tips and tricks

As always, dry teeth to see what's on them. Plaque can be thick or thin and especially tenuous plaque can be present on the maxillary anterior teeth in mouth breathers. Be wary of patient profile (Increased overjet, long faces and lip incompetence) which may be aetiological in mouthbreathers. Mouthbreathing causes air to flow over teeth causing them to dry. This leads to plaque increasing in stickiness causing even thin layers of plaque to adhere to teeth strongly. This may not be removed with prophylaxis. A sickle scaler can be useful to remove this plaque. Orthodontist referral is useful in these patients.

The replacement of anterior teeth, particularly single teeth, should normally be accomplished using fixed partial dentures or implant-supported restorations. However, there are instances in which the replacement of anterior teeth is best accomplished with a removable partial denture. Removable partial denture therapy should be considered in the following anterior applications: 1. In young patients, tooth preparation for a fixed restoration might compromise pulpal health. A removable partial denture can be used until more definitive therapy is possible. 2. For patients in poor general health, extended dental appointments may be contraindicated. Removable partial denture therapy often permits a reduction in "chair time." 3. Periodontal compromise of proposed abutments may contraindicate conventional fixed partial denture therapy. Removable partial denture therapy permits the distribution of forces throughout the dental arch, thereby creating a more favorable clinical s...

From the Oxford Handbook of Clinical dentistry: " Lidocaine/adrenaline   Most commonly used preparation (2% lidocaine 1:80 000 adrenaline), gives effective pulpal analgesia for 1.5h and altered soft-tissue sensation for up to 3h. Extremely safe; maximum dose (adult) 500mg (10 × 2.2mL cartridges) (4.4mg/kg lidocaine with 44mg per cartridge). Also available in ampoules 1% + 2% lidocaine plain or with 1:200 000 adrenaline. There are theoretical criticisms that the maximum dose is too high but these have not been borne out in practice, nor has the demonstrated effect of a change in serum potassium levels after lidocaine/adrenaline injection in the mouth. Prilocaine/octapressin  Similar but slightly less duration and effect compared to lidocaine/adrenaline. May cause methaemoglobinaemia in excess. Maximum safe dose (adult) 600mg (8 × 2.2mL cartridges). In reality, there are few hard indications for the use of prilocaine over lidocaine. Mepivacaine  Short-acting LA advo...

-Don't worry about money, Make your dentistry as good as you can and the money will follow -Don't start with speed, build good habits and increase your skills. Rubbish in= rubbish out. -Don't worry about where your peers are at. It's not a competition, it's life. Focus on making yourself as good as you can be. -You have worked hard to get where you are today, don't let patients think they know more than you. In the end their treatment decision lies with themselves but they shouldn't force you to do something you don't believe is right.

Splinting of teeth that have undergone physical trauma allows the periodontal ligament to undergo repair without the trauma of mobile teeth. It is necessary in mobile and displaced teeth i.e Subluxation (in some cases), Lateral luxation, intrusion, extrusion, avulsion, horizontal root fractures, alveolar bone fractures. An easy way to remember splinting times is that hard tissue injuries (Root fracture, lateral luxation (damage to bone), alveolar bone fractures) will require 4 weeks of splinting. An exception is cervical 1/3 root fractures which will require 4 months of splinting. Non-crushing injuries (avulsion, extrusion) are actually less damaging to the periodontal ligament and so will require up to 2 weeks of splinting to allow repair. Intrusion depends on the treatment provided. In very young teeth with minimal intrusion, spontaneous reeruption may occur that will not require splinting. Orthodontinc repositioning and surgical repositioning will require splinting times (4 weeks)

Stay back at the end of the day and review your notes and xrays. You owe it to the patient and yourself to have good notes and not miss anything diagnostically. Always ask yourself: "if this was taken to court, would it be defensible?" Professionally written notes are important as someone reading back on them can question your level of knowledge etc. Everything needs to be in writing or it didn't happen. If you got correspondence from the patient's GP, then that needs to be in writing in a formal letter from them. But don't get that during their work hours, you can send off an email and they will reply at the end of their day (as you can be disturbing their daily schedule)

In a review appt for full dentures (especially immediate dentures- as they have more going on), if a patient presents with a sore spot, Always check the occlusion first before hacking away at the denture. If they have an occlusal interference or CR is incorrect, the patient may be causing a denture base shift in function which will require occlusal adjustment or remake rather than a denture intaglio adjustment.