Restorative - Obj 1-3 - Week 2 PP Flashcards

Question

Caries Detection Devices

Answer 1

Several different varieties are available on the market. These devices function through different ways such as through detecting bacterial by-products, measuring differences in tooth structure and lasers which can reveal bacterial activity under the enamel surface.

Answer 2

1. Describe the Behaviour of Materials Materials all have specific behaviours once placed into the oral cavity, which can affect the success of a restoration. When choosing materials to use, the material should: * Present no harm the patients’ health * Be easy enough to use * Be able to withstand the patient’s oral conditions 2. Handle Materials Safely Dental materials are bio-materials, that are man-made, and used to replace tissues or function in close contact with living tissues. Understanding the physical, chemical, and mechanical properties of materials are very important, as it influences their handling. Proper handling of materials is a major factor in its success or failure. If materials are properly stored, mixed, and placed, improved patient care will result. 3. Assess and Prepare Materials Prior to Treating the Patient The dental assistant must be able to identify the use of all dental materials intra-orally to prevent serious errors. Some materials may have contra-indication with the patient’s medical or dental health status. Others have very specific instructions to be followed in the preparation and placement, that can affect the outcome of the restoration. The assistant must be aware of the manufacturer’s instructions and guidelines for the use of all materials used in the practice. 4. Educate the Patient Dental assistants are responsible for educating patients regarding treatment options, including comparing one dental material to another. Knowledge of dental materials is critical to ensure that the patient is provided with complete, and accurate answers to assist in treatment choices.

Answer 3

the extent of decay in the tooth, how much tooth structure remains intact to hold the new material in place, the condition of the entire mouth, the location of the restoration, and cost factors.

Answer 4

Amalgam Composite Resin Glass ionomer Temporary restorative materials tooth-whitening products gold alloy ceramic castings

Answer 5

Mechanical - material must have sufficient strength to withstand biting force (28000 lbs of pressure per square inch on a single cusp of a molar tooth) (Tensile stress and strain) Ductility - is the ability of a material to have its shape changed by being streched or by a pulling of tensile force without losing strength or breaking Malleability - measure of a material's ability to be extended in all directions by a compressive force Thermal Change - withstand contraction and expansion due to temp change (from hot and cold food) and the need to protect the pulp from thermal shock from extreme difference in temp Electrical - electrical current (or galvanic action or shock) can take place in the oral cavity when two different/dissimilar metals are present. Conditions that can create - salt in saliva is conductor of electricity, or two metallic components used in restoration or a fork placed in mouth can act as a battery. Corrosive - corrosion of metals when exposed to corrosive factors such as temp, humidity, and saline. Hardness - permanent restoration must have enough hardness to resist indentation, scratching, or abrasion (Strength and wearability) Solubility - degree to which a substance will dissolve in a given amount of another substance Application - Flow , Adhesion, Retention, Curing

Answer 6

Auto-Cure Light-Cure Dual-Cure

Answer 7

Silver fillings - powder metal (mostly silver) are mixed with mercury to form a soft mixture

Answer 8

- Esthetics (if in anterior teeth and can be seen) -if patient has history of allergy to mercury or other components -when large restoration is required (and cost is not a factor)

Answer 9

43% mercury & 54% alloy (mix metals - silver, tin, copper, and zinc) powder - although typically a 1:1 ratio is used (Eames technique)

Answer 10

In preparation of a local anesthetic injection Prevent gagging in procedures such as radiography or impressions Temporary pain relief from oral ulcers, wounds or inflammation

Answer 11

Allergy to ingredients (i.e. red food dye in flavored topical anesthetic Heart conditions or High Blood Pressure (if a vasoconstrictor is on ingredient list)

Answer 12

a minimum of 15 seconds to 30 seconds with a maximum of 1 or 2 minutes to have optimum effectiveness

Answer 13

is useful when applied at the back of the throat in patients that have a strong gag reflex. an appropriate time to use this is when taking impressions of for radiography. Can pose a potential danger if too much is administered - its absorbed into the blood stream an can cause irregular heartbeat and respiratory failure

Answer 14

Local anesthesia is used for dental procedures that have the potential to cause discomfort or pain. It blocks sensations from teeth, soft tissue, and bone in the area of anesthetization and is used for many dental procedures. Examples include: Root planning and scaling Restorative procedures (restoring teeth into function or esthetics) Surgical procedures (extractions) Prosthodontic procedures (crown and bridge) Endodontic procedures (root canals) Periodontal procedures (gingival surgery)

Answer 15

The anesthetic carpule is typically clear glass or plastic and contains the anesthetic solution.

Answer 16

Each carpule typically contains 1.8 ml of anesthetic solution and is labeled with the following information: 1. The type of anesthetic solution (generic and common name) 2. Percentage of concentration of anesthetic in the solution. 3. Type of concentration of vasoconstrictor present 4. Expiration date

Answer 17

1. The silicon rubber stopper must be flush with the glass. - If it is pushed out it may indicate that the solution may have been frozen - If it is pushed in, it may have already been used. 2. The carpule must not be chipped, cracked or damaged -The glass may shatter during the injection and may have been contaminated (IPC breach) 3. The solution must not be cloudy or discoloured. - may indicate expired, contaminated and no longer effective

Answer 18

Thumb ring, finger grip - these parts allow the dentist to control the syringe firmly and aspirate effectively with one hand harpoon - is a sharp hook that locks into the rubber stopper of the anesthetic cartridge, so the stopper can be retracted by pulling back on the piston rod. this action makes aspiration possible. piston rod - this rod pushes the rubber stopper of the anesthetic cartridge and forces the anesthetic solution out through the needle barrel of the syringe - the barrel firmly holds the anesthetic cartridge in place. the cartridge is loaded through the open side of the barrel. a window on the other side allows the dentist to watch for blood during aspiration. threaded tip - the hub of the needle is attached to the syringe on the threaded tip. the cartridge end of the needle passes through the small opening in the center of the treaded tip, puncturing the rubber diaphragm of the anesthetic cartridge

Answer 19

Diagnosing early dental caries is challenging for the DDS. The following methods are used to detect dental caries: * Dental Explorer - When the sharp tip of an explorer is pressed into an area of suspected caries it will “stick” when being removed * Radiographs - A dark “shadow” will appear on radiographs when decay is present. Caries are often two times deeper and more widespread than it appears on a radiograph * Visual Appearance - Gray shadowing underneath enamel can indicate decay * Indicator Dyes - Dye applied to the inside of a cavity preparation can indicate through color change whether decay remains * Caries Detection Devices - These devices detect bacterial by-products and quantify sound signals to aid in caries detection * Laser Caries Detector - Reveals bacterial activity underneath the enamel surface. It does not detect interproximal, subgingival, secondary caries or decay under restorations.

Answer 20

* Practice of various psychological, physical, and chemical approaches to prevent and treat preoperative, operative, and postoperative anxiety and pain Methods of pain control used in dentistry to alleviate or reduce anxiety and pain include: * Topical anesthesia * Local anesthesia * Inhalation sedation * Antianxiety agents * Intravenous (IV) sedation * General anesthesia * Mind-body medicine

Answer 21

* Nonirritating to the tissues in the area of the injection * Associated with minimal toxicity * Rapid onset * Able to provide profound anesthesia * Sufficient duration of action * Completely reversible * Sterile or capable of being sterilized by heat without deterioration

Answer 22

#30 gauge is used to anaesthetize maxillary arch needle is very thin/short

Answer 23

#27 gauge is used to anesthetize mandibular arch # 27 GAUGE NEEDLE IS VERY THICK /LONG

Answer 24

The larger the gauge number the thinner the needle

Answer 25

1) Always use new needle, new anaesthetic carpule. Sterile syringe 2) Point the needle away from you when loading and unloading syringe 3) Never touch the needle with your hands 4) Ensure anesthetic carpule is appropriate for your patient’s medical history.

Answer 26

* Subgingival - below the gumline. Enters the bloodstream

Answer 27

* Patients who have heart disease, high blood pressure, medications that have contra— indications, anxiety or fears or previous negative reactions

Answer 28

* To slow down the intake of an aesthetic agent and increase the duration of action

Answer 29

* May cause unwanted side effects such as nervousness, excitement, muscular twitching, high blood pressure, and increased heart rate and respiration. * Dental treatment, the most widely used epinephrine ratio is 1:100,000. * This means that there is one part (drop) of epinephrine per 100,000 parts (drops) of anesthetic solutions. * When longer duration is necessary, a ratio of 1:50,000 (which contain twice as much epinephrine) is used.

Answer 30

* Cartridges should be stored at room temperature and protected from direct sunlight * Never use a cartridge that has been frozen * Do not use a cartridge if it is cracked, chipped, or damaged in any way * Never use a solution that is discolored or cloudy or has passed the expiration date * Do not leave the syringe preloaded with the needle attached for an extended period * Never save a cartridge for reuse

Answer 31

Mucobuccal fold

Answer 32

* completed by injecting into a small, isolated area *completed by injecting the anesthetic directly into the soft tissue area of the nerve endings affecting a specific area

Answer 33

* When the injection is placed near a larger terminal nerve branch *refers to injecting the anesthetic near a larger terminal nerve branch affecting a larger surface area of the operative field. When two or three teeth are being restored, a field block is indicated.

Answer 34

* When local anesthetic is deposited close to a main nerve trunk – indicated for quadrant dentistry *occurs when local anesthetic is deposited close to a main nerve trunk. This type of injection is indicated for quadrant dentistry. Examples of these types of injections are the posterior superior alveolar, the anterior superior alveolar, and the nasopalatine nerve block.

Answer 35

Middle Superior Alveolar - in buccal/vestibule - near first premolar

Answer 36

Posterior Superior Alveolar –in buccal/vestibule - near 1st molar

Answer 37

Anterior Superior Alveolar - mucobuccal fold injection

Answer 38

provides anesthesia in the posterior portion of the hard palate

Answer 39

produces anesthesia in the anterior hard palate

Answer 40

often referred to as mandibular nerve block - is obtained by injecting the anesthetic solution near, but not into, the branches of the inferior alveolar nerve close to the mandibular foramen. patient will experience numbness over half of the lower jaw, including the teeth, tongue & lips.

Answer 41

provides anesthesia to the buccal soft tissues closest to the mandibular molars

Answer 42

is given only when the mandibular anterior teeth or premolars require anesthesia. The incisive block injection is given at the site of the mental foramen. The branch of nerves continues within the mandibular canal to the apices of the anterior teeth

Answer 43

an alternative infiltration technique involves injection of the anesthetic solution under pressure directly into the periodontal ligament and surrounding tissues. Is usually an addition to conventional techniques. This type of injection may be completed with the use of a conventional syringe or a special periodontal ligament injection syringe.

Answer 44

Patient Name: ____________________ Date P – patient presented to sait dentail clinic with pain in tooth 4.6 (initial) A – MHU updated, consent forms signed (initial) R – DDS requisitioned 1 PA of tooth 4.6, prescribed 250 mg of amoxicillin 2x daily 5 x days (initial) T – CO (Visual), PPR, Denticare Cherry Topical anesthetic, 2 carps lidocaine 1:100,000 Post op instructions given (POIG) written and verbal (initial) S – Pt will book in 1 week for RCT after antibiotics are finished (initial) Signature

Answer 45

Avoid hot and cold foods * Chew on other side of mouth * Avoid biting cheek or tongue * How long will topical anaesthetics last ? ◦ 15 min * How long will local anesthetics last ? ◦ 2 - 4 hours

Answer 46

A noninvasive method to block pain electronically with the use of a low-level current of electricity through contact pads that target a specific electronic waveform directly to the nerve bundle at the root of the tooth Benefits: * No needles * No post op numbness or swelling * Chemical free * No cross contamination risk * Reduced fear and anxiety in patients * Patient control over own comfort level

Answer 47

1. Intravenous (IV) Sedation 2. Unconscious Sedation 3. Inhalation Sedation 4. Oral Sedation

Answer 48

* Nitrous oxide/oxygen (N2O/O2) * Combination of gases inhaled to help eliminate fear and to aid relaxation * Effects * Non-addictive * Onset is easy, side effects are minimal, and recovery is rapid * Produces stage 1 anesthesia/analgesia * Dulls the perception of pain - works well for kids who are nervous of dental work to be done

Answer 49

* Administration is simple and easily managed * The services of an anesthesiologists or other specialized personnel are not required * Excellent safety record * Side effects are minimal * The patient is awake * Recovery is rapid * Can be used with patients of all ages

Answer 50

* Some patients may experience nausea or vertigo * Patients who have behavioral problems may react in a negative way and act out those behavior issues - exaggerate negative behaviors

Answer 51

* Pulmonary disorders * Respiratory disorders * Pregnancy (1st trimester) * Psychiatric * Immune compromised * Multiple Sclerosis * Frequent marijuana or drug use * Middle ear blockage * Alcoholic or recovering alcoholic * Nasal Obstruction * Emphysema * Emotional Instability Review health history for these and advise dentist of these red flags.

Answer 52

Ask patients to refrain from speaking or mouth breathing while nitrous is being administered. Breathe in and out through nose * There is no set dosage regimen as patients can react differently to treatment from one appointment to the next. Dentist determines dosage amount. * Assess the patient for dizziness, headache or lethargy once nitrous has been removed

Answer 53

Scavenger System * Reduces the nitrous oxide released into the treatment room *Takes excess N2o/o2 out of room Venting Exhaust Fumes Outside * Exposure overtime has proven adverse health effects. Ventilation should not be close to fresh-air intake vent Testing Pressure Conditions * Soap solution is applied to lines to test for leaks - if bubbles form, you know it's leaking *actually tank - make sure it's not leaking Inspection of Equipment * Look for wear, tear, cracks, holes and replace any damaged parts Properly Fitting Mask - comes in sizes for individual patients (kids sizes)

Answer 54

Sedatives are the drug of choice for physicians and dentists seeking to relieve anxiety in their patients - taken orally to relax body Criteria for use * A patient is very nervous about a procedure * A procedure is long or difficult * The patient is mentally challenged * The patient is a very young child requiring extensive treatment

Answer 55

Antianxiety drugs administered IV throughout a procedure at a slower pace, providing a deeper stage 1 analgesia. Prior to administration a health exam (including patient weight) and a signed consent. Baseline vitals are taken, blood O2 levels recorded. - The IV line should be continuously monitored to make sure that there is not inflammation or pain at the insertion site or that the needle has not become dislodged, is leaking, has clotted or cracked. -Physiologic measurements should be recorded at least every 15 min. (2nd assistant's job) -Supplemental oxygen and a defibrillator must be available for immediate use in case of emergency

Answer 56

A controlled state of unconsciousness (not awake, not able to follow verbal prompts) with a loss of protective reflexes—including the ability to maintain an airway independently and to respond appropriately to physical stimulation or verbal command—that produces stage 3 general anesthesia only done in operatory type settings - hospital type setting, or private hospital

Answer 57

Always document the following measures and observations: * Review of the patient’s medical history * Preoperative and postoperative vital signs * Vitals are also documented every 15 min in the patient chart during IV, general and oral sedation * Patient’s tidal volume if inhalation sedation is being used - how much/amount that was given * Times at which anesthesia began and ended * Peak concentration administered * Postoperative time (in minutes) required for patient recovery * Adverse events and patient complaints

Answer 58

Stage I - anti anxiety, inhalation & IV(-is a deeper state of stage 1) * Patient is relaxed and fully conscious. The patient experiences a sense of euphoria and reduction in pain. Vital signs are normal. Stage II * Excitement stage. Patient is less aware. Patient may lose consciousness, vomit or become unmanageable. Undesirable stage. Stage III * General anesthesia. The patient feels no pain or sensation. Patient becomes unconscious. Can be achieved only under the guidance of an anesthesiologist in a controlled environment. Stage IV * Respiratory failure or cardiac arrest. If not quickly reversed, it can result in death.

Answer 59

Patient undergoes a preoperative physical exam and signed consent is completed. Most appointments are scheduled in the early morning as the patient cannot eat or drink for 8-12 hours before the procedure The patient must have someone to drive them home Once the procedure is completed the patient is monitored closely until normal reflexes return. Can not be sent home if still "loopy". The patient should NOT be left alone while regaining consciousness.

Answer 60

Methods of reducing anxiety and pain through different non-pharmacologic techniques Some common techniques include: * Distraction (e.g., listening to music, watching iPad) * Relaxation techniques * Guided techniques * Deep breathing * Biofeedback * Hypnosis * Acupuncture

Answer 61

Dr. Black did more to standardize restorative procedures in dentistry than any other man in history. In the early 1900’s he devised a method of classifying cavities that is still in use today. His influence is still felt in teaching programs because of the example he set in research and academics. Cavity classifications designed by Dr. Black are made based on the anatomic surfaces of teeth.

Answer 62

Class I - Pit and fissure surface of teeth. Occlusal of Buccal pits on premolars or molars. Lingual pit on incisors. Class II - Include at least one interproximal surface of a bicuspid or molar. Class III - Interproximal surfaces of anterior teeth that do not involve the incisal edge. Class IV - Interproximal surfaces of anterior teeth that require restoration of the incisal edge. Class V - Smooth surface of the cervical one-third lingual or facially on any tooth. Class VI - Incisal edges or cusp tips of teeth; usually caused by abrasion, wear, or anatomical defects.

Answer 63

MO - Mesial occlusal or mesio-occlusal DO - Distal occlusal or disto-occlusal L - Lingual V - Vestibular F - Facial I - Incisal

Answer 64

The following procedures may be performed by a Registered Dental Assistant (RDA) in order to assist the dentist in a diagnosis of decay. * Diagnosing decay is not in the Dental Assistants scope of practice. Exam Clinical Observation/ Visual Evaluation X-rays Indicator Dyes Caries Detection Devices

Answer 65

Exam Use the mirror and explorer to detect cariogenic lesions (decay) decay on accessible tooth surfaces. Existing restorations are also evaluated for stability and integrity.

Answer 66

Clinical Observation/ Visual Evaluation Perform a clinical observation to note any suspicious areas for decay for the dentist to follow-up for diagnosis.

Answer 67

X-rays Take, process, and mount X-rays for the dentist to interpret and diagnose any conditions.

Answer 68

Indicator Dyes Apply a carious indicator dye inside of the cavity preparation to indicate any decayed areas. *Dentist places to ensure all decay is removed prior to placing the restoration.

Answer 69

Caries Detection Devices Several different varieties are available on the market. These devices function through different ways such as through detecting bacterial by-products, measuring differences in tooth structure and lasers which can reveal bacterial activity under the enamel surface.

Answer 70

Class I - Pit and fissure surface of teeth. Occlusal of Buccal pits on premolars or molars. Lingual pit on incisors.

Answer 71

Class II - Include at least one interproximal surface of a premolar or molar.

Answer 72

Class III - Interproximal surfaces of anterior teeth that do not involve the incisal edge.

Answer 73

Class IV - Interproximal surfaces of anterior teeth that require restoration of the incisal edge.

Answer 74

Class V - Smooth surface of the cervical one-third lingual or facially on any tooth.

Answer 75

Class VI - Incisal edges or cusp tips of teeth; usually caused by abrasion, wear, or anatomical defects.

Answer 76

Materials all have specific behaviours once placed into the oral cavity, which can affect the success of a restoration. When choosing materials to use, the material should: * Present no harm the patients’ health * Be easy enough to use * Be able to withstand the patient’s oral conditions

Answer 77

Dental materials are bio-materials, that are man-made, and used to replace tissues or function in close contact with living tissues. Understanding the physical, chemical, and mechanical properties of materials are very important, as it influences their handling. Proper handling of materials is a major factor in its success or failure. If materials are properly stored, mixed, and placed, improved patient care will result.

Answer 78

The dental assistant must be able to identify the use of all dental materials intra-orally to prevent serious errors. Some materials may have contra-indication with the patient’s medical or dental health status. Others have very specific instructions to be followed in the preparation and placement, that can affect the outcome of the restoration. The assistant must be aware of the manufacturer’s instructions and guidelines for the use of all materials used in the practice.

Answer 79

Dental assistants are responsible for educating patients regarding treatment options, including comparing one dental material to another. Knowledge of dental materials is critical to ensure that the patient is provided with complete, and accurate answers to assist in treatment choices.