Video

Wednesday, January 1, 2014

1. INTRODUCTION

Fortunately, medical emergencies in the dental office are a rare occurrence.  Unfortunately, this rarity prevents us from becoming comfortable with management of problems, and worse still, may lead to complacency.  In light of their uncommon occurrence, it is useful to revisit the subject, sometimes from a different perspective.  The perspective taken for today's discussion is a relatively broad one, allowing for a  "from first principles " approach to the prevention of preparation for, recognition of and action involved in the management of medical emergencies.
2. DEFINITION
A medical emergency is a stress induced, relatively sudden, acute, uncontrolled failure of physiologic adaptation capability (or decompensation in the face of stress ).
A. Stress induced:  This implies that there is usually a more or less recognizable cause or identifiable stress that is driving the system toward failure.  This could be the presence of an allergen, anxiety, drugs or foreign object in the airway that stresses the system maximally and beyond in such a manner that the system is no longer able to cope.

MEDICAL EMERGENCIES IN THE DENTAL PRACTICE

1. INTRODUCTION Fortunately, medical emergencies in the dental office are a rare occurrence.   Unfortunately, this rarity prevents us ...

Introduction
Effective pain management of a child, especially an anxious one, is a challenge to every dentist. The need for good management of anxiety and pain in paediatric dentistry is paramount. A common cause of complaint from parents and their children is that a dentist 'hurt' unnecessarily. Such a complaint can jeopardize access to life-long dental care.
Children are anatomically and physiologically different from adults. The anatomy of the airway means that breathing is through a narrower, more fixed 'wind pipe'. Physiologically, a child is less capable of taking in a bigger volume of air even when urgently required. Coupled with this, both the demand for oxygen (consumption) and the incidence of periodic breathing and apnoeas are higher compared to adults. These differences mean that a child can become hypoxic more easily.

Children's perception of pain

Pharmacological management of pain and anxiety-Paediatric Dentistry

Introduction Effective pain management of a child, especially an anxious one, is a challenge to every dentist. The need for good ma...

Nursery Toothbrushing Saves in Dental CostsCurated News:

By Timberlake Dental curated from BBC News Scotland
Image Courtesy of  Flickr - crimfants
“A scheme to encourage nursery children to brush their teeth has saved more than £6m in dental costs, according to a new study…”
See full article on BBC News Scotland

Commentary:

The study discussed in the article is about Scottish nurses who have been supervising toothbrushing by nursery school age children.  The early training in good oral hygiene was very successful, saving millions of pounds in dental costs.
Dr. Rodney D. Chowning, DDS, Dentist, Denton, TX

Nursery toothbrushing saves £6m in dental costs

Curated News: By   Timberlake Dental   curated from  BBC News Scotland -  Image Courtesy of  Flickr - crimfants “A scheme to encoura...



Premature eruption, natal, and neonatal teeth

Teeth erupted at birth (natal teeth) or which erupt within the first 30 days of life (neonatal teeth) are uncommon, occurring in about 1 in 3000 live births in most reported series. In about 80 per cent of cases the mandibular incisors, usually one or both central incisors, are involved. They are thought to arise from normal tooth germs developing in a superficial position in the jaw with subsequent premature eruption. Coronal enamel and dentine formation is normal for the chronological age of the tooth, but because of the premature eruption the enamel may be hypoplastic. However, there is usually a virtual absence of root formation and any radicular dentine or cementum that forms is generally irregular in structure due to the mobility of the tooth in the jaw (Such teeth may be lost spontaneously or have to be extracted if there is a risk of dislocation and inhalation, or if they interfere with feeding.

Disorders of Teeth other Than Dental Caries and Developmental Disorders Disorders of eruption and shedding of teeth

Premature eruption, natal, and neonatal teeth Teeth erupted at birth (natal teeth) or which erupt within the first 30 days of life (...

A procedure performed in a tooth with a deep carious lesion approximating the pulp but without signs and symptoms of pulp degeneration. The caries surrounding the pulp is left in place to avoid pulp exposure and is covered with a biocompatible material. A radiopaque liner such as a dentin bonding agent, resin modified glass ionomer, calcium hydroxide, zinc oxide-eugenol or glass ionomer cement is placed over the remaining carious dentin to stimulate healing and repair. Then the tooth is restored with a material that seals the tooth from micro leakage.

Indirect pulp treatment

A procedure performed in a tooth with a deep carious lesion approximating the pulp but without signs and symptoms of pulp degeneration. ...

Ancient  Dentistry
The Indus Valley Civilization has yielded evidence of dentistry being practised as far back as 7000 BC.
Earliest form of dentistry involved curing tooth related disorders with bow drills operated, perhaps, by skilled bead craftsmen.In what could be one of the earliest examples of dentistry.Scientists at the University of Missouri-Columbia in the United States have found tiny, perfectly rounded holes in teeth found in Mehrgarh in pre-historic Pakistan, which they suspect were drilled to repair tooth decay.Researcher Andrea Cucina, who first discovered the tiny holes, reveals that they didn't appear to be a funeral rite and the teeth were still in the jaw so they had not been drilled to make a necklace. He and his colleagues suspect the holes were a treatment for tooth decay and that plants or another substance had been inserted into the holes to prevent bacterial growth.

Old dental system

Ancient   Dentistry The Indus Valley Civilization has yielded evidence of dentistry being practised as far back as 7000 BC. Earliest ...

Women in pre-20th century seems to play an unknown role in dentistry. In an early copper engraving by Lucas Van Leyden, a traveling dentist can be seen along with a woman acting as his assistant.  In 1852, AmaliaAssur became the first female dentist in Sweden. She was given special permission from the Royal Board of Health to practice independently as a dentist, despite the fact that the profession was not legally opened to women in Sweden until 1861. 
Emeline Roberts Jones became the first woman to practice dentistry in the United States in 1855.  She married the dentist Daniel Jones when she was a teenager, and became his assistant in 1855 and later on put up her own practice. Rosalie Fougelberg in 1866 became the first woman in Sweden to officially practice dentistry when profession was legally opened to females in 1861.

Women in dentistry

Women in pre-20th century seems to play an unknown role in dentistry. In an early copper engraving by Lucas Van Leyden, a traveling dent...

Dr. John M. Harris started the world's first dental school in Bainbridge, Ohio, and influenced establishing dentistry as a health profession. It opened on 21 stFebruary 1828, and today is a dental museum. The first dental college, Baltimore College of Dental Surgery, opened in Baltimore, Maryland, USA in 1840.Chapin Harris and Horace Hayden founded the Baltimore College of Dental Surgery, the first school dedicated solely to dentistry. The college merged with the University of Maryland School of Dentistry in 1923, which still exists today.

Dental education

Dr. John M. Harris started the world's first dental school in Bainbridge, Ohio, and influenced establishing dentistry as a health pr...

Here is the diagrammatic presentation of  Examination and Self Screening for Oral Cancer


Examination and Self Screening for Oral Cancer-Chart

Examination and Self Screening for Oral Cancer-Chart

Here is the diagrammatic presentation of  Examination and Self Screening for Oral Cancer Examination and Self Screening for Oral Cance...



A profession that is ignorant of its past experiences has lost a valuable asset because “it has missed its best guide to the future.” 
B.W. Weinberger Dentistry: An Illustrated History 
(Mosby, 1995)

The history of dentistry

A profession that is ignorant of its past experiences has lost a valuable asset because “it has missed its best guide to the future....
Pulpectomy
This involves the complete amputation of the pulpal tissue in a tooth that is reversibly infected or necrotic due to caries or trauma. The root canals are debrided mechanically with hand or rotary files and chemically with disinfectants such as sodium hypochlorite or chlorhexidine to ensure optimal bacterial decontamination of the canals. After proper drying of the canals a resorbable material such as non-reinforcedzinc oxide-eugenol, iodoform based paste or a combination paste of iodoform and calcium hydroxide is used to seal the canals.Then the tooth is restored with a material that seals the tooth from micro leakage.

Nonvital pulp therapy for primary teeth diagnosed with irreversible pulpitis or necrotic pulp

Pulpectomy This involves the complete amputation of the pulpal tissue in a tooth that is reversibly infected or necrotic due to carie...

 

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