Dental students must be _____ and must act with _______ and _____ to instill confidence to their patients.
competent;firmness and ease
How do dental students be competent and act with firmness and ease?
1. Study the theories.
2. Study hard.
3. Practice the craft.
Two Important Factors to a Successful Dental Treatment
1. Patients cooperation with the dentist regarding medication and operation.
2. The need for the patient to have faith and confidence to himself in natures healing process and in building up positive thinking that he will get well.
Interprofessional Referrals
1. Physicians
2. Other dentists (Intraprofessional Referrals)
3. Medical Technologist
4. Pharmacist
5. Nurses
Professional Boundary Lines
1. Dentist must maintain a good image in the community. This will benefit the dental profession.
2. Good public relation does not only make relations towards your staffs, patients and other dentists. It also includes relations towards technical people necessary to maintain your clinic, such as electricians, plumbers, painters, etc.
3. Dentist must be knowledgeable in basic medical/biological science.
4. To be able to understand pathologic conditions
Main Clinical Dental Subjects
1. Operative/Restorative Dentistry
2. Prosthodontics
3. Orthodontics
4. Dental/Oral Surgery
5. Pedodontics
6. Periodontics
7. Dental Radiology/Roentgenology
8. Endodontics
General Considerations in Setting-up a Dental Office
1. Space
2. Location
Fundamental Compartments of an Ideal Dental Office
1. Reception Room (waiting area)
2. Operating Room (clinic)
3. Laboratory Area (for prosthetic, radiographic processing, restorative preparations, etc.)
4. Lavatory Facilities
Optional Compartments
1. Sterilizing Room
2. Business and Secretarial Office
3. Dark Room (X-ray room)
4. Recovery Room
5. Stock Room
Features of a Reception Room
1. Telephone, television, radio, Wi-Fi
2. Magazine, newspaper rack
3. Toilet facilities
4. Basic living room furniture
5. Proper interior decoration
6. Pieces of art
Features of the Operating Room
1. Dental Chair
2. Dental Unit
3. Sterilizer
4.Instruments
5. Restorative/Surgical Equipment
6. X-ray Apparatus
7. Diagnostic Equipment
Types of a Dental Chair
1. Portable Dental Chair
2. Stationary Dental Chair
Parts of the Dental Unit
1. Cuspidor/Spittoon
2. Electric Engine for Rotary Control
3. Saliva Ejector
4. Tumbler Holder
5. Tray
6. Air Syringe
7. Handpiece
8. Mouth Lamps w/ Mouth Mirror
9. X-ray Viewer (Negatoscope)
10. Gas burner
11. Water Syringe
12. Cautery
13. Pulp Tester
14. Pilot Light
X-ray Apparatus: diagnostic apparatus
X-ray machine
X-ray Apparatus: resistant to x-rays (bone, enamel)
Radiopaque
X-ray Apparatus: less resistance to x-rays, appears darker (soft tissues)
Radioluscent
Radiographic Films
1. Intra-oral Films
2. Extra-oral Films
Films placed inside the mouth about 1 inch more or less in length and width
Intra-oral Films
Types of intra-oral Films
1. Standard/Periapical films
2. Child-sized films
Intra-oral Films for routine radiography
Standard/Periapical films
Intra-oral Films for young patients
Child-sized films
Extra-oral Films
1. Placed outside the mouth
2. Useful for viewing large areas
3. Used for patients who cant open their mouths
4. Used for pictures of the temporomandibular joint, the tissue of the face and the skull
Types of Extra-oral X-rays
1. Panoramic X-rays
2. Cephalometric Projections
3. Computed Tomography
Covers 3D of the image
Cone Beam Computer Tomography (CBCT)
HYGIENE FOR THE CLINIC
1.Comfortable clean attire when treating his patient
2.Protect self, wear PPE (Personal Protective Equipment)
Prevention of cross-contamination
Infection control
Attire of a Dental Clinician (Dental Assistant)
1. Head cap
2. Disposable mask
3. Face-shield / eye protection
4. Gown (closed neck, tight cuff, below the knee and wide in diameter)
5. Flat comfortable shoes
6. Clean gloves / sterile gloves
Patients Attire
1. Head cap
2. Eye shield / dental protective glasses
3. Disposable bib
4. Gown
The process of eliminating all forms of microorganisms, both vegetative type and spores
Clinical Sterilization
Process that uses chemicals to destroy pathogenic microorganisms
Disinfection
Process that inhibits growth of bacteria
Bacteriostasis
Agent that can kill bacteria
Bactericidal
Substances that stop and prevent the growth of microorganisms
Antiseptic
Factors that determine whether or not infection would set in:
1. Susceptibility of the host
2. Virulence of the organism
3. Number of concentration of the organisms entering the body
4. The portal of entry
Methods that can destroy bacterial sterilization:
1.Physical
2.Chemical
Bacterial sterilization by temperature:
flame
hot air
steam under pressure
moist heat, boiling
Also called cold sterilization
Chemical
Is a method of sterilization that requires the reusable semi critical items to be immersed in EPA-approved liquid chemicals
Chemical
Chemicals that can be include in cold sterilization:
glutaraldehydes
paracetic acid
hydrogen peroxide-based solution
Glutaraldehyde, Phenols, Hydrogen Peroxide
Alcohols i.e. 70% ethyl alcohol
Gas
Physical Sterilants
Steam under pressure
Dry heat
Filtration
Ultraviolet Radiation
Ionizing Radiation
Gas Vapor Sterilants
Ethylene oxide
Formaldehyde Vapor
Plasma Gas
Hydrogen Peroxide
Chlorine Dioxide
Chemical Sterilants
Peracetic Acid - 0.2%
Glutaraldehyde (CIDEX) - 2%
Apparatus for sterilizing superheated steam under pressure. It is the preferred method of sterilization for destroying resistant sporeformers and fungus. May use 2-3 sheets of cotton or a sheet of thick paper to wrap bundles of instruments; may also use disposable sterile pack.
Autoclave
Small packs for oral surgery
30 min, 250F under 20lbs pressure
Dental Sterilizer (boiling)
Phenolic Compounds
Sporicidin
Dry heat Sterilizer
Glass-bead Sterilizer (instruments)
Ethylene Oxide
It means to kill most of microbial forms except some resistant organisms or bacterial spores
Disinfection
Categorization of disinfection:
High level sterilization
Intermediate level e.g. Amalgam Plugger
Low level
A substance or method used to kill microbes on surfaces
Disinfectants
PROs and CONs of Steam (moist) and dry heat
PROs: the most common methods for most materials
CONS: no good for heat sensitive, toxic or volatile chemicals
PROs and CONs when Filtration is removed
PRO: Remove bacteria and fungiform air solutions e.g. HEPA filters (high-efficiency particular air)
CONS: usable to remove viruses and some small bacteria microplasma
the most common gas vapor sterilant
Ethylene oxide
PROs and CONs of Plasma gas
PROs: hydrogen peroxide, reactive free radicals
no toxic byproducts
may replace many applications for ethylene oxide
CONS: not good for materials absorbing or reacting with H202
an oxidizing agent with good activity, end products nontoxic
Peracetic acid
not safe, can burn skin
Glutaraldehyde
Used for items involved in invasive procedures but not withstand sterilization e.g. Endoscopes, Surgical Equipments
High Level Disinfectants
High Level Disinfectants
Moist heat
Hydrogen peroxide
Formaldehyde
Chlorine Dioxide
Glutaraldehyde
Peracetic acid
Chlorine Compounds
Used for cleaning surfaces or instruments without bacterial spores and highly resilient organisms. E.g. Laryngoscopes, Anesthesia breathing circuits, etc.
Intermediate-Level Disinfectants
Intermediate-Level Disinfectants
Alcohol (ethyl, isopropyl)
Phenolic compounds
Iodophor compounds
Used to treat noncritical instruments and devices, not penetrating into mucosa surfaces or sterile tissues
Low-level Disinfectant
Low-level Disinfectant
Quaternary ammonium
Is the removal of dirt and debris; brushing and sweeping; (water, soap and detergent)
Cleansers
Cleansing agent, as water, soap or a soluble or liquid preparation (soapless) synthetic
Detergent
Made usually by action of alkaline fat or fatty acids (or the soap detergent emulsify)
Soap
Parts held by dentist during work in the patients mouth maybe sterilized w/ _____ every operation
70% alcohol
Handpieces and contra-angles should be _____ before sterilization of internal parts.
disassembled
Nontoxic antiseptics like triethylene glycol vapor can be used to disinfect the air. True or False.
True
Nontoxic antiseptics like triethylene glycol vapor cannot be used to disinfect the air. True or False.