Practical Examination of ADC

Practical Examination of ADC is the third and final stage of ADC assessment process. The candidates get a chance to demonstrate that they are competent to practice safely as a dentist in Australia. Practical Examination assesses candidates across the range of the entry level competencies of the newly qualified dentist.

We, at the Academy of Dental Knowledge provide complete training for the practical examination.  For detail mail us to support@dentalknowledge.in

Written Examination of ADC

The written examination of ADC for dentist is a computer based examination.  It evaluates candidate’s knowledge of the science and practice of dentistry, and assesses application of clinical judgement and reasoning skills relevant to dental practice in Australia.

The written examination is conducted over 2 days by Pearson VUE.  It consists of four papers, each containing 80 scenario based and single answer multiple choice questions.  The examination is held in multiple locations in Australia and overseas.

For preparation of written examination we are here to help you.  Write us at support@ dentalknowledge.in

Initial assessment

If you're reading this article, it is sure that you are a dentist with a dental degree of non-Australian origin and you are willing to register yourself in the Dental Board of Australia to practice dentistry in Australia.  To register yourself in the dental Board of Australia, the first step of the three steps is the initial assessment of your documents by Australian Dental Council.

In the initial assessment process the following documents will be assessed by ADC:

  1. Your professional qualification (bachelor degree)
  2. Your work experience
  3. Details of your dental registration or all registrations if you had/have registration in various countries.
  4. Good standing stated by registering authority

You are eligible for initial assessment by Australian Dental Council, if you have a dental degree of your own country or any country which is recognized by the Australian Dental Council.

As a dentist, you can get assessed by ADC at any time of year by submitting an Initial assessment of professional qualification application form.

Once the application form and supporting documents have been received, you will be assigned an ADC candidate reference number. This number should always be used when you contact the ADC.

For initial assessment, we are here to help you.  Write us at

support@dentalknowledge.in

Fluoride Therapy

Fluoride therapy is widely used to prevent dental caries. Evidence have shown that a constantly maintained low level of fluoride in oral environment is most effective in caries prevention against the earlier popular belief of being it most beneficial against caries during pre-eruptive forming enamel.

Dietary Fluoride supplementation Schedule

American academy of Paediatric Dentistry & American Dental Associations Council on Dental Therapeutics recommend the following regimen for fluoride supplement for an individual having insufficient daily fluoride intake:

Age

Less than 0.3 ppm F 0.3-0.6 ppm F More than 0.6 ppm F

Birth- 6 mos

0

0

0

6 months-3 yrs.

0.25 mg

0

0

3 yrs.-6 yrs.

0.5 mg

0.25 mg

0

6 yrs. to at least 16 yrs. 1.0 mg 0.5 mg

0

Evaluate fluoride exposer before prescribing fluoride therapy. Document the patient’s fluoride exposer in the record and review at periodic visits. Have a water analysis done prior to issuing supplemental fluoride.

Point of use, water conditioning (filtration system significantly reduce fluoride content. Activated carbon filters reduce fluoride concentration by 81%. Bottled water can have variable fluoride concentrations.

Preschool children require supervision during tooth brushing. No more than a pea size amount of tooth paste should be used, avoid swallowing of the pastes & rinse after brushing.

Fluoride mouth rinses containing 0.05% or 0.2% should not be used by children under the age of six years or those who are unable to adequately expectorate.

Supervise professionally applied topical fluoride treatments. Use 5-10 ml of fluoride gel in well fitting brays, ham the patient lean forward in the dental chair, admonish not to swallow, and use a saliva ejector positioned between trays.

Fluoride Toxicity:

Chronic Toxicity (results in fluorosis)

Dean’s Classification 0-4 scale

  • 0-none
  • 1-very mild
  • 2-mild
  • 3-moderate
  • 4-severe
  • 59% of population at optimal population level will exhibit no flourosis
  • Very mild 7.4 % of population at optimal dose.
  • (mild) greater than 25%, less than 50% of surface with opaque defect (greater than 1.2 ppm)
  • (Moderate) brown stains present (greater than 2 ppm).
  • (Severe) pitting and attrition problems (greater them 2-3 ppm)

Flourosis occurs during maturation process. For incisors, age 2-3 yrs is the critical period.

Acute Toxicity

CLD (certain lethal dose 32-64 mg/kg body wt in one source,71-140 mf/kg in another source. A death has been reported at 17 mg/kg.

PTD (Probable Toxic Dose) 5mg/kg i.e.50 mg for a 10 kg 2 yrs old.

STD (Safely Tolerated Dose) 8-16 mg/kg

Toxicity at low doses is due to gastric irritation.

Hypocalcaemia and hyperkalemia at high doses leads to cardiovascular collapse and death.

Treatment of Overdose

  • Less than 5 mg/kg-oral calcium (milk) and observe
  • More than 5 mg but less than 15 mg/kg- induce vomiting, oral calcium (milk, calcium gluconate, calcium lactate, admit to hospital
  • More than 15 mg/kg- admit to hospital immediately, induce vomiting, monitor cardiac function, 10% calcium gluconate solution IV and monitor electrolytes.

COMMON SIGNS AND SYMPTOMS OF ACUTE FLUORIDE TOXICITY

LOW DOSES

  1. Nausea
  2. Vomiting
  3. Hyper salivation
  4. Abdominal pain
  5. Diarrhoea

HIGH DOSES

3-C’s

  1. Convulsions
  2. Cardiac arrhythemia
  3. Comatose
  • Patients become hypocalcaemic due to Ca binding with fluoride.

Calculating mg Fluoride in Compound

Ist step: Find % F in compound

Name Molecular weight ratio
APF

1

NaF

1/2.2 or 1/2

SnF2

1/4.1 or 1/4

MFP-sodium Mono fluoro Phosphate

1/7.6 or 1/8

Multiply % compound by molecular weight ratio= % F

 

2nd Step: Express % Fluoride in compound in mg F/ml

By definition % solution is gram/100 ml.

Gram/100 ml=1000mg/100 ml=10 mg/ml

Multiply step 1 by 10 = mgF/ml

3rd Step: Multiply step 2 by ml ingested to get mg F ingested

  •  23% APF x 1 = 1.23% F x 10 = 12.3 mg F / ml
  • 2% NaF x 1/2 = 0.1 x10 = 1 mg F / ml
  • 2% NaF x 1/2 = 1 x 10 =10 mg F / ml
  • 4 % SnF2 x ¼ = 0.1 x 10 mg = 1 mg F / ml
  • 10% SnF2 x 1/4 = 2.5% x 10 =25 mg F / ml

Compare with CLD and STD for weight of individual

 WATER FLUORIDATION

Decrease in caries activity

  • Primary-40%
  • Secondary- 50-60%

MECHANISM OF ACTION OF FLUORIDE

  • Decreases enamel solubility.
  • Improves enamel crystalinity.
  • Promotes re mineralisation.
  • Decreases free surface energy of bacteria so it cannot stick on tooth.
  • Bactericidal or bacteriostatic
  • Causes developing crystal to get bigger and less soluble

FLUORIDE PROTOCOL

  • Home use in trays, topical
  • H2O supply
  • Systemic also topical when chewing tablets
  • High frequency low dose is effective

SEALANTS:

  • Efficacy due to physical obstruction of pit & fissures.
  • May be used over sites with incipient and active caries.
  • Effective for primary teeth.
  • Fluoride releasing sealants.
  • Sealant failures occur during first year, check closely and repair.
  • Dentin bonding agent improves sealant bond wet environment.
  • Timing: Increase failure (54%) with occlusal gingival tags.

Fluoride mouth rinses

Reduce caries by 20-50 %. Weekly 0.2% NaF and daily 0.05% NaF rinses were considered to be ideal public health measure.

Daily rinses

  • 0.02% acidulated phosphated fluoride.
  • NaF (100 ppm).
  • Partly acidulated solution of 0.04% NaF (200 ppm).

Weekly or fortnightly rinses

  • 0.2% NaF (1000 ppm).

Indications :

  • Patients who are undergoing orthodontics treatment.
  • Post-irradiation xerostomia Sufferers.
  • Children unable to perform adequate tooth brushing.

Contraindications:

  • Non recommended for preschool aged children.

Fluoride varnishes:

  • Reduction in caries rate-30 %

Indications:

  • Hypersensitive areas.
  • Newly erupted tooth.
  • Arresting early caries.

Duraphat

  • is an alcoholic solution of natural varnishes.
  • contains 50 mg NaF/ml (2.5%=25000 ppm F)

Fluor Protector

  • A silane fluoride varnish in a poly polyurathane lacquer.
  • Contains lower concentration of fluoride 0.8%.

With such highly concentrated fluoride products, great care must be taken to avoid overuse & ingestion. They should not be used before the eruption of permanent incisors.

Prophylaxis:

  • before fluoride application is not usually needed.
  • may acts as reservoir of fluoride.

Concentrated fluoride gels and solutions:

APF (Acidulated Phosphate Fluorides – 1.23 % F ie 12,300 ppm F

  • AFP gels are mainly used for the prevention of caries development.
  • Used for professional application.
  • Has a mixture of NaF, HF and orthophosphate acid.
  • Should be limited for professional use.
  • Should not be dispensed for home use.
  • Incorporation of a water soluble polymer i.e. Sodium carboxymethyl cellulose into APF produces a viscous solution that improves the ease of application using custom made trays.
  • Thixotropic gels in tray flow under pressure, so facilitating the penetration of the gel between teeth.

Neutral NaF 2.2%

  • Preferred in cases of erosion, exposed dentin ‘Calais dentin Or where very porous enamel exist.
  • Chemically very Stable, has an acceptable taste, nonirritating to the gingival docs not discolors teeth, composite or porcelain restorations as APF or stannous fluoride may.

Stannous fluoride Sn F2

  • 10%.Sn F2 is used to target local at risk surfaces of teeth such as deep fissures & pits.
  • Rapid penetration of tin and fluoride into enamel and the formation of a highly insoluble tin-fluorophosphates complex coating on the enamel are the main mechanisms of its action.
  • Often produces discoloration of teeth and staining on margins of restorations-particularly in hypocalcified areas.
  • 0.4% SF2 get in a methylcellulose and glycerin base has proved effective in arresting root caries. It has been incorporated into a synthetic Saliva solution to reduce caries in post-irradiation cancer patient.

Systemic fluorides

  • Fluoride supplement (tablets & drops have limited application as a public health measure but may be of benefit to individuals with a high caries brisk.
  • Beneficial in non-fluoridated communities. Benefit is small.
  • Overzealous use –Fluorosis.
  • Fluoride tablets should be chewed rather than swallowed-both topical & systemic benefit.
  • In the Period between 2-3 years maxillary incisor teeth are most susceptible to fluorosis.

Daily F supplement doses schedule for persons concerned at particularly high caries risk

 

Age interval

F level in water <0.3 mg/L

F level in water 0.3-0.5 mg/L

6 monthts-4 yrs.

0.25 mg

0

4-8 yrs.

0.5 mg

0.25 mg

> 8 yrs.

1.0 mg

0.5 mg

*All supplement should be formulated as lozenges,

*A person whose daily dose is 0.5 mg should consume 0.25 mg tablet two times daily.

Take the Mock Test 15: Fluoride Therapy by clicking HERE.

 

Nine reason you should not go for implant supported prosthesis

Implant supported prostheses include over-dentures, crowns and bridges. These are the treatment of choice in modern dentistry. They are very predictable in nature and have a track record of very successful life span serving their purpose. But, there are certain conditions where the dental implants cannot be provided due to the inherent nature of the disease. The implant supported prostheses are contraindicated in the following conditions:

  1. Immune disorders (leukemia)
  2. Cancer
  3. Disorders of coagulation (anticoagulants, liver cirrhosis, thrombocytopenia, tendency to hemorrhage)
  4. Rheumatoid disease (steroid medication)
  5. Unstable endocrine disorders
  6. Chemotherapy (i.e. bisphosphonates) and radiotherapy within the last 5 years
  7. Patients under 16 years old (incomplete development of bones)
  8. Psychosis
  9. Pregnancy

    It's not that the implant will fail in these patients, but their physiology, especially bone physiology gets changed; therefore, these patients do not get the full advantage of the implant supported prostheses.

    So, it would be wise to provide them the other type of prosthesis, unless they have been treated and have a stable condition.

    Article written by Dr. Ajai Singh.

Books for ADC Examination

e books

The following is a list of books, read by a successfully passed out ADC candidate. 

Anatomy

  1. SICHER and DuBRULS ORAL ANATOMY by E. LLOYED DuBRUL 8th Ed

Oral Pathology

  1. Burket’s Oral Medicine Diagnosis & Treatment Tenth Edition
  2. Regezi: Oral Pathology: Clinical Pathologic Correlations, 4th ed.
  3. Color Guide Oral Pathology, R. A. Cawson & E. W. Odel.
  4. Slide Interpretation in Oral diseases Chrispian Scully
  5. Colour Atlas of Oral Diseases in Children and Adolescence, Crispian Scully & Richard Welbury
  6. Oral Diseases Crispian Scully & Roderick A. Cawson
  7. Oral and Maxillofacial Pathology - 1st Ed _2003
  8. PDQ Oral Disease Diagnosis & Treatment 2002
  9. Pocket Atlas of Oral Diseases 2nd ed.,G Laskaris

Prosthodontics

  1. Mc Cracken's Removable Partial Prosthodontics 10th ed.
  2. Principles & Practices of Complete Dentures, I. Hayakawa
  3. Color Atalas of Removable Partial Dentures, Devenport, Bhaskar, Heath & Ralph
  4. Hugh Delvin Complete Dentures; A Clinical Manual for The General Dental Practitioner
  5. Planning and Making crown and Bridge, Bernard GN Smith
  6. Contemporary Prosthodontics Rosensteil, land, Fuzimoto
  7. Fundamentals of Fixed Prosthodontics 3rd Ed. Shillingburg, Hobo, Whitsett, Jacobi & Brackett

Dental Materials

  1. Dental Materials-Properties & Manipulations 8th Ed. Craig, Powars & Wataha

Oral Surgery

  1. Oral Surgery-Fragiskos D. Fragiskos
  2. Atlas of Minor Oral Surgery 2nd Ed. David McGovan, Martin Dunitz
  3. Hand Book of Local Anasthesia, 4th ed. Stanely F. Malamed
  4. Peterson's Principles of Oral and Maxillofacial Surgery 2nd Ed 2004
  5. Principles of Oral and Maxillofacial Surgery
  6. Surgical Approaches to the Facial Skeleton Edward Ellis III & Michael F. Zide
  7. Essentials of Traumatic Injuries to The Teeth, JO Andreasen & FM andreasen
  8. Treatment Planning for Traumatised Teeth, Mitsuhiro Tsukiboshi DDS
  9. Key Topics in Oral and Maxillofacial Surgery
  10. The Extraction of teeth 2nd Edition Groffrey L Howe

Endodontics

  1. Text book of Endodontology
  2. Color Atlas of ENDODONTICS, William T Johnson.
  3. Dental Secrets, 2nd Ed, Stephen T. Sonis.
  4. Endodontics, Problem Solving in Clinical Practice 2002, TR Pitt Ford, JS Rhodes, & HE Pitt Ford.
  5. ENDODONTICS, Fifth Edition, JOHN I. INGLE, DDS, MSD
  6. Endodontic Therapy, 6th Ed., Weine
  7. Cohen: Pathways of Pulp, 9th ed., 2006 Mosby

Radiology

  1. Essentials of Dental Radiography and Radiology, 3rd Ed. Eric Whaites, Forwarded by RA Cawson.
  2. Color Atlas of Dental Medicine Radiology, Friedrich A Pasler
  3. Oral Radiology-Principales and Interpretation - White & Pharoah
  4. Panoramic Radiographic - Seminar on Maxillofacial Imaging and Interpretation Allan G Farman -Springer

Oral Medicine

  1. Essentials of Oral Medicine, Sol Silverman, L. Roy Eversole, Edmond L. Truelove
  2. Oral Medicine, Tyldesley 5th Ed
  3. Oral Medicine Picture Test Series Wray & Gibson
  4. A Colour Handbook of Oral Medicine Lewis & Jordon
  5. A GUIDE TO COMMON ORAL LESIONS, DR. CHARLES L. DUNLAP AND DR. BRUCE F. BARKER
  6. Oxford Handbook of Clinical Dentistry - 4th Ed. (2005)
  7. A Color Atlas of Cardio-Pulmonary Resucsitation Technique, Page, Mils &  Marton
  8. Pocket Guide of Drug Interactions

Tooth Conservation

  1. Pickard's Manual of Operative Dentistry
  2. Pathways of Pulp - Cohen
  3. Sturdvant’s Art and Science of Operative Dentistry 2000

Periodontics

  1. Carranza’s Clinical Peridontology 9th ed. Newman, Takei, Carranza

Orthodontics & Paedodontics

  1. Handbook of Paediatric dentistry 2nd ed. Cameron & Widmar
  2. Orthodontic and Paediatric Dentistry-Millett & Welbury
  3. Restorative Techniques in Paediatric Dentistry 2nd ed, An Illustrated Guide to The Restoration of Carious Primary Teeth, Duggal, Curzon, Fayle, Toumba, Robertson

Preventive Dentistry

  1. Primary Preventive Dentistry Norman O. Harris, Franklin Garcia-Godoy

Medicine

  1. Medical problems in Dentistry Scully & Cawson

All Inclusive Books

  1. Master Dentistry Volume 1
  2. Master Dentistry Volume 2
  3. REVIEW of Diagnosis, Oral Medicine, Radiology and Treatment Planning 4th Ed. Noman K Wood

You can write us to help you get all these book at a much cheaper price all together at dentalknowledge@outlook.com


The following book have been recommended by ADC. General Dentistry

  1. Australian Dental Association Inc. Policy Statement 6.5.1, Code of ethics for dentists.
  2. Australian Dental Association, Victorian Branch. By-law 2, Ethics.
  3. Fan KFM, Jones J. MCQs in dentistry, 2nd edn. Knutsford, UK: PasTest Ltd, 2010
  4. Ireland R, ed. A dictionary of dentistry. Oxford: Oxford University Press, 2010
  5. Mitchell DA, Mitchell L. Oxford handbook of clinical dentistry, 6th edn. Oxford: Oxford University Press, 2014

Cariology

  1. Fejerskov O, Nyvad B, Kidd E, eds. Dental caries: the disease and its clinical management, 3rd edn. Hoboken, NJ: Wiley Blackwell, 2015

Community Dentistry

  1. Burt BA, Eklund SA, eds. Dentistry, dental practice and the community, 6th edn. St Louis: Elsevier Saunders, 2005

Endodontics

  1. Torabinejad M, Fouad A, Walton RE. Endodontics: principles and practice, 5th edn. St Louis: Elsevier Saunders, 2015

Diagnosis

  1. Okeson, JP. Bell's Oral and facial pain (formerly Bell's Orofacial pain), 7th edn. Chicago: Quintessence, 2014

Infection control

  1. Australian Dental Association. Guidelines for infection control; 2nd ed. 2012

Materials

  1. Anusavice KJ, Shen C, Rawls HH, eds. Phillip's Science of dental materials, 12th edn. Amsterdam: Saunders Elsevier, 2012

Medicine

  1. Walker BR, Colledge NR, Ralston SH, Penman I, eds. Davidson's principles and practice of medicine, 22nd edn. Edinburgh: Churchill Livingstone Elsevier, 2014 15

Operative/Restorative

  1. Heymann HO, Swift EJ, Ritter AV, eds. Sturdevant's art & science of operative dentistry, 6th edn. St Louis: Elsevier Mosby, 2013
  2. Mount GJ, Hume WR, eds. Preservation and restoration of tooth structure, 2nd edn. Brighton, QLD, Australia: Knowledge Books and Software, 2005

Oral medicine/Oral pathology

  1. Cawson RA, Odell EW. Cawson's Essentials of oral pathology and oral medicine, 8th edn. Amsterdam: Churchill Livingstone Elsevier, 2008
  2. Soames JV, Southam JC. Oral pathology, 4th edn. Oxford: Oxford University Press, 2005

Orthodontics

  1. Profitt WR, Fields HW, Sarver DM, Ackerman JL. Contemporary orthodontics, 5th edn. St Louis: Elsevier Mosby, 2013

Paediatric dentistry

  1. Cameron AC, Widmer RP. Handbook of pediatric dentistry, 4th edn. St Louis: Elsevier Mosby, 2014
  2. McDonald RE, Avery DR, Dean JA. McDonald and Avery's Dentistry for the child and adolescent, 9th edn. St Louis: Mosby, 2011

Periodontology

  1. Newman MG, Takei HH, Klokkevold PR, Carranza FA. Carranza's clinical periodontology, 11th edn. St Louis: Saunders Elsevier, 2012

Pharmacology/Therapeutics

  1. Therapeutic guidelines – Oral and dental, Version 2. Melbourne: Therapeutic Guidelines Limited, 2012
  2. Rang HP, Ritter JM, Flower RD, Henderson G. Rang & Dale's Pharmacology, 7th edn. Edinburgh: Churchill Livingstone, 2012

Prevention

  1. Murray JJ, Nunn JH, Steele JG, eds. Prevention of oral disease, 4th edn, Oxford: Oxford University Press, 2003

Prosthodontics

  1. Zarb GA, Hobkirk J, Eckert S, Jacob R, eds. Prosthodontic treatment for edentulous patients: complete dentures and implant-supported prostheses, 13th edn. St Louis: Elsevier Mosby, 2014
  2. Shillingburg HT, Sather DA Jr, Wilson EL Jr, Cain JR, Mitchell DL, Blanco LJ, Kessler JC. Schillingburg Fundamentals of fixed prosthodontics, 4th edn. Chicago: Quintessence Publishing, 2012
  3. Davenport JC, Basker RM, Heath JR. Clinical guide to removable partial dentures. London: BDJ Books, 2000 16

Radiology

  1. Australian Radiation Protection & Nuclear Safety Agency. Radiation Protection Series Publication No. 10, Code of practice and safety guide for radiation protection in dentistry, 2005. www.arpansa.gov.au
  2. White SC, Pharoah MJ. Oral radiology: principles and interpretation. St Louis: Elsevier Mosby, 2014

Regulations and Guidelines

  1. Dental Board of Australia. Various policies, codes and guidelines. www.dentalboard.gov.au

Special Needs

  1. Little JW, Falace D, Miller C, Rhodus NL. Dental management of the medically compromised patient, 8th edn. St Louis: Elsevier Mosby, 2013
  2. Scully HC. Scully's medical problems in dentistry, 7th edn. Edinburgh: Churchill Livingstone, 2014

Traumatology

  1. Andreasen JO, Andreasen FM. Essentials of traumatic injuries to the teeth: a step-by-step treatment guide, 2nd edn. Hoboken, NJ: Wiley-Blackwell, 2010

Journals

  1. Australian Dental Journal
  2. British Dental Journal
  3. Journal of the American Dental Association
  4. Journal of Prosthetic Dentistry
  5. Journal of Dentistry
  6. Operative Dentistry
  7. Quintessence

Teeth Whitening

Teeth whitening is done to correct the discoloration of teeth. When we talk about discoloration of teeth, we mean, the color of the teeth has become light yellow, yellow,  light brown to dark brown  or from light grey to dark grey to complete black. The discoloration may be of one tooth or all the teeth may be discolored. Discoloration of a tooth is caused by several factors. It may be due to deposition of external stains over the surfaces of a tooth or it may be because of the internal deposition of certain chemicals into the teeth structure at molecular level during the formative period when teeth were being formed in the mother's womb.

External Discoloration of the Teeth

External stains deposited on the surface of the teeth may be due to smoking, drinking tea or coffee or food colorants like turmeric. Poor oral hygiene habits may also lead to the external discoloration of teeth.

Internal Discoloration of Vital Teeth

Tetracycline, excessive fluoride or other medication intake by a pregnant mother during developmental phase of the teeth of the fetus may result into the discoloration of the teeth as a child.

The Internal Discoloration of a Non-Vital Teeth

The discoloration of non-vital tooth is caused by the death of the pulp tissue due to trauma. In such cases, the pulp of the traumatized tooth go through the death process and becomes necrotic. The necrosis or rotting of the pulp tissues produces Sulphur compounds that give the light brown to dark grey color of that particular tooth.

Procedure of Teeth Whitening

The procedure for teeth whitening depends whether the tooth is vital or non-vital.

The procedures described in this article are for in-office use. These procedures should be performed by a qualified dentist.

For common people, teeth whitening kits are available in the market. They can be utilized by anyone with care. Anyone can purchase these kits from HERE.

The chemicals used for tooth whitening may be either hydrogen peroxide or carbamide peroxide.

Technique of tooth whitening for non-vital teeth

  • A successful root canal treatment of 3 dead tooth should be done. Then only, a tooth whitening procedure should be performed to correct the discoloration of the tooth involved.
  • It'll be a good idea to wait for at least 2 weeks after the completion of root canal treatment before the start of the tooth whitening procedure. During this time period we should watch for the development of any symptom. If no symptoms arise then we should proceed for the tooth whitening procedure.
  • Color of the tooth should be matched with the shade guide and it is recorded in the patient's file.
  • The temporary filling material used to fill the access cavity after the root canal obturation should be removed up to 3 millimeters beyond the cervical line.
  • Then, the remaining root canal filling material is covered by a setting calcium hydroxide paste of 1 millimeter thickness. The walls of the access cavity should be smoothed with the help of a dental bur. During smoothing procedure, a smear layer develops over the smooth surface of the cavity.
  • This smear layer should be removed from the walls of the access cavity. This is necessary otherwise the opening of the dentinal tubules will remain blocked and the tooth whitening chemical will not give its full effect. To do this, 37% orthophosphoric acid is applied over the surface of the access cavity and left for 20 seconds. It is rinsed thoroughly with water and air dried.
  • A cotton pledged, soaked in hydrogen peroxide or carbamide peroxide is placed inside the access cavity and sealed by a temporary filling material, e.g. zinc oxide eugenol cement.
  • It is left there for 2-3 or more days and continuously observed. The patient is instructed to report back when the color of the tooth becomes slightly lighter than the neighboring tooth, the cotton pledge is removed from the access cavity and a suitable filling is done.

Teeth whitening of the vital teeth

Sometimes, few of us, especially younger ones think that the color of their teeth is yellow or gray, not the white. These days, beauty conscious people seek the help of teeth whitening procedure to lighten the teeth color and make it look whiter. This is done by "Vital Teeth Whitening Procedure".

Procedure of Vital Teeth Whitening

  • The original shade of the tooth is noted in the file.
  • The shade guide is shown to the patient and the desired shade is also noted.
  • A thorough scaling and polishing is done.
  • All over the face, petroleum jelly is applied for protection from spill of etchant.
  • Soft tissues are protected by protecting gel which is supplied by the manufacturer.
  • The whitening agents are mixed as per manufacturer's instructions and applied over the labial surfaces of anterior teeth, from canine to canine or from premolar to premolar.
  • A light source is placed over it to enhance the chemical reaction.
  • It is left there for the time period specified by the manufacturer.
  • The whitening gel is washed away after the specified time.
  • The color of the teeth are matched with the help of shade guide.
  • If needed, the procedure is repeated again and again till the desired color is achieved.

As a last step, the teeth, after washing away the whitening gel, are coated with a fluoride containing varnish.

The patient is instructed for not eating or drinking anything, especially the carbonated drinks for one hour. This period is necessary for remineralization of the enamel by calcium present in the saliva.

Before patient leaves the dental office, (s)he is advised to avoid eating or drinking foods that may speed up the discoloration of the teeth.

A lot of home kits are available in the market for teeth whitening. They can be used at home by anyone with little care. They are useful for mild to moderate discoloration of teeth.

Teeth Whitening Home Kit – Buy Now

 

 

Finish Lines of a Crown Preparation

The margins of crowns preparations in fixed Prosthodontics are place in three positions

  1. Supragingival
  2. Equigingival
  3. Subgingival

Advantages supra-gingival finish line:

  1. It is conducive for better periodontal health
  2. It facilitates accurate impression making
  3. It allows accurate assessment of the fit

Advantages of Equigingival finish line:

  1. It provides better better retention
  2. It is conducive for better periodontal health

Advantages of sub gingival finish line:

  1. It is used when additional retention is needed
  2. It is indicated in anterior zone where aesthetics is a prime consideration
  3. it is used in cervical erosion and root hypersensitivity cases