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Dental Guide

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Your guide to the most common dental procedures.

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Guide published by United Citizen federation Medical Detachment, Dental Corps. [UCFMDDC]

 


This guide will provide the basics of dental nursing, the most basic procedures and uncover the different instruments for medical personnel to be able to perform check-ups while also providing insight to more advanced procedures if a patient were to require it. The guide will cover the following procedures :

  • Bonding

  • Extractions

  • Gum Surgery

  • Fillings and Repairs

  • Application of Dentures

  • Application of Crowns and Caps

  • Application and Removal of Braces

 

 


A Brief Guide on Dental Instruments.

 

The dental mirror:

The mouth mirror is a small mirror attached to a metal stick. The purpose of this instrument is  it allows the dentist to view places in the mouth that ordinarily would take an act of physical contortion to see. This makes it easier to find tooth decay or other potential oral problems that would otherwise go undetected. Second, it gives the dentist an easy way to move your tongue or push on the inside of your cheek without doing so with their hands.

 

Sickle Probe:

A sickle probe, also known as a dental explorer is beneficial in finding signs of cavities or periodontal (gum) disease. This instrument has a long handle with a sharp-looking hook on the end. This is primarily used to explore the pockets between teeth, while also scraping away tartar and plaque. If you have a visible cavity, the dentist may also use the sharp tip to investigate.

 

Scaler:

While a sickle probe is effective at removing small areas of plaque and tartar, scalers are more essential for the removal of a greater buildup. Most patients who require scaling have more significant issues with periodontal disease.

 

Saliva Ejector or Suction Device:

When a dentist is exploring your mouth, they often need a dry surface. A suction device is a long tube attached to a vacuum that removes saliva and water from your mouth. You may hear some vacuum sounds and feel the ejector stick to your cheek or tongue, but it’s nothing that should startle you. It can also be used to remove parts of your teeth if a drill is use.

 

Dental Drill:

The dental drill is the most effective way to remove tooth decay before filling a cavity. This electric drill spins at over 250,000 rpm while shooting water into your mouth. If the drill didn’t administer water, it would get hot enough to damage the tooth. While the dental drill can feel uncomfortable because of vibrations on your teeth, it’s usually not painful when you receive a local anaesthetic.

 

Dental Syringe:

The dental syringe is what delivers the numbing blow to your mouth. They’re a bit longer than a typical needle or syringe so the dentist can hit the correct spot when administering the anaesthetic [Lidocaine]. As with a shot, the initial injection may cause discomfort for a moment, but this is quickly numbed by the anaesthetic

 

Molds:

The molds small frames filled with a soft substance and are placed in your mouth. When you bite down, it provides a perfect mold of your teeth. The molding material doesn’t taste great, but it’s nothing you can’t tolerate for a few seconds.

 

Dental X-ray:

The X-rays show the whole tooth from the crown, to beyond the root where the tooth attaches into the jaw. The x-rays detect any unusual changes in the root and surrounding bone structures. It will detect decay between teeth and changes in the thickness of bone caused by gum disease. It can also see any wear or breakdown of dental fillings. REMINDER don’t forget to wrap a lead neck brace around the patient’s neck for protection against radiation.



 

 


 

The Most Common Dental Procedures.

Bonding:

Bonding is one of the cheapest and simplest cosmetic dental procedures. The procedure uses a resin that is applied to the tooth, shaped and then hardened. The procedure is used for discolored teeth, chipped teeth, to close spaces or gaps between teeth and lengthen teeth. The procedure goes as the following:

  1. A shade guide is used to select the correct colour matching the other teeth.

  2. Then the dentist will then etch and roughen the tooth, this requires no anesthetic as it’s painless.

  3. The tooth is then covered in a conditioning liquid to help the bonding procedure.

  4. Finally the resin is applied to the tooth and shaped using a sickle probe and a scaler.

  5. To fully harden the resin a bright light is used.

  6. After the hardening process some more trimming and shaping may be done to ensure the tooth is shaped correctly.

 

Extractions:

A dental extraction or tooth pulling as it’s more commonly referred to is one of the more advanced dental procedures as it’s only used if a tooth has become unrestorable through tooth decay, periodontal disease or dental trauma. A patient with condition most commonly experiences ‘toothache’. The procedure can also be used to create space if an ‘extra’ tooth has grown or if a tooth has gotten stuck and refuses slot out of place. The procedure goes as the following:

  1. The area around the tooth is cleaned with fresh water and a cleaning solution.

  2. A suction unit is then placed shortly afterwards to suck up water and any saliva that may form throughout the procedure. Most of the time this requires a orderlie’ to keep the suction unit in place and from sticking to the cheek or tongue.

  3. Then a local anesthetic is applied (Lidocaine) to surrounding bone and gum tissues through a syringe, the anesthetic is applied to the area around the tooth and depending on where it’s located it may also require the cheek or vestibule respectively the hard palate.

  4. The dentist will then use a dental mirror and cut away some gum and bone tissue that cover the tooth and then, using forceps, grasp the tooth and gently rock it back and forth to loosen it from the jaw bone and ligaments. This however is only used for hard-to-pull teeth. Most commonly a set of dental pliers is used and the tooth is pulled out with relative ease.

  5. After the tooth is pulled the ‘hole’ will be flushed with some water and then examined for any infection and then a bone grafting resin may be injected into the hole to prevent the hole to shrink this will also make sure that a dental implant may be placed in that spot.

  6. Near the end of the procedure the hole or now tooth implant is sutured in place and then a small gauze piece is applied to the area to soak up any minor bleeding the coming hour.

Beware:

The patient is to floss and brush their teeth twice a day like normally but to take extra care around the new implant or sutatured hole. The patient is also to stay away from mouthwash and alcohol as this can irritate and cause pain.  



 

Gum Surgery:

Gum surgery is one of the most uncommon procedures due to the fact that antibiotics are used to clear infection and gum surgery is done when excessive bacteria builds up in your mouth and creates excess plaque and your body is unable to fight the infection thus a serious case of gum disease has formed.

The procedure goes as the following:

  1. The patient is put under the effect of anesthesia and an oderlie along with the dental surgeon begin giving the gum and teeth a ‘deep clean’.

  2. A suction unit is placed to suck up saliva and prevent liquids from disturbing the procedure as well as pick up any pieces of bacteria or infected tissue that may come loose.

  3. The surgeon will then remove infected tissue and damaged teeth with what the surgeon sees fit.

  4. The infected tissue is cleaned once more before stitching the gums into place as the tissue tends to ‘retract’ once it’s been infected.

  5. - In case of the bone that surrounds the root of the tooth is damaged or destroyed, a person may need a bone graft to the point which the surgeon will cut into the tissue and replace the bone with a manufactured bone. The point of this is for the teeth to regain their original state and posistion.

  6. - Guided tissue regeneration may also be needed if the bone is exposed, the procedure prevents the gum from growing into space where bone should be, allowing the bone and connective tissue to regrow. It uses a small piece of mesh-like material between a person's bone and gum tissue that the dental surgeon may place if he/she sees fit.

  7. - Tissue grafting is also a possibility for when the gum line has receded. The dental surgeon will then typically remove tissue from one part of the body and re-attaches it to the area where the gum has receded. The tissue often comes from the roof of the mouth.

 

Fillings and Repairs:

The most common and simple dental procedure is applying a filling and repairing one once it’s broken down after a few years of wear. The procedure is performed once a tooth damaged by decay and it’s to bring the tooth back to its normal function and shape. The dentist will clean the affected area, and then fill the cleaned out cavity with a filling material that may consist of gold, Amalgam, a Composite resin or Porcelain. The most common material is a plastic composite resin though the others can be used of the patient provides a reason for it or wishes to pay extra as the other fillings are not cheap.

The procedure goes as the following:

  1. The mouth is cleaned and a suction unit is placed.

  2. The dentist will administer a local anesthesia to the gum around the tooth and if need be the cheek and roof of the mouth.

  3. The dentist will then use a dental mirror along with a drill to clean and remove any plaque and tooth decay.

  4. Then the tooth is flushed with water and the suction unit is used to suck up any pieces of tooth and saliva/water mixture.

  5. Afterwards the filling is put into place and shaped correctly, a spray may be used to harden the resin faster and the dental drill along with the sickle probe will be used to shape the filling for the tooth to form its original shape and state.


 

Application of Dentures:

The Denture is a simple but useful set of ‘fake teeth’ that come in two variations. ‘Complete and partial dentures’. The complete ones are a set of two full rows of fake teeth and the partial ones are dentures for when you still have some of your original teeth left. The dentures don’t require any form of procedure other than making sure to find the right fit of ‘fake teeth’ and also making sure the gum is fully healed after a surgery procedure has been done.

 

Application of Crowns and Caps:

A dental crown is a tooth-shaped "cap" that is placed over a tooth -- to cover the tooth to restore its shape and size, strength, and improve its appearance. The procedure is done when a small part of a tooth has been ‘cracked’ or a chunk of it has decayed. The tooth is then treated like a normal filling procedure but instead of ‘cleaning’ the local area the entire tooth is shaped to fit a ‘crown’ that acts like a hard shell that slides over the tooth core and protects it.  

 

Application and removal of braces:

Another common procedure is getting braces, the braces are used whenever a patient is suffering from crooked or crowded teeth to the point where it’s causing pain. The dentist or orthodontist will then apply plastic white squares to the teeth and held in place by a resin. After the squares are placed a small wire is threaded through the square and small plastic rings are placed over the wire and stuck to the squares to keep it all in place and under the right amount of tension. The patient will then be called regularly for check ups to either straighten the braces or increase/decrease the tension. The braces will be removed after 1-2 years depending on the condition of the patient’s teeth.





 

For more advanced dental surgery speak to your Senior Medical Staff.

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