Behavior management

Non pharmacological 1. Tell show do Tell – Explain procedure with age appropriate language Show – Demonstrate procedure Do – Perform procedure Communication should be gentle, addressing the child. Use euphemism (eg. call LA “sleeping juice”, rubber dam “umbrella”) and smile. Have positive reinforcement. 2. Behavior modelling – Show other children getting procedures and how they behave 3.…

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Molar incisor hypomineralization (MIH)

Clinical appearance of enamel hypomineralization of systemic origin affecting one or more permanent first molars (PFM) that are frequently associated with incisors Etiology: Oxygen shortage + low birth weight Parental risks – infection, maternal psychological stress Complications during delivery Respiratory diseases and oxygen shortage of ameloblasts Children born with poor general…

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Dental fluorosis

Developmental disturbance of dental enamel, caused by successive exposure to high concentrations of fluoride – 1.5 mg/l (1.5 ppm) in drinking water – during tooth development , leading to enamel with lower mineral content of increased porosity Etiopathogenesis: Direct inhibitory effect on enzymatic action of ameloblasts leading to defective matrix formation and subsequent…

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Prescribing Drugs

How to prescribe 1. Formulation of drug: PO, IV, IM, PV, PR 2. Name of drug: Paracetamol, Amoxycillin 3. Dosage: mg, g, avoid decimals 4. Frequency: OD, BD, TDS, Nocte, PRN (state minimum dose interval in PRN) 5. Duration: 5/7, 2/52, 3/12 Eg. PO Augmentin 625mg BD x 5/7 1-5 years: 1/4 of adult dose 6-12 years: 1/2 of adult dose Calculating Drug dosage Use the app Dental Drugs (App…

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Radiology: X-Ray positions

Bilateral bite wing (BBW) Patient head straight so occlusal plane is parallel to the floor Bite should be normal X-ray central beam: Vertical angulation: +10° Horizontal angulation: Premolar BBW: 30° from mid-sagittal plane, aimed at inner canthus of the eye Molar BBW: 60° from mid-sagittal plane, aimed at outer canthus of the eye Watch video Intraoral periapical (IOPA) Identification…

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Dental instruments

Download Medicos Dental Material App on: App store Play store This app has instruments, their name and use and tray set ups for all dental procedures

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Chronology of tooth development and eruption

Primary teeth Sequence of eruption: A-B-D-C-E ToothArchCalcification(Weeks in utero)Crown completion (Months)Eruption(Months)Root completion(Years)ACIMaxMand141.52.51081.5BLIMaxMand162.53111321.5CCMaxMand17919203DM1MaxMand1565.5162EM2MaxMand1918111029273Primary teeth development and eruption Permanent teeth Sequence of eruption: Maxilla: 6-1-2-4-5-3-7-8 Mandible:…

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Tooth extraction

Patient positioning when extracting teeth Maxillary teeth: 3 inch below shoulder level of operator and 45 degree chair angulation Mandibular teeth: At elbow level of operator and 90 degree chair angulation 1st, 2nd and 3rd quadrant: Right front of patient 4th quadrant anterior teeth: Right front of patient 4th quadrant posterior teeth: Behind right side of patient/ just right side Tooth…

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Extraction forceps

Maxillary extraction forceps Maxillary anterior forceps – Incisors and canines ©Association of Oral and Maxillofacial Surgeons of India Maxillary premolar forceps – Premolars ©Association of Oral and Maxillofacial Surgeons of India Maxillary molar forceps – Molars ©Association of Oral and Maxillofacial Surgeons of India Maxillary cow horn forceps – Molars with extensive loss of coronal…

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Radioanalysis of impacted teeth

Canine localization Parallax in horizontal plane: Two IOPA or USO + IOPA Parallax in vertical plane: OPG (↑8°) + USO (↓65-70°) to horizontal plane SLOB: Same Lingual Opposite Buccal If in line with arch, will not move Can do CBCT Third molars X-rays used: IOPA – difficult due to gagging OPG Oblique lateral view Lower/upper oblique occlusal view – buccolingual position CBCT 1.…

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Trauma and fractures

Classification of dentoalveolar injuries Injuries to dental hard tissues and pulp Enamel infraction – incomplete crack of enamel, no loss of tooth structure Enamel fracture – loss of tooth structure involving enamel only Enamel dentine fracture – loss of enamel and dentine, pulp not involved Complicated crown fracture – crown fracture involving pulp Complicated crown root fracture – enamel,…

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Local Anesthesia

Techniques of administrating LA 1. Inferior alveolar nerve block: Mandibular posterior teeth Picture Between pterygomandibular raphe and coronoid notch (feel with thumb) Insert from contralateral side, 1cm above occlusal plane Contact bone, withdraw slightly and give LA 2. Mental nerve block: Mandibular anterior teeth Picture Between 1st and 2nd premolar 3. Anterior, middle, posterior…

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Soft tissue cysts

Dermoid cyst: Etiology: Epithelial tissue implanted into another structure Commonly: Face, inside skull, lower back, ovaries Clinical: Mature skin with sweat glands, hair follicle, sebum, blood, fat, bone, cartilage, nails, teeth Benign, solitary, expand slowly due to accumulation of epithelial debris and glandular secretion Non tender Can rupture Picture Epidermoid cyst: Lined with…

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Soft tissue radiopacities and dystrophic calcifications

Calcification is soft tissues i.e. heterotopic ossification 1. Dystrophic calcification Degenerated, diseased, dead tissue Normal calcium and phosphate levels Localized to site of injury (trauma, infection, inflammation) eg. cysticercosis parasite a. Chronically inflamed cysts – eg. Residual cyst b. Calcified lymph nodes Cervical tuberculosis adenitis Sarcoidosis Cat scratch…

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Maxillary sinus radiology

1. Inflammatory a. Retention cyst – Mucosal gland blocked b. Mucocele Sinus opening in nasal passage blocked (allergy/cold) Sinus filled with thick viscous fluid Radiology: Clouding/opacification of whole sinus, sclerotic border still intact If bacterial infection – destroy sclerotic wall Picture c. Sinusitis Mucosa lining thickened – opaque thickening on sclerotic border Long standing…

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Radiology of lesions

Radiolucent lesions A. Periapical radiolucency Apical periodontitis – widened PDL at root apex Bone cyst – UL/ML – round at periapex or scalloped between PM and M roots Periapical abscess or granuloma Periapical COD – early Radicular cyst Scar – dense fibrous tissue in RCT treated tooth B. Pericoronal radiolucency (impacted teeth) AOT Ameloblastoma – UL/ML – resorbed roots Ameloblastic…

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Exostosis, enostosis and tori

Exostosis Overgrowth of mature bone from periosteal surface extending outwards Picture Enostosis Overgrowth of bone from endosteal surface extending into marrow space Picture Tori Bony overgrowths, not a neoplasm Picture

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