tips and tricks

 I thought of a good analogy as to why pulpitis pain can be so severe for our patients. I don't know how useful this will be in a clinical scenario but it may come in handy in the future. Have you ever put a ring on that was too tight and you were scared because you knew that if you couldn't get it off at first then it would be harder and harder to get off? The problem is that as the finger is irritated and compressed, the blood flow increases to the area and the soft tissue swells. On top of that, The ring is a hard material and doesn't expand in response to the swelling tissue. The same is true in a tooth. The tooth is the proverbial ring and the pulp tissue is the finger. Localised insults cause an increase in blood flow to the area due to the inflammatory cascade but the pulp is entombed in the tooth and there is nowhere for the excess pressure to go and this increase in pressure causes firing of nerve endings that manifest as pain. If we burn our skin, the skin swells,...

 I had a mishap just a couple of days ago where I had to remove a crown to perform endodontic therapy as the crown eventually required replacement. It was a lower central incisor and all the lower teeth had been crowned with the same white, monotone, textureless ceramic.I was very paranoid about cutting into the wrong tooth as all the teeth appeared the same. I counted mesial to distal, correlating the tooth to the xrays, counted, and then counted again. Finally, I made a bur mark into the tooth to mark it and got into cutting. Somehow, I still managed to cut into the wrong tooth and ended up sectioning halfway through the contralateral central incisor before I realised my mistake. This is a very real risk in these situations and I put it half down to how uniform the teeth looked, half down to my stupidity and carelessness.  In the future, in a situation like this, I will be making a mark on the tooth with an indelible marker before double checking and triple checking the toot...

I have recently been getting back into endos after spending the past year referring them to the principal dentist who was an endo aficionado. I find endos quite difficult, therefore time consuming and draining. Logically I know that the less I like something, the more I should do of it to become proficient but I thought that I had reached a point in my career where I could focus on my special interests. However, due to changes in my work circumstances, I have to take on these procedures again.  I have recently gone through the All things endo online course from Ashley Mark in the US (https://all-things-dentistry.teachable.com/courses). It was a very cost effective course that gave a good refresher for endo knowledge. The main benefit I got from it was the repetition of recordings of endo accesses. This is the most important part of the endo procedure and improves the outcome of each step follow this. Seeing this being done over and over with some tips to give confidence to know tha...

It has been a turbulent year from my end. Lots of changes at work as earlier in the year, the principal dentist and my mentor at the practice I started at suddenly passed away. I stayed on to help the transition after this but have now become the main practitioner at this practice. After building the practice for over 30 years, there was a significant and loyal patient base with a large amount of complex prosthodontic and implant work. As a result, there is a lot of complex work for me to maintain and inevitably a lot of complications and periimplantitis. Luckily we have arranged for an experienced dentist to come by once or twice a month to take over the larger, more complex cases but I am getting a lot of pressure from the practice to be able to tackle cases beyond my experience. I am trying to quickly upskill to be able to manage some of the more difficult implant and pros cases but it is a very fine line between pushing my boundaries and getting out of my depth.  I have started...

I have borrowed the book: "Mastering digital dental photography" by Wolfgange Bengel (2006) as it was one of the recommended books from the Szabi Hant dental photography course.  It is a fairly extensive book and covers in depth very technical aspects of photography and aspects relevant to dentistry. I will not be reading the whole book as it goes deep into certain topics such as how camera sensors work and camera recommendations that are fairly dated. However I will try to extract the more useful points form this text and summarise them on this blog. I find that after taking photographs for some years I can take fairly well exposed, reproducible photos but it would be good to have a theoretical basis behind what I do to understand why a photo doesn't turn out as well as it could and maybe learn a few things about how to make my photos even better. The first chapter talks about why we take photographs in dentistry. Human beings are visually driven people and ...

Grey cards are reference cards that are used to calibrate camera software. It ensures that pictures produced by the camera have colours that match the object being photographed. Many factors can affect the colour of the object, the camera sensor just captures the light reflected through the lens so mainly, factors that affect the light source affect the colour. For non dental photography, ambient lighting e.g flourescent lights, weather conditions etc can introduce colours that affect the object. In dental photography, due to the strong flash needed for illumination, most of these external factors are  inconsequential. This can be seen if you expose a photograph with the flash off, you should expect to see a black image due to the small aperture, low ISO and high shutter speed. This means that room lights shouldn't affect the image significantly. Potential flash factors that can affect object colour include: -The plastic cover in front of the flash can yellow with time due to degra...