Hard tissue pathosis and detection of:

 

1) Overhangs

2) Open contacts

3) Defective restorations

4) Recurrent caries

5) Incipient caries

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  • Procedure codes PrevTX1 through PrevTX4 should be entered in your SOAP note for the exam
  • Preventive treatment should be entered in the Preparatory sequential treatment plan.
  • Preventive consult should be signed by the restorative instructor who gave you the restorative consult.

Restorative Cassette contain:

  • 21 instruments counting across the cassette

8 additional items:

  • amalgam carrier
  • Dycal (Birtle) spatula
  • hemostat
  • scissor
  • amalgam well
  • articulating paper forceps
  • tofflemire retainer
  • anesthetic syringe
  • stone

 

When you open a sterilized cassette, make sure that there are 21 instrumentsand that the additional eight items are present. It is at this time thatyou can return the cassette indicating that one of more items are missing,you’ll be given a new cassette and you wont be held responsible (charged). It is to your advantage to take a few seconds (literally) to check at the beginning of your appointment.


  • Do not expect the dentures to feel comfortable at first. The muscles tend to dislodge the dentures, but with experience these muscles can be trained to assist in keeping these dentures, especially the lower, in place. Do not form the habit of loosening the dentures with the tongue and lips. The lower denture is seldom equal to the upper either in ability to remain in place or to withstand biting pressure.
  • Soreness may develop at any time.
  • Wearers of artificial dentures must learn to eat and talk with them. Begin with soft foods and gradually learn to eat foods which are more difficult to chew. Cut you food into small pieces, and take small bites and chew slowly. Preferably, bite food off at the side of the mouth. The front teeth were not placed in the denture for biting food, but to restore appearance and phonetics.
  • Learning to talk with your denture requires practice and patience. Reading aloud in front of a mirror is a good way to learn to speak distinctly. Avoid movements of lips and tongue that tend to dislodge the dentures.
  • Cleanse the dentures several times a day. Procure a denture brush at any drugstore. Use denture cleaning pastes, one-half baking soda and one half salt, or ordinary soap as a cleanser. The dentures may be cleansed occasionally by soaking in a solution containing one teaspoon of Clorox and two teaspoons of Calgon in a half glass of water. Fill the basin over which the denture is being held and hold close to the water. If dropped, the water will break the fall.
  • We recommend removing the dentures during the sleeping hours, thus giving the mouth tissues a rest. They should be placed in a glass of water because warpage may occur if they dry out.
  • Dentures are artificial substitutes. Since your own teeth did not last, certainly you cannot expect these to be permanent. The patient who gives his dentures the care and upkeep which any mechanical device should have will receive maximum comfort and usefulness from them.

Young adults who have lost teeth due to caries or periodontal disease may have an increased risk of death from heart disease


Radiograph FAQ

06Sep07

    Frequently Asked Questions (FAQ)

  1. How do dental X-rays work?
  2. How often should radiographs be taken?
  3. What are the benefits of a dental radiograph examination?
  4. How do dental X-rays compare to other sources of radiation?
  5. What if I’m pregnant and need a dental radiograph examination?
  6. How do dental X-rays work?

    When X-rays pass through your mouth during a dental exam, more X-rays are absorbed by the denser parts (such as teeth and bone) than by soft tissues (such as cheeks and gums) before striking the film. This creates an image called a radiograph. Teeth appear lighter because fewer X-rays penetrate to reach the film. Tooth decay, infections and signs of gum disease, including changes in the bone and ligaments holding teeth in place, appear darker because of more X-ray penetration. Dental restorations (fillings, crowns) may appear lighter or darker, depending on the type of material used for the restoration. The interpretation of these radiographs allows the dentist to safely and accurately detect hidden abnormalities.

     

    How often should radiographs be taken?

    How often X-rays (radiographs) should be taken depends on the patient’s individual health needs. It is important to recognize that just as each patient is different form the next, so should the scheduling of X-ray exams be individualized for each patient. Your dentist will review your history, examine your mouth and then decide whether you need radiographs and what type. If you are a new patient, the dentist may recommend radiographs to determine the present status of the hidden areas of your mouth and to help analyze changes that may occur later. If you have had recent radiographs at your previous dentist, your new dentist may ask you to have the radiographs forwarded.

    The schedule for needing radiographs at recall visits varies according to your age, risk for disease and signs and symptoms. Recent films may be needed to detect new cavities, or to determine the status of gum disease or for evaluation of growth and development. Children may need X-rays more often than adults. This is because their teeth and jaws are still developing and because their teeth are more likely to be affected by tooth decay than those of adults.

  7. ADA, FDA Guide to Patient Selection for Dental Radiographs
  8. What are the benefits of a dental radiograph examination?

    Many diseases of the teeth and surrounding tissues cannot be seen when your dentist examines your mouth. An X-ray examination may reveal:

  9. small areas of decay between the teeth or below existing restorations (fillings);
  10. infections in the bone;
  11. periodontal (gum) disease;
  12. abscesses or cysts;
  13. developmental abnormalities;
  14. some types of tumors.
  15. Finding and treating dental problems at an early stage can save time, money and unnecessary discomfort. It can detect damage to oral structures not visible during a regular exam. If you have a hidden tumor, radiographs may even help save your life.

     

    How do dental X-rays compare to other sources of radiation?

    We are exposed to radiation every day from various sources, such as frequent airplane travel and high altitudes, minerals in the soil, and appliances in our homes (like smoke detectors and television screens).

    Source

    Estimated Exposure (mSV*)

    Dental radiographs x

    Bitewings (4 films)

    Full-mouth series (about 19 films)

     

    0.038

    0.150

    Medical radiographs x

    Lower GI series

    Upper GI series

    Chest

     

    4.060

    2.440

    0.080

    Average radiation from outer space In Denver, CO (per year)

    0.510

    Average radiation in the U.S. from Natural sources (per year)

    3.000

    Source: Adapted from Frederiksen NL. X-Rays: What is the Risk? Texas Dental Journal. 1995;112(2):68-72.

    *A millisievert (mSV) is a unit of measure that allows for some comparison between radiation sources that expose the entire body (such as natural background radiation) and those that only expose a portion of the body (such as radiographs).

     

    What if I’m pregnant and need a dental radiograph examination?

    A radiograph may be needed for dental treatment or a dental emergency that can’t wait until after the baby is born. Untreated dental infections can pose a risk to the fetus, and dental treatment may be necessary to maintain the health of the mother and child. Radiation from dental X-rays is extremely low. However, every precaution is taken to minimize radiation exposure. A leaded apron minimizes exposure to the abdomen and should be used when any dental radiograph is taken. A leaded thyroid collar can protect the thyroid from radiation, and should be used whenever possible. The use of a leaded thyroid collar is strongly recommended for women of childbearing age, pregnant women and children. Dental radiographs are not contraindicated if one is trying to become pregnant or is breast feeding.

     

     

    Taken from <http://ada.org/public/topics/xrays_faq.asp>

     


    RAP’s = Roentgen Area Product. Product of skin exposure (R) times exposure area (cm2). California Average Background Radiation per year = 1,836 RAP’s.

    Clinical exposure for Gendex 1000 UNIT set at 70 kVp, 15 mA using Precision Collimators for Periapicals using Bitewing Tabs for Bitewings, using Kodak Insight film.

    Use these numbers to update the patient’s Radiographic Exposure Record.

     

    ADULT PERIAPICALS

    Time in Impulses

    RAPs w/ Collimator

    RAPs w/o Collimator

    Incisors

    12

    1.2

    2.8

    Canine-Premolar

    15

    1.3

    3.2

    Molar

    18

    1.3

    3.8

    Occlusal

    21

    1.6

    3.8

     

    ADULT BITEWINGS

    Time in Impulses

    RAPs w/ Collimator

    RAPs w/o Collimator

    Premolar

    15

    3.2

    Molar

    18

    3.8

     

    EDENTULOUS PERAPICALS

    Time in Impulses

    RAPs w/ Collimator

    RAPs w/o Collimator

    Incisors

    12

    1.2

    2.8

    Canine-Premolar

    12

    1.2

    2.8

    Molar

    15

    1.3

    3.2

    Occlusal

    18

    3.8

     

    CHILDREN

    Time in Impulses

    RAPs w/ Collimator

    RAPs w/ Collimator

    Anterior

    12

    0.6

    2.8

    Posterior

    12

    0.6

    2.8

    Bitewing

    12

    0.6

    2.8

    Occlusal

    15

    0.7

    3.2

     

    MULTIPLE PROJECTIONS

    Time in Impulses

    RAPs w/ Collimator

    RAPs w/o Collimator

    ADULT 21 FILM SURVEY

    35.2

    67.