Basic Guide to Dental Procedures 2nd edition by Carole Hollins 9781119064879 1119064872

Chapter 1 Preventive techniques

REASON FOR PROCEDURE

BACKGROUND INFORMATION OF PROCEDURE – FISSURE SEALANTS

Figure 1.1 Molar tooth model showing occlusal fissure system

DETAILS OF PROCEDURE – FISSURE SEALANTS

TECHNIQUE:

Figure 1.2 Fissure sealant instruments and materials

Figure 1.3 Tooth isolation techniques

BACKGROUND INFORMATION OF PROCEDURE – TOPICAL FLUORIDE

DETAILS OF PROCEDURE – FULL MOUTH TOPICAL FLUORIDE APPLICATION

Figure 1.4 Fluoride gel for professional application – Duraphat

TECHNIQUE:

DETAILS OF PROCEDURE – SPECIFIC TOOTH TOPICAL FLUORIDE APPLICATION

Figure 1.5 Brown spot lesion indicating previous enamel damage

Chapter 2 Oral hygiene instruction

REASON FOR PROCEDURE

BACKGROUND INFORMATION OF PROCEDURE – DISCLOSING AGENTS

Figure 2.1 Disclosing tablets

Figure 2.2 Disclosed teeth showing the presence of plaque

DETAILS OF PROCEDURE – DISCLOSING AGENTS

Figure 2.3 Appearance of undisclosed gingival plaque

TECHNIQUE:

BACKGROUND INFORMATION OF PROCEDURE – TOOTHBRUSHING

DETAILS OF PROCEDURE – TOOTHBRUSHING

Figure 2.4 Examples of various toothpastes

TECHNIQUE:

Figure 2.5 Tooth brushing the gingival margins

Figure 2.6 Comparison of new and worn toothbrush

BACKGROUND INFORMATION OF PROCEDURE – INTERDENTAL CLEANING

Figure 2.7 Contact points of the teeth

Figure 2.8 Interdental ‘flossettes’

DETAILS OF PROCEDURE – FLOSSING

Figure 2.9 Examples of dental floss and tape products

TECHNIQUE:

DETAILS OF PROCEDURE – INTERDENTAL BRUSHING

Figure 2.10 Correct positioning of floss around fingers

Figure 2.11 Flossing technique

TECHNIQUE:

Figure 2.12 Interdental brush design

Figure 2.13 Size range of interdental brushes

Figure 2.14 Use of interdental brush for posterior cleaning

Figure 2.15 Electric brush attachment for interdental cleaning

Chapter 3 Scaling and polishing

REASON FOR PROCEDURE

Figure 3.1 Supragingival calculus

BACKGROUND INFORMATION OF PROCEDURE – SCALING

DETAILS OF PROCEDURE – SIMPLE SCALING

Figure 3.2 Ultrasonic scaler showing water spray effect

Figure 3.3 Supragingival scalers. (a) Sickle scaler. (b) Jaquette scaler. (c) Push scaler

Figure 3.4 Instruments and materials for simple scale and polish procedure. (a) Prophylaxis paste. (b) Ultrasonic scaler. (c) Hand scalers. (d) Polishing brush with handpiece

TECHNIQUE:

DETAILS OF PROCEDURE – DEEP SCALING AND DEBRIDEMENT

Figure 3.5 Personal protective equipment. (a) Oral health team members – gloves, mask and eye protection. (b) Patient – bib and safety glasses

Figure 3.6 Appearance after completion of supragingival scaling

TECHNIQUE:

Figure 3.7 Currettes for subgingival scaling and debridement

Figure 3.8 Local anaesthetic equipment. (a) Topical anaesthetic and cotton wool roll. (b) Syringe – aspirating or non-aspirating. (c) Cartridge – content specific to patient need. (d) Needle – long or short

BACKGROUND INFORMATION OF PROCEDURE – POLISHING

DETAILS OF PROCEDURE – POLISHING

Figure 3.9 Polishing brush and cup in dental hand pieces

TECHNIQUE:

Chapter 4 Diagnostic techniques

REASON FOR PROCEDURE

BACKGROUND INFORMATION OF PROCEDURE – INSTRUMENTS

DETAILS OF PROCEDURE – INSTRUMENTS

Figure 4.1 Cavity in tooth

Figure 4.2 Diagnostic probes. (a) Right angle probe. (b) Briault probe. (c) Sickle probe. (d) Periodontal BPE probe

TECHNIQUE:

TECHNIQUE:

BACKGROUND INFORMATION OF PROCEDURE – DENTAL RADIOGRAPHS

Figure 4.3 BPE probe inserted in periodontal pocket

DETAILS OF PROCEDURE – DENTAL RADIOGRAPHS

Figure 4.4 Examples of intra-oral radiographic views. (a) Bitewings. (b) Periapical. (c) Upper occlusal

Figure 4.5 Dental pantomograph

Figure 4.6 Lateral skull view

TECHNIQUE:

Figure 4.7 Examples of film holders. (a) Bitewing holder. (b) Anterior periapical holder. (c) Posterior periapical holder

BACKGROUND INFORMATION OF PROCEDURE – STUDY MODELS

Figure 4.8 Film packet and holder in place ready for exposure

Figure 4.9 Patient positioned in DPT machine

Figure 4.10 Set of simple study models

DETAILS OF PROCEDURE – STUDY MODELS

Figure 4.11 Equipment and materials for taking a set of simple study models

TECHNIQUE:

Chapter 5 Tooth restoration with fillings

REASON FOR PROCEDURE

BACKGROUND INFORMATION OF PROCEDURE – AMALGAM FILLINGS

DETAILS OF PROCEDURE – AMALGAM FILLINGS

TECHNIQUE:

Figure 5.1 Instruments and materials for amalgam filling procedure. (a) Moisture control items. (b) Hand instruments. (c) Amalgam capsule, well and carrier

Figure 5.2 Completed amalgam filling

BACKGROUND INFORMATION OF PROCEDURE – COMPOSITE FILLINGS

DETAILS OF PROCEDURE – COMPOSITE FILLINGS

Figure 5.3 Rubber dam instruments. (a) Dam punch. (b) Dam clamp forceps, with clamp. (c) Dam frame. (d) Selection of other clamps

Figure 5.4 Equipment and materials for composite filling procedure. (a) Acid etchant. (b) Resin and applicator. (c) Composite material example. (d) Transparent matrix strip. (e) Finishing strip. (f) Articulating paper

TECHNIQUE:

Figure 5.5 Rubber dam in place on lower molar tooth

BACKGROUND INFORMATION OF PROCEDURE – GLASS IONOMER FILLINGS

Figure 5.6 Completed composite filling – old filling shown as new one is not easily visible

DETAILS OF PROCEDURE – GLASS IONOMER FILLINGS

TECHNIQUE:

Figure 5.7 Equipment and materials for glass ionomer filling procedure. (a) Conditioning liquid and applicator. (b) Powder and liquid filling material example. (c) Waxed pad, spatula, and measuring scoop. (d) Varnish and applicator

AFTERCARE OF FILLINGS

Figure 5.8 Completed glass ionomer filling on lower molar

Chapter 6 Tooth restoration with crowns, bridges, veneers or inlays

REASON FOR PROCEDURE – CROWNS

BACKGROUND INFORMATION OF PROCEDURE – CROWNS

DETAILS OF PROCEDURE – CROWNS

Figure 6.1 Equipment and materials for crown preparation procedure. (a) Elastomer based impression material example. (b) Selection of impression trays. (c) Temporary crown form example

TECHNIQUE:

Figure 6.2 Teeth prepared for crown procedure

Figure 6.3 Temporary crowns in place on the upper left incisors

Figure 6.4 Equipment and materials for crown cementation procedure. (a) Mixing pad and spatula. (b) Luting cement example. (c) Articulating paper

Figure 6.5 Cemented crowns

AFTERCARE OF CROWNS

BACKGROUND INFORMATION OF PROCEDURE – BRIDGES

DETAILS OF PROCEDURE – BRIDGES

TECHNIQUE:

AFTERCARE OF BRIDGES

Figure 6.6 Superfloss for cleaning beneath a bridge pontic

BACKGROUND INFORMATION OF PROCEDURE – VENEERS

DETAILS OF PROCEDURE – VENEERS

TECHNIQUE:

Figure 6.7 Tooth preparation for veneers

Figure 6.8 Equipment and materials for veneer cementation procedure. (a) Acid etchant. (b) Resin and applicator. (c) Veneer luting cement example. (d) Mixing pad and spatula

Figure 6.9 Cemented porcelain veneers

AFTERCARE OF VENEERS

REASON FOR PROCEDURE – INLAYS

BACKGROUND INFORMATION OF PROCEDURE – INLAYS

DETAILS OF PROCEDURE – INLAYS

TECHNIQUE:

AFTERCARE OF INLAYS

Figure 6.10 Inlay preparation with in-filled undercuts

Figure 6.11 Inlay cemented in tooth

Chapter 7 Tooth restoration with endodontic techniques

REASON FOR PROCEDURE

BACKGROUND INFORMATION OF PROCEDURE – PULP CAPPING

DETAILS OF PROCEDURE – PULP CAPPING

TECHNIQUE:

BACKGROUND INFORMATION OF PROCEDURE – PULPOTOMY

Figure 7.1 Illustration of pulp capping technique

DETAILS OF PROCEDURE – PULPOTOMY

TECHNIQUE:

BACKGROUND INFORMATION OF PROCEDURE – PULPECTOMY

Figure 7.2 ‘Gum boil’ appearance of a chronic infection

DETAILS OF PROCEDURE – PULPECTOMY

TECHNIQUE:

Figure 7.3 Equipment and materials for pulpectomy procedure. (a) Barbed broach and hand files. (b) Paper points. (c) Gutta percha points and finger spreader. (d) Irrigation syringe and needle. (e) Measuring ruler. (f) Sealing material example

AFTERCARE OF ROOT-TREATED TEETH

BACKGROUND INFORMATION OF PROCEDURE – APICECTOMY

DETAILS OF PROCEDURE – APICECTOMY

Figure 7.4 Examples of surgical instruments to carry out an apicectomy procedure. (a) Scalpel blade and handle. (b) Instruments to raise the tissue flap off the bone and remove infected soft tissue. (c) Micro-head with bur to prepare root cavity. (d) Suturing equipment

TECHNIQUE:

PATIENT AFTERCARE FOLLOWING MINOR ORAL SURGERY

Chapter 8 Tooth extraction

REASON FOR PROCEDURE

BACKGROUND INFORMATION OF PROCEDURE – SIMPLE EXTRACTIONS

DETAILS OF PROCEDURE – SIMPLE EXTRACTIONS

TECHNIQUE:

Figure 8.1 Examples of extraction forceps. (a) Upper anterior and premolar teeth/roots. (b) Upper molar teeth/roots. (c) Lower teeth and roots

Figure 8.2 Examples of other extraction instruments. (a) Luxator. (b) Elevators

Figure 8.3 Example of written post-operative instruction leaflet

PATIENT AFTERCARE FOLLOWING A SIMPLE EXTRACTION

BACKGROUND INFORMATION OF PROCEDURE – SURGICAL EXTRACTIONS

DETAILS OF PROCEDURE – SURGICAL EXTRACTIONS

TECHNIQUE:

PATIENT AFTERCARE FOLLOWING A SURGICAL EXTRACTION

Chapter 9 Tooth replacement with dentures

REASON FOR PROCEDURE

BACKGROUND INFORMATION OF PROCEDURE – ACRYLIC DENTURES

Figure 9.1 Examples of acrylic dentures. (a) Full upper denture. (b) Partial upper denture with clasp, on model

DETAILS OF PROCEDURE – ACRYLIC DENTURES

TECHNIQUE:

Figure 9.2 Second stage of denture construction. (a) Wax bite rims on models. (b) Special trays

BACKGROUND INFORMATION OF PROCEDURE – CHROME DENTURES

Figure 9.3 Equipment and materials for the bite recording stage. (a) Wax knife, carver and pink wax. (b) Bite gauge. (c) Heat source

Figure 9.4 Try-in stage of lower full denture

Figure 9.5 Equipment and materials for the fitting stage. (a) Straight hand piece and acrylic bur. (b) Articulating paper. (c) Pliers to adjust clasps

Figure 9.6 Example of chrome-cobalt partial denture on model

DETAILS OF PROCEDURE – CHROME DENTURES

TECHNIQUE:

Figure 9.7 Chrome and tooth try-in on model

BACKGROUND INFORMATION OF PROCEDURE – IMMEDIATE REPLACEMENT DENTURES

DETAILS OF PROCEDURE – IMMEDIATE REPLACEMENT DENTURES

TECHNIQUE:

AFTERCARE OF DENTURES

Figure 9.8 Examples of denture cleaning products

Chapter 10 Tooth replacement with implants

REASON FOR PROCEDURE

BACKGROUND INFORMATION OF PROCEDURE – SINGLE TOOTH IMPLANT

DETAILS OF PROCEDURE – SINGLE TOOTH IMPLANT

Figure 10.1 Example of implant kit

TECHNIQUE:

Figure 10.2 Personal protective equipment suitable for an implant procedure

Figure 10.3 Example of implant placement hand piece and irrigation system

Figure 10.4 Radiograph showing position of implant cylinder

Figure 10.5 Implant head in place

AFTERCARE OF IMPLANTS

Chapter 11 Tooth alignment with orthodontic appliances

REASON FOR PROCEDURE

BACKGROUND INFORMATION OF PROCEDURE – REMOVABLE APPLIANCES

Figure 11.1 Proclined incisors with damage evident to the left tooth

Figure 11.2 Examples of removable appliances

DETAILS OF PROCEDURE – REMOVABLE APPLIANCES

TECHNIQUE:

Figure 11.3 Removable appliance in the mouth

Figure 11.4 Activated spring on the right incisor

BACKGROUND INFORMATION OF PROCEDURE – CONVENTIONAL FIXED APPLIANCES

Figure 11.5 Conventional upper fixed appliance in place

DETAILS OF PROCEDURE – FIXED APPLIANCES

Figure 11.6 Components of a conventional fixed appliance

Figure 11.7 Examples of materials and instruments for fixed appliance procedures. (a) Acid etch and bonding material. (b) Bracket holders. (c) Elastic holders. (d) Archwire cutters

TECHNIQUE:

BACKGROUND INFORMATION OF PROCEDURE – SHORT-TERM COSMETIC FIXED APPLIANCES

DETAILS OF PROCEDURE – SHORT-TERM COSMETIC FIXED APPLIANCES

Figure 11.8 Prepared quadrant of short-term fixed appliance

TECHNIQUE:

Figure 11.9 Short-term cosmetic fixed appliance in place on model

BACKGROUND INFORMATION OF PROCEDURE – ALIGNERS

DETAILS OF PROCEDURE – ALIGNERS

AFTERCARE OF ORTHODONTIC BRACES

Figure 11.10 Orthodontic head for an electric toothbrush

Chapter 12 Tooth whitening

REASON FOR PROCEDURE

BACKGROUND INFORMATION OF PROCEDURE – HOME TRAY WHITENING

DETAILS OF PROCEDURE – HOME TRAY WHITENING

TECHNIQUE:

BACKGROUND INFORMATION OF PROCEDURE – POWER WHITENING

Figure 12.1 Home whitening tray on spaced model

DETAILS OF PROCEDURE – POWER WHITENING

TECHNIQUE:

Figure 12.2 Application of whitening agent into tray ‘well’

Figure 12.3 Soft tissue retraction and moisture control in place

Figure 12.4 Isolation of teeth before whitening

AFTERCARE OF WHITENED TEETH

Figure 12.5 ‘Zoom’ light in use

Figure 12.6 End result after power whitening of upper teeth

Figure 12.7 Examples of whitening oral healthcare products

Chapter 13 Extended duties of the dental nurse

Reason for Inclusion

BACKGROUND INFORMATION ON BASIC DUTIES

BACKGROUND INFORMATION ON EXTENDED DUTIES

FURTHER SKILLS IN ORAL HEALTH EDUCATION AND ORAL HEALTH PROMOTION

SIMPLE BRUSHING, FLOSSING AND INTERDENTAL CLEANING INSTRUCTIONS

Figure 13.1 Examples of aids and products for use during OHI session. (a) Demonstration model. (b) Disclosing tablets. (c) Tooth brushes. (d) Toothpastes

Tooth brushing

TECHNIQUE:

Figure 13.2 Dental nurse demonstrating child tooth brushing techniques

Flossing and interdental cleaning

TECHNIQUE:

DIET ADVICE

Figure 13.3 Interdental and interspace brushes

Figure 13.4 Interdental brush angled to aid use

ASSISTING IN THE TREATMENT OF PATIENTS WHO ARE UNDER CONSCIOUS SEDATION

Intravenous sedation

Figure 13.5 Example of items to set out for intravenous sedation. (a) Intravenous drug and antidote. (b) Selection of cannulas. (c) Syringe and needle to draw up agents. (d) Tourniquet and tape

Figure 13.6 (a) Example of a combined pulse oximeter and blood pressure machine (b) Dedicated blood pressure machine in use

Monitoring the patient during the procedure

Figure 13.7 Example of an intravenous sedation monitoring sheet

Inhalation sedation

Figure 13.8 Inhalation sedation machine in use with nasal hood in place

Pre-operative checks

Figure 13.9 Nitrous oxide tank, valve and gauge

Figure 13.10 Oxygen flush button

FURTHER SKILLS IN ASSISTING IN THE TREATMENT OF ORTHODONTIC PATIENTS

Laying out instruments and materials

Figure 13.11 Fixed appliance instruments. (a) Wire cutters. (b) Bracket removers. (c) Band removers

Setting up for a bonding procedure

Figure 13.12 Orientation card ready for upper bonding

Orthodontic oral hygiene instruction

Figure 13.13 Use of interdental brush to clean beneath the arch wire

Measurement and recording of plaque indices

METHOD 1:

METHOD 2:

TAKING IMPRESSIONS

Figure 13.14 Examples of plaque index recording methods. (a) Variation of standard periodontal chart. (b) Pre-printed dental arches

Selection of the trays

Mixing of the alginate and loading of the trays

Figure 13.15 Sizing of tray for impression taking. (a) Tray catching molar teeth – too narrow. (b) Correct tray size, just covering the dental arch

Figure 13.16 (a–e) Alginate mixing and tray loading

Insertion of the trays

Removal of the trays after setting

Monitoring and handling of the patient

Figure 13.17 Example of an upper alginate impression

CONSTRUCTING BLEACHING TRAYS

Figure 13.18 EVA tray material pack

Figure 13.19 Example of a vacuum tray machine

Figure 13.20 Machine loaded with model and tray material

Figure 13.21 Warmed EVA sheet ready for use

Figure 13.22 Bleaching tray trimmed and ready for use

INTRA- AND EXTRA-ORAL PHOTOGRAPHY

Figure 13.23 Digital camera and ring flash

Figure 13.24 Lip retractors and intra-oral mirror

Figure 13.25 Portrait view

Figure 13.26 Intra-oral view

REMOVING SUTURES

Figure 13.27 Examples of memory card readers and adapters

Figure 13.28 Suture removal instruments

Figure 13.29 Holding suture end taut while cutting through the loop

Post-operative advice