teeth and palatal graft harvests can affect this artery. The artery is always located at around the anterior-posterior level of the upper 7 at the transition of the vertical and horizontal slope of the palate. Iif you cut the palatal artery: 1. Take a deep breath, don't panic 2. Inject a whole catridge of local anaesthetic at the side of bleed. Will cause temporary haemostasis due to pressure and vasoconstriction 3.  Find the site of the artery by pressing your mirror handle firmly at the expected site. You will...

 This week I had my first experience in a teaching capacity. Earlier in the week I was one of the supervisors in the bachelor of oral health simulation clinics and also as a surprise I was rostered with the dental students in the extraction clinic today. I still have a fair bit to learn about dentistry but it was good to impart some knowledge onto the students. Unfortunately with the lockdown not many of the students were present in the simulation clinics and all the students had experienced significant disruption to their learning schedule and were lacking in variety of experience. In some way it is the duty of a teacher to try and impart their knowledge and experience onto the students but the students have to reciprocate with an open ear and an open mind. I found that some students were willing to listen and learn and they gained quite a bit from our time together but others were content in powering on their own. It is a testament to the wide variety of personalities that we com...

 Today an elderly man dropped off a broken lower full denture which belonged to his wife. She was in a nursing home due to her severe dementia and had thrown her denture on the floor. It had split in half and was a clean break so was definitely repairable. I had a bit of free time and we had some cold cure acrylic in the back lab so I thought I would attempt the repair rather than send it out to our lab as they didn't offer same day work. The steps I followed are below: -Inspect the denture: If the break is clean and there aren't too many pieces then the denture is deemed repairable. With traumatic fractures, the denture usually breaks at the thinnest part of the denture which tends to be down the midline with lower full dentures or at the flanges for upper full dentures. If there is a fracture through the tooth arches it will almost always pass through the contact point and not fracture a tooth in half as this point is a weak spot. Put the pieces together and if they fit toget...

With the hospital on higher restrictions we have shifted to emergency only and I spent a day in the extraction clinic today. I had some successes and some challenges and I will put my thoughts about some particular challenges below: - When a lower molar is heavily carious and the caries on the buccal or lingual is subgingival, it can be difficult to get forceps around the tooth. If you still have one root that has solid buccal and lingual tooth structure i.e the caries is on the distobuccal aspect subgingivally, you may be able to fit a set of lower universal forceps on this good root to try and move the whole tooth. The upside is that you may be able to extract the tooth straightforwardly if the roots are fairly straight or there is bone loss. The downside is that if the caries on the weak root is too extensive, the tooth may section unfavourably and make access difficult. - When you break a root tip you can use an Endo file to remove it when the canal is visible. I had difficult with...

 Today I had to cement a metal band around a virgin lower 6 with a distal crack into the pulp. Difficulties I've had in the past with metal bands were:  -    Band selection: Today I used a periodontal probe to measure the mesial-distal dimension of the tooth. The issue with the probe I had was the measurements didn't go far enough to measure the whole tooth in one go so I had to guess the last few millimetres. ensure you use a proble that has measurements far along enough to measure the entire width of the tooth. The mesiodistal width is the most important measurements to fit snugly as the width of the band is often limited by the position of the adjacent teeth. Ensure you measure from the widest part of the tooth not the marginal ridge as the band has to fit all the way past where the contact point is. The more worn the occlusal surface of the tooth the closer the occlusal table dimension will resemble the widest part of the tooth. With a tooth that isn't worn signi...

 After seeing Tom Giblin's example of sectioning the premolar during a difficult extraction I decided to try the same today. He sectioned the tooth when the crown fractured off to avoid fracturing the buccal plate as he was grafting the site for a future potential implant. Today I had a carious upper premolar that fractured when I put forceps on it. The patient was elderly and the arch was slightly crowded so the premolar was lingually placed. What this meant was that althought I could fit forceps on the tooth, the force to the buccal was hindered as it pushed against the adjacent teeth. In hindsight I would've just gone straight to cutting the interproximal contacts to give space for the tooth to move into and avoid pressure on the adjacent teeth. Instead, the crown fractured off. In hindsight this is a benefit as it removes the interference of the adjacent teeth and allows an elevator to fit 360 degrees around the tooth. In my eagerness to try the new technique I went straigh...

Been pretty slack lately in making posts instead just jotting some notes onto a draft post and leaving it for later. I have just over 100 posts I have to sort through and write up so will try to find some time to do this. This post was from over a year ago from the full mouth rehab course. It will be good to look back and refresh myself on what I learned back then as well as have the opportunity to add on knowledge that I have picked up since then. It turns out I already posted a lot of the information on this post as it was from a draft where I had dumped notes from the whole course but I thought I Would repost it with some additional information I have picked up since then. The second stage of a fixed pros rehabilitation involves the refinement of preps and the records taken to guide the technician towards the construction of the restorations. It can be useful to think of the appointment this way i.e in terms of a set of objectives rather than a list of procedures. An overall guide o...