tips and tricks

Today I had an interesting presentation of a lower 8. It had almost fully erupted but still had a distal operculum that had caused an initial bout of pericoronitis. It was obvious that there was proper spacing for the tooth to fit in the arch and My question is if the operculum would receede naturally or would require removal. The patient was 25 years old and apaprently it had been a while since the eruption of the tooth. A couple of thoughts: -Start with conservative management, improve OH, and mouth rinses -Antibiotics are not indicated for mild pericoronitis. -Do not perform an operculectomy on an inflamed site, it will bleed more, be more difficult to handle and once inflammation has settled, the result may not look ideal as this site will be larger than at its baseline state. I will recheck this case and check the healing.

No one can deny that dentistry is a stressful profession. It is not the most physically challenging though it does have its physical hurdles but I do believe that the mental side of the job takes the biggest toll on its workers. I have heard many explanations of the high suicide rate for dentists including the fact that there are just less dentists so any suicide will obviously make a bigger statistical difference. Here are some of my thoughts on the matter than I personally have experienced or have noted in others on a day to day basis: -Dentistry attracts a certain personality: Perfectionist, anal retentive, uptight individuals. The academic marks required to get in are fairly high and university places are competitive so the applicants it attracts have generally always aimed high and wanted the best performance out of themselves. When it comes to their work, this can leave them feeling unfullfilled and unsatisfied at the outcomes of their treatment. We forget that half the work is...

So it was mentioned to me that multiple layers of fibres can be used in the pontics of fibre bridges. A common situation is the replacement of lower incisors lost due to perio. Then you get the benefit of splinting as well as tooth replacement. With the first palatal fibre cured into place joining the abutment teeth together why not tack another strip of fibre labial to this in the pontic space. This is only possible when you don't have the natural tooth to adhere and are recreating the teeth in composite resin. The more fibre in the bridge the stiffer and potentially stronger it will be. After this second layer, a vertical fibre for each pontic tooth can be used as well as a horizontal fibre labial to that. This is the densenst arrangement with fibres going in different directions which will provide a satisfactory result. the translucency of the fibres means that not much composite is required over them to provide a good aesthetic result.

Often there is the temptation to take on more and more responsibilities. This is especially common in people who have difficulties saying no and who don't want to disappoint others. What you do have to remember is that you yourself must always come first. Though this may seem selfish, no one will care for you in the end other than yourself. Approach commitments with a rational mind and ask yourself if it is too much for your schedule. Do take into account that it is important for mental health to have time for leisure and recreation even if that is just lying back and doing nothing. Taking on tasks, committees and commitments may be beneficial to others but it may not be for yourself. Don't be afraid of saying no

Okay I think it's about time I start making a series of posts on dental sleep medicine. I have been doing Derek Mahony's mini residency for almost a year now and have learned a lot. What this series will cover: -Pathophysiology of OSA, snoring ,TMD and bruxism -The link between Bruxism, TMD and OSA -Parasomnias -Clinical examination -Sleep studies -Management strategies -Side effects of treatment and their management

Today I was in a situation where there was a 46 tooth with an MODB fracture. The mesial and distal margins were equigingval. The tooth is set for an endo or and exo but I did not have the required equipment to perform either (In the dental truck). So the plan is a temporary restoration and the patient will seek treatment privately. There are two options from here. -Restore to decent contour and contact -Restore with a stump with open contacts Ideally I would have a good contact to stop food packing but at a copmromise I would consider a wide open contact to allow interdental brushes to fit in. Without anaesthesia which was my plan, Wedges would be painful and making a contact would be difficult. This was due to the equigingival margin. In the past to make a decent contact I have used a light cure GIC like Fuji2LC and restored in stages. Sectional matricies are usually too unstable to be used due to the minimal surface area they are in contact with the tooth and there is the same ...

In the past I have had difficulties in placing the clear mylar strips in class 3 cavities where there is a strong or a sharp contact as in the picture below. -Tight contacts tend to bunch up the matrix and when you eventually jam it down it has a poor contour -Sharp contact will do the same, where there is a thin bit or supported incisal edge and it will catch or dent the matrix -Sharp incisal corner i.e if there is a small chip just off the location of the incisal corner. This may be in composite veneer cases where you want a clear strip to separate the teeth or in class 3 cases in a bruxer. I have found the matrix may want to go into this little divot rather than sliding between the teeth Solutions are currently: -Take a bur or polishing disc and cut off the obstruction. This is destructive especially for the tight contact case where there is a fair bit of supporting tooth structure -Use a tofflemire matrix or other metal matrix. This is more rigid and can be forced between th...