Hand washing technique 0. Wet hands with a water 1. Apply enough soap to cover all surfaces 2. Rub hands palm to palm 3. Rub back of each hand with the palm of other hand with fingers interlaced 4. Rub palm to palm with fingers interlaced 5. Rub with backs of fingers to oposing palms with fingers interlocked 6. Rub each thumb clasped in opposite hand using rotation movement 7. Rub tips of fingers in opposite palm in a circular motion 8. Rub each wrist with opposite hand 9. Rinse hands with water 10. Use elbow to turn off the tap 11. Dry thoroughly with single use towel 12. Your hands are now safe Hand rubbing technique 1. Apply a small amount of the product in a cupped hand, covering all surfaces 2. Rub hands palm to palm 3. Rub back of each hand with the palm of other hand with fingers interlaced 4. Rub palm to palm with fingers interlaced 5. Rub with backs of fingers to oposing palms with fingers interlocked 6. Once dry your hands are safe Manual toothbrushing technique Two Minutes, Twice a Day To brush your teeth correctly, spend at least two minutes using a recommended brushing technique, which includes 30 seconds brushing each section of your mouth (upper right, upper left, lower right and lower left), both morning and night. Since most manual toothbrushes don't have built-in two-minute timers, you may want to have a clock handy so you can be sure you're brushing long enough. Step 1: Start with outer and inner surfaces, and brush at a 45-degree angle in short, halftooth-wide strokes against the gum line. Make sure you reach your back teeth. Step 2: Move on to chewing surfaces. Hold the brush flat and brush back and forth along these surfaces. Step 3: Once you get to the inside surfaces of your front teeth, tilt the brush vertically and use gentle up-and-down strokes with the tip of brush. Step 4: Be sure to brush gently along the gum line. Step 5: Brush your tongue in a back-to-front sweeping motion to remove food particles and help remove odor-causing bacteria to freshen your breath. Proper Flossing Technique Use about 18 inches of floss, so you have a clean piece of floss to use on each tooth in the cleaning process. Curve the floss into a C-shape as you slide it up and down along the side of each tooth. Don’t forget to floss the back sides of your back teeth on both the left and right of the upper and lower teeth. Post-operative instructions ( Extraction ) 1. No rinsing of the mouth for about 24 hours as this could disturb the clot and cause bleeding from the socket 2. Do not eat or drink for two hours 3. No alcohol as this raises the blood pressure and may promote bleeding 4. Avoid smoking for at least 48 hours as this may cause an acute infection of the bone socket known as dry socket 5. No exercise or operating heavy machinery as again it promotes bleeding 6. No hot cups of drink for the day. However, gentle hot saltwater rinsing the following day is advised 7. Some pain & discomfort is possible after the local anaesthetic wear off. Take some painkillers to reduce the discomfort associated with post-operative pain. Avoid Aspirin as it is an anticoagulant and may encourage bleeding Paracetamol 1 g four times a day or if stronger pain relief it can be combined with Ibuprofen 400 mg three times a day (so long as there is nothing in the patient’s medical history, such as asthma or peptic/gastric ulceration to contraindicate it) 8. If your socket starts bleeding for whatever reason, a gauze pack is provided for inside the extraction pack for you with to bite on for 10-15 minutes to form a new clot & control the bleeding If bleeding cannot be controlled by biting on the gauze for 15 minutes, then they should contact the surgery If you can’t contact the surgery call to Emergency Department 9. Advise the patient on oral hygiene for the next few days. Warm, salty mouthwashes (put a teaspoon of salt in a glass of warm water) are ideal for keeping the socket clean and aiding healing. These should not be started until 6 hours after the procedure for fear of dislodging the clot 10. Some degree of swelling and limited mouth-opening is normal and should resolve in a few days Advantages & Disadvantages of the Composite material Advantages Disadvantages Excellent aesthetics with a wide range of shade choice Adhesive to tooth, using acid etch and bond Little marginal leakage occurs, due to their adhesion to enamel Sufficient strength in smaller posterior restorations Usually only require lining of calcium hydroxide Indirect inlay technique possible for larger restorations Fast set with curing light Technique sensitive Longer procedure than for amalgam restoration More expensive material than amalgam Not as strong and hard-wearing as amalgam in posterior teeth Possible safety issue with resin bond Can only use glass ionomer as a base, as composites react with other bases Acid etchant can burn soft tissues if used carelessly Available in premixed compoules Safety issue with curing light causing for easy insertion into cavity eye damage; orange-tinted safety shield must always be used DIETARY ADVICE Every time you eat or drink anything sugary, the teeth are under acid attack for up to one hour. This is because the sugar will react with the bacteria in plaque (the sticky coating on the teeth) and produce the harmful acids. So it is important to follow these recommendations: All sugars can cause decay. Sugar comes in many forms such as sucrose, fructose and glucose. These sugars can all damage the teeth. Many processed foods have sugar in them. Fizzy drinks can increase the risk of dental problems. The sugar can cause decay and the acid in both normal and diet drinks can dissolve the enamel of the teeth. The risk is higher when these drinks are taken between meals Acidic foods and drinks can be just as harmful to the teeth as acid erodes the enamel, exposing the dentine underneath which can make the teeth sensitive and unsightly.Fruit does contain acid which can erode the teeth. However it is only damaging to the teeth if an unusually large amount is eaten A diet that is rich in vitamins, minerals and fresh produce can help to prevent gum disease. Gum disease can lead to tooth loss and cause bad breath Increase the amounts of fresh fruit and vegetable eaten. Try to limit dried fruit as it is high in sugar and can stick to the teeth If you snack, savoury snacks are better such as: - Cheese - Raw vegetables - Nuts Chewing gum and cheese will stimulate saliva flow and may help after eating sugary snacks. Although chewing gum may not be appropriate for young children. It is better for the teeth if you eat three meals a day instead of having 7-10 snack attacks. The main point to remember is that it is not the amount of sugar you eat or drink, but how often you do it. Sweet foods are allowed, but it is important to keep them to mealtimes. Fissure sealant Fissures - grooves or crevices located on the chewing surfaces of the back teeth POSSIBLE BENEFITS Dental sealants are thin plastic coatings that are applied to the grooves on the chewing surfaces of the back teeth to protect them from tooth decay Most tooth decay in children and teens occurs on these surfaces. Sealants protect the chewing surfaces from tooth decay by keeping germs and food particles out of these grooves. It is used only for permanent teeth Permanent molars are the most likely to benefit from sealants. The first molars usually come into the mouth when a child is about 6 years old. It is best if the sealant is applied soon after the teeth have erupted, before they have a chance to decay. The greatest risk of caries in molars appear to be 2-4 years after eruption, but the pit and fissures remain susceptible to caries into adolescence and beyond Teeth should be sealed as soon as possible after eruption Fluoride will help reduce caries on smooth surfaces but has little effect on pit and fissure caries; covering these stagnation points with a sealant can prevent caries developing7 PROCEDURE a. Applying sealants does not require injections, drilling or removing tooth structure. The process is short and easy. b. After the tooth is cleaned, a special gel is placed on the chewing surface for a few seconds (30-60 secs) c. The tooth is then washed off and dried. d. Then, the sealant is painted on the tooth. The dentist or dental nurse may shine a light on the tooth for about 20-40 seconds to help harden the sealant. FURTHER DISCUSSION Sealants can only be seen up close. Sealants can be clear, white, or slightly tinted, and usually are not seen when a child talks or smiles. As with anything new that is placed in the mouth, a child may feel the sealant with the tongue. Sealants, however, are very thin and only fill the pits and grooves of molar teeth. A sealant can last for as long as 5 to 10 years. Sealants should be checked at each regular dental appointment and can be reapplied if they are no longer in place. About 60% of surfaces treated remain covered after 5-6 years Sealants need to be checked after placement as the probability of loss of the sealant is highest so on after placement Dentures Advice WHAT CAN YOU EXPECT WHEN YOU START WEARING DENTURES? The dentures may feel large in the mouth Your lips may feel like they’re being pushed forward You may experience a gag reaction You may experience an increased amount of saliva The denture may feel loose while your mouth muscles adapt to holding it in place. Your mouth will soon become accustomed to holding your dentures Pain & soreness sometimes occur with new dentures. Adjustments may be required. WILL DENTURES AFFECT SPEECH? Practice speaking by reading aloud in front of a mirror Prior to speaking, bite down & swallow to “set” the dentures in place With a little practice, speech returns to normal WILL DENTURES AFFECT EATING? Eating may be difficult at first Take care with hot & cold foods while you adapt to your new dentures Avoid hard, tough or sticky foods over the learning period Cut your food into small pieces & take your time chewing. Start by eating soft foods that are easy to chew & swallow Take small bites & chew slowly & evenly on both sides of your mouth Patience is the key to new dentures – it will take some time but you will soon get used to them SHALL I USE DENTURE FIXATIVES? Denture fixatives make denture wearers more confident in social situations Denture fixatives make dentures feel more comfortable Denture fixatives make chewing food easier & requires fewer bites to eat meals Denture fixatives make less food trapped under the dentures Denture fixatives make breath stays fresher longer HOW TO CLEAN THE DENTURES? Remove your dentures and clean them after a meal over a bowl of water in case the denture drops from the grip of the hand whilst cleaning The outer surfaces as well as the inner surfaces of the denture (the palate) should be brushed thoroughly to prevent any fungal infection developing on the roof of the mouth. Use soft-brush (denture brush) with soap & cold water for the denture. Using a toothpaste for cleaning can abrade the denture surface Alternatively, a proprietary denture cleaner may be used, following the manufacturer’s instructions Use toothpaste for brushing the remaining natural teeth ANY OTHER ADVICE? Remove your dentures at night to allow the soft tissues to relax and store it in water to prevent them from drying out If the dentures are painful, leave the dentures out & arrange an appointment with your dentist as soon as possible. Wear the dentures the day you return to the dentist so that the sore area may be seen and the dentures adjusted accordingly. Offer the patient some leaflets for some written information on how they would take care of their new dentures Epilepsy 1. check for any dangers around the area 2. remove the cardigan and use it to support the head while undergoing a fit, remove the patient's eyeglasses,remove the rucksack 3. cover the patient with a blanket 4. time the fit (use the clock on the table) 5. when the patient recovers, put them in recovery position 6. tell them what happened and constantly reassure them 7. patient will decide to stand up as they feel much better assist / support them gently while they stand and advise them to sit on the chair for a few minutes 8.ask patient if you can call somebody from their home to collect them 9.tell patient appointment needs to be rebooked
