Additional Information
Book Details
Abstract
The new edition of this highly successful pocketbook continues to offer readers the essentials of clinical dentistry in quick reference format. Authored by a team of experienced clinicians and teachers from individual specialities, Churchill’s Pocketbook of Clinical Dentistry 4e will be ideal for all dental students, both from within the UK and worldwide.
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- Places emphasis on information of practical clinical significance to maximise usefulness by the chairside!
- Authored by a team of experienced clinicians and teachers to ensure the most accurate and current information is provided for a given topic
- Quick reference format makes revision and learning easy
- Exclamation mark icon draws attention to important points and likely pitfalls for the inexperienced practitioner
- Improved page design and reorganised content make the book easy to use and navigate
- Tailored to meet current examination requirements
- Ideal for use as an aide-memoire prior to carrying out clinical tasks or to enable readers to apprise themselves of important details prior to tutorials and seminars
- Perfect for dental students at both the undergraduate and post-graduate level
- Updated page design and reordered content to make navigation easier
- In full colour throughout
- Updated chapter on law, ethics and quality dental care
- Includes advances in restorative, implant and aesthetic dentistry
- Additional chapters on the dental team and on practice management
- New chapters on public health in dentistry and on special care dentistry
- Updated guidance on emergencies
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | cover | ||
| Churchill's Pocketbooks Clinical Dentistry | i | ||
| Copyright Page | iv | ||
| Preface to the Fourth Edition | v | ||
| Contributors | vii | ||
| Table Of Contents | xvii | ||
| 1 Dental public health, epidemiology and prevention | 1 | ||
| Dental public health | 1 | ||
| Oral health epidemiology | 3 | ||
| The prevention of oral diseases | 4 | ||
| The wider determinants of health | 5 | ||
| Oral health promotion | 6 | ||
| Prevention. | 6 | ||
| Health education. | 6 | ||
| Health protection. | 6 | ||
| Common risk factors | 6 | ||
| Barriers to healthy behaviours | 7 | ||
| Changing disease levels | 8 | ||
| Caries risk | 9 | ||
| Population basis. | 10 | ||
| Individual basis. | 10 | ||
| Diet and dental caries (see also Chapter 3) | 10 | ||
| Evidence that sugar causes caries | 10 | ||
| Factors influencing cariogenicity of foods | 11 | ||
| Dietary advice | 11 | ||
| Diet diary | 11 | ||
| Non-sugar sweeteners. | 12 | ||
| ‘Tooth-friendly’ sweets. | 12 | ||
| Chewing-gum. | 12 | ||
| Carbonated beverages. | 12 | ||
| Detersive foodstuffs. | 12 | ||
| Fluoride | 12 | ||
| Modes of action | 12 | ||
| Systemic (pre-eruptive) effect. | 12 | ||
| Topical (post-eruptive) effect. | 13 | ||
| Evidence that fluoride prevents caries | 13 | ||
| Mechanisms for delivering fluoride | 13 | ||
| Water fluoridation | 13 | ||
| Fluoride toothpaste | 13 | ||
| Fluoride drops and tablets | 14 | ||
| Fluoridated salt | 14 | ||
| Fluoridated milk/fruit juices | 15 | ||
| Fluoride gels | 15 | ||
| Fluoride mouthwashes | 15 | ||
| Indications. | 15 | ||
| Fluoride varnishes | 15 | ||
| Fluoride foams | 15 | ||
| Fluorosis | 16 | ||
| Safety of fluoride | 16 | ||
| Antidote. | 16 | ||
| Smoking and oral health | 16 | ||
| Smokeless tobacco and oral health | 17 | ||
| Electronic cigarettes and oral health | 18 | ||
| Hookah (shisha) and oral health | 19 | ||
| Alcohol consumption and oral health | 19 | ||
| Other substance abuse and oral health | 21 | ||
| HIV infection and oral health | 21 | ||
| Prevention of dental neglect | 22 | ||
| Sport trauma | 23 | ||
| Temporomandibular disorders | 23 | ||
| Frequency of dental attendance | 23 | ||
| Routine scale and polish | 23 | ||
| Prevention in older patients | 24 | ||
| Factors complicating disease prevention in older patients | 24 | ||
| Plaque control | 24 | ||
| Diet | 24 | ||
| Denture care | 24 | ||
| Advanced restorative care | 24 | ||
| Pregnancy and oral health | 25 | ||
| Oral health in special population groups (see also Chapter 20) | 25 | ||
| Conclusion | 26 | ||
| References | 26 | ||
| 2 Social and psychological aspects of dental care | 27 | ||
| The social determinants of oral health | 27 | ||
| 1. Social class | 27 | ||
| 2. Gender | 27 | ||
| 3. Age | 27 | ||
| 4. Disability status | 28 | ||
| 5. Ethnicity | 28 | ||
| Communication and the dental team | 29 | ||
| Providing structure | 29 | ||
| Building the relationship | 29 | ||
| The consultation | 30 | ||
| Changing oral health-related behaviour | 31 | ||
| Providing information about behaviour change | 31 | ||
| Improving the understandability of information | 31 | ||
| Improving the recall of information | 31 | ||
| Creating an intention to change (Motivation) | 32 | ||
| Creating a plan to implement change (Volition) | 32 | ||
| Dental anxiety and phobia | 32 | ||
| Assessment of dental anxiety | 33 | ||
| Interventions for individuals with low levels of anxiety | 33 | ||
| Interventions for individuals with moderate levels of anxiety | 35 | ||
| Interventions for individuals with high levels of anxiety | 35 | ||
| Psychological management of pain | 35 | ||
| Acute pain | 36 | ||
| Reducing anxiety | 36 | ||
| Distraction | 36 | ||
| Increasing perceptions of control. | 36 | ||
| Language | 36 | ||
| Chronic pain | 37 | ||
| References and further reading | 37 | ||
| The social determinants of oral health | 37 | ||
| Communication and the dental team | 37 | ||
| Changing oral health-related behaviour | 37 | ||
| Dental anxiety and phobia | 38 | ||
| Psychological management of pain | 38 | ||
| 3 Dental disease | 39 | ||
| Health | 39 | ||
| WHO (World Health Organization) definition of health | 39 | ||
| Oral health | 40 | ||
| Disease | 40 | ||
| Oral health and disease | 40 | ||
| Teeth: health and disease | 41 | ||
| Dental caries | 42 | ||
| Microbiology of dental caries | 42 | ||
| Consequences if caries is not treated | 46 | ||
| Pain and dental caries | 46 | ||
| Diet and dental caries | 47 | ||
| Factors protective of caries | 48 | ||
| Particular patterns of caries | 49 | ||
| Arrested caries. | 49 | ||
| Dentine caries. | 49 | ||
| Early childhood caries (ECC). | 49 | ||
| Enamel caries. | 49 | ||
| Fissure caries. | 49 | ||
| Occult caries. | 49 | ||
| Radiation caries. | 49 | ||
| Rampant caries. | 49 | ||
| Recurrent caries. | 50 | ||
| Root caries. | 50 | ||
| Secondary caries. | 50 | ||
| Prevention of caries | 50 | ||
| Diagnosis of caries | 50 | ||
| Clinical diagnosis | 51 | ||
| Radiographic diagnosis | 51 | ||
| Fibreoptic transillumination (FOTI) | 51 | ||
| Lasers | 51 | ||
| Electronic caries detector | 51 | ||
| Caries detection dyes | 51 | ||
| Caries charting | 52 | ||
| Caries risk | 52 | ||
| Assessing caries prevalence and treatment needs in populations | 53 | ||
| Attrition | 54 | ||
| Abrasion | 54 | ||
| Erosion | 55 | ||
| Trauma | 56 | ||
| Abfraction | 56 | ||
| Consequences of tooth surface loss | 56 | ||
| Periapical abscess (Dental abscess) | 56 | ||
| Infections of dental origin (odontogenic infections) | 58 | ||
| Apical (dental) abscess. | 58 | ||
| Periodontal abscess. | 58 | ||
| Pericoronitis. | 58 | ||
| Spreading infection. | 58 | ||
| Other dental disease (see also Box 3.2) | 58 | ||
| Tooth eruption problems | 58 | ||
| Delays in eruption | 61 | ||
| Impacted teeth | 61 | ||
| Malocclusion. | 61 | ||
| Pericoronitis. | 61 | ||
| Variations in tooth number | 62 | ||
| Hypodontia (too few teeth) | 62 | ||
| Missing premolars. | 62 | ||
| Missing lower central incisor. | 62 | ||
| Hyperdontia (too many teeth) | 63 | ||
| Anomalies of tooth form, position or structure | 63 | ||
| Abnormalities of tooth form | 63 | ||
| Dens-in-dente. | 63 | ||
| Dilaceration. | 63 | ||
| Abnormalities of tooth position | 64 | ||
| Impacted first molars. | 64 | ||
| Abnormal position of crypts. | 64 | ||
| Ectopic upper canines. | 64 | ||
| Transposition. | 64 | ||
| Abnormalities of tooth structure | 64 | ||
| Abnormal enamel | 64 | ||
| Enamel hypoplasia. | 64 | ||
| Enamel hypomineralization. | 64 | ||
| Local aetiology. | 65 | ||
| General aetiology. | 65 | ||
| Hereditary. | 65 | ||
| Amelogenesis imperfecta. | 65 | ||
| Abnormal dentine | 65 | ||
| Dentinogenesis imperfecta. | 65 | ||
| Discoloured teeth | 65 | ||
| Fluorosis | 66 | ||
| Tooth (dentine) hypersensitivity | 66 | ||
| Abnormal cementum | 66 | ||
| Hypercementosis. | 66 | ||
| Hypocementosis. | 66 | ||
| Malocclusion | 66 | ||
| Pain | 67 | ||
| Halitosis | 68 | ||
| Periodontal health and disease | 68 | ||
| Other infections | 68 | ||
| Dry socket (focal alveolar osteitis) | 68 | ||
| Sinusitis | 69 | ||
| General aspects | 69 | ||
| Clinical features | 69 | ||
| General management | 69 | ||
| Dental aspects | 70 | ||
| References | 70 | ||
| 4 The dental team | 71 | ||
| Introduction | 71 | ||
| Regulation of dentistry | 72 | ||
| Dental undergraduate education and training | 72 | ||
| The Dental Schools Council | 73 | ||
| The role of the General Dental Council (GDC) | 74 | ||
| The GDC requirement regarding the aims of dental education | 75 | ||
| Dental undergraduate student fitness to practise | 76 | ||
| Dental postgraduate education and training | 78 | ||
| Specialist dentists | 79 | ||
| The dental team | 79 | ||
| Scope of practice | 82 | ||
| Dentists | 82 | ||
| Dental nurses | 82 | ||
| Orthodontic therapists | 83 | ||
| Dental hygienists | 85 | ||
| Dental therapists | 86 | ||
| Dental technicians | 87 | ||
| Clinical dental technicians (CDTs) | 88 | ||
| Direct access to dental care professionals | 89 | ||
| Registered dentists | 91 | ||
| Dentists who can practise in the UK | 91 | ||
| Specialists | 91 | ||
| 5 Law, ethics and quality dental care | 93 | ||
| Practising lawfully, professionally and ethically | 93 | ||
| Legislation | 93 | ||
| Ethical guidance, standards and regulation | 94 | ||
| The nine principles dental registrants must keep | 96 | ||
| Duty of candour | 96 | ||
| The General Dental Council’s guidance to patients | 97 | ||
| Standards for the dental team and how they are upheld | 98 | ||
| Education for dental registrants | 98 | ||
| Continuing Professional Development (CPD) | 98 | ||
| CPD requirements for registrants | 99 | ||
| Minimum CPD hours | 99 | ||
| Verifiable CPD | 99 | ||
| General or non-verifiable CPD | 100 | ||
| CPD requirements – dentists | 100 | ||
| CPD requirements – dental care professionals | 100 | ||
| Professionalism and fitness to practise | 100 | ||
| Fitness to practise procedures | 101 | ||
| The Investigating Committee | 102 | ||
| The Interim Orders Committee | 102 | ||
| The Practice Committees | 103 | ||
| The Health Committee | 103 | ||
| The Professional Performance Committee | 104 | ||
| The Professional Conduct Committee | 104 | ||
| Appeals to decisions made by committees of the GDC | 105 | ||
| Support for registrants | 105 | ||
| The Dentists’ Health Support Trust and Programme (see Figure 5.3) | 105 | ||
| Treating patients | 106 | ||
| Duty of care | 106 | ||
| Confidentiality | 107 | ||
| Consent | 108 | ||
| Contractual considerations | 109 | ||
| Referring patients | 109 | ||
| Carrying out treatment | 110 | ||
| Record keeping – clinical records | 110 | ||
| Record keeping – other records | 111 | ||
| Equality and diversity | 112 | ||
| Quality dental care | 112 | ||
| Clinical governance | 112 | ||
| Clinical audit | 113 | ||
| Audit and research | 114 | ||
| Peer review | 114 | ||
| Reflective learning | 115 | ||
| Evidence-based dentistry | 115 | ||
| Clinical effectiveness | 116 | ||
| Improving clinical performance | 116 | ||
| Protocols | 116 | ||
| Patient and stakeholder involvement | 116 | ||
| Significant event analysis | 117 | ||
| Complaints | 117 | ||
| Underperformance | 118 | ||
| Data collection and retention | 118 | ||
| Conclusion | 119 | ||
| References | 119 | ||
| 6 Practice management | 121 | ||
| Introduction | 121 | ||
| Management skills | 122 | ||
| Communication | 122 | ||
| Staff meetings | 122 | ||
| Delegation | 123 | ||
| Teamwork | 123 | ||
| Staff training | 124 | ||
| Pay | 124 | ||
| Financial management | 124 | ||
| Cost analysis | 125 | ||
| Financial ratios | 125 | ||
| Cost control and budgets. | 125 | ||
| Budgets. | 126 | ||
| Fee setting | 126 | ||
| Cash flow | 126 | ||
| Borrowing and repayment methods | 127 | ||
| An awareness of economic influences | 127 | ||
| Financial record keeping | 127 | ||
| The role of financial advisers | 127 | ||
| Monitoring performance (KPIs) | 128 | ||
| Interest free/Finance options | 128 | ||
| Marketing | 128 | ||
| Product | 128 | ||
| Place | 128 | ||
| Price | 129 | ||
| Promotion | 129 | ||
| Employing staff and management | 129 | ||
| Recruitment | 129 | ||
| Person specification | 130 | ||
| Pay structure | 130 | ||
| Advertising | 130 | ||
| Screening applications | 131 | ||
| The interview | 131 | ||
| Job offer | 132 | ||
| Employment contract | 133 | ||
| Ending employment | 135 | ||
| Minimum legal notice entitlement | 135 | ||
| Exit interviews. | 135 | ||
| Post-employment restrictions | 136 | ||
| Information for patients | 136 | ||
| Data protection, information governance and Freedom of Information | 137 | ||
| Further considerations | 138 | ||
| Freedom of Information Act (FOIA) | 138 | ||
| General Dental Council regulations and obligations (see Chapter 4) | 138 | ||
| The internet and social media guidelines | 138 | ||
| Fitness to practise proceedings (see Chapter 5) | 139 | ||
| Health and safety in the dental practice | 140 | ||
| Hazardous substances | 141 | ||
| Mercury safety | 142 | ||
| Latex allergies | 142 | ||
| Nitrous oxide | 142 | ||
| Disposal of dental waste | 142 | ||
| Cross Infection Control | 143 | ||
| RIDDOR (2013) Reporting of Injuries, Diseases, and Dangerous Diseases | 143 | ||
| Medical devices directive | 144 | ||
| Water supply and dental unit water lines | 144 | ||
| X-rays, CBCT machines and radiography | 144 | ||
| Fire safety | 144 | ||
| Practice electrical equipment | 145 | ||
| Electrical inspections | 145 | ||
| Visual inspections | 145 | ||
| Portable Appliance Testing (PAT) | 146 | ||
| Computers and Visual Display Units (VDUs) | 146 | ||
| Autoclaves and compressors | 146 | ||
| Lasers | 147 | ||
| Dental radiographs and regulations (see Chapter 8) | 147 | ||
| The Ionising Radiations Regulations 1999 (IRR99) | 148 | ||
| The Ionising Radiation (Medical Exposure) Regulations 2000 (IRMER) (Amendments 2006 and 2011) | 148 | ||
| Legal responsibility and staff appointments | 148 | ||
| Legal Person | 148 | ||
| Radiation Protection Supervisor | 148 | ||
| IRMER practitioner | 148 | ||
| IRMER referrer | 149 | ||
| Operator | 149 | ||
| External appointments | 149 | ||
| Radiation Protection Advisor (RPA) | 149 | ||
| Dental Cone Beam Computerized Tomography (CBCT) | 150 | ||
| Justification | 150 | ||
| CBCT training | 151 | ||
| Building design | 151 | ||
| Basic design features | 151 | ||
| Ergonomic design | 152 | ||
| Reception and waiting areas | 152 | ||
| Non-clinical consultation rooms | 152 | ||
| Clinical areas | 152 | ||
| Implications of HTM 01-05 to the design of dental practices | 152 | ||
| Design features of the whole dental practice for cross infection control | 153 | ||
| Steri-walls (Sterilization walls) | 153 | ||
| Cross infection prevention | 153 | ||
| Personal Protective Equipment (PPE) and Infection Control Protocols | 155 | ||
| Sharps safety and needle-stick injuries | 155 | ||
| Work surfaces | 156 | ||
| Immunization | 156 | ||
| Blood spillages | 156 | ||
| Laboratory impressions and clinical appliances | 156 | ||
| Time management | 156 | ||
| Dental Foundation Training, Dental Core Training and Dental Career Development Posts (DCDP) | 158 | ||
| Dental Foundation Training (DFT1) | 158 | ||
| Dental Foundation study days | 159 | ||
| Contracts and completion of DFT | 159 | ||
| Dentists who have not completed DFT | 159 | ||
| Who may need to be admitted by assessment? | 160 | ||
| Dental Core Training posts | 160 | ||
| Dental Career Development Posts (DCDP) | 160 | ||
| Clinical governance, clinical audit, peer review and Continuing Professional Development (see Chapter 5) | 161 | ||
| Clinical governance | 161 | ||
| Main components of clinical governance | 162 | ||
| Clinical governance effects the following areas of dental practice | 162 | ||
| Clinical audit and peer review (see Chapter 5) | 163 | ||
| Legal/Contract requirement | 163 | ||
| Aims of clinical audit | 163 | ||
| Audit outline | 163 | ||
| Mechanism of clinical audit | 163 | ||
| Continuing Professional Development | 164 | ||
| For dentists | 164 | ||
| For DCPs | 164 | ||
| Personal Development Plan (PDP) | 164 | ||
| References | 165 | ||
| 7 History and examination | 167 | ||
| History | 167 | ||
| The purpose of a history | 167 | ||
| Presenting complaint | 168 | ||
| History of presenting complaint (HPC) | 168 | ||
| Determine | 168 | ||
| Location. | 169 | ||
| Initiating or relieving factors. | 169 | ||
| Character. | 169 | ||
| Severity. | 169 | ||
| Spread/radiation. | 169 | ||
| Previous dental history (PDH) | 169 | ||
| Establish | 169 | ||
| Previous medical history (PMH) | 169 | ||
| Social history (SH) | 170 | ||
| Examination | 171 | ||
| Extraoral examination | 171 | ||
| Look for | 171 | ||
| Palpate | 171 | ||
| Intraoral examination | 171 | ||
| Diagnosis | 172 | ||
| Provisional diagnosis | 172 | ||
| Special tests and investigations | 172 | ||
| Radiographs. | 172 | ||
| Sensitivity (vitality) tests. | 172 | ||
| Study models. | 172 | ||
| Tests often sent for referral | 172 | ||
| Definitive diagnosis | 172 | ||
| Treatment planning | 173 | ||
| Factors influencing treatment planning | 173 | ||
| Patient-related factors | 173 | ||
| Dentist-related factors | 173 | ||
| Cost-related factors | 173 | ||
| Other factors in treatment planning | 173 | ||
| 8 Dental and maxillofacial radiology | 175 | ||
| The nature of X-rays, their production and interaction | 175 | ||
| Photoelectric absorption | 177 | ||
| Compton scatter | 177 | ||
| Image formation | 177 | ||
| Film-based imaging | 177 | ||
| Developing | 178 | ||
| Intermediate washing | 178 | ||
| Fixing | 178 | ||
| Final washing | 178 | ||
| Drying | 178 | ||
| Digital imaging | 178 | ||
| Advantages | 178 | ||
| Disadvantages | 178 | ||
| Radiation dose measurement and radiation protection | 179 | ||
| Doses for common radiographic examinations and their comparative risk | 180 | ||
| The biological effects of radiation | 181 | ||
| Deterministic effects | 181 | ||
| Stochastic effects | 182 | ||
| Dose limitation in dental radiography | 182 | ||
| Justification | 182 | ||
| Optimization | 182 | ||
| Equipment | 182 | ||
| X-ray generator. | 182 | ||
| Voltage. | 182 | ||
| FSD. | 182 | ||
| Film holders. | 182 | ||
| Collimation. | 182 | ||
| Image capture. | 183 | ||
| Technique | 183 | ||
| Quality assurance (QA) | 183 | ||
| Inspection of X-ray equipment. | 183 | ||
| Checks on darkroom, films and processing. | 183 | ||
| Digital systems. | 183 | ||
| Programme of staff training. | 183 | ||
| Image quality. | 183 | ||
| Audit. | 183 | ||
| Lead aprons and radiography in pregnancy | 184 | ||
| Ionizing radiation regulations | 185 | ||
| Notification. | 185 | ||
| Risk assessment. | 185 | ||
| Radiation Protection Adviser (RPA). | 185 | ||
| A controlled area. | 185 | ||
| Local rules. | 185 | ||
| Personnel. | 185 | ||
| Training. | 185 | ||
| Justification and optimization. | 185 | ||
| Quality assurance (QA). | 186 | ||
| Radiographic technique | 186 | ||
| Intraoral views | 186 | ||
| Periapical radiography | 186 | ||
| Paralleling technique. | 186 | ||
| Bisecting angle technique. | 186 | ||
| Bitewing | 186 | ||
| Occlusal radiographs | 187 | ||
| Upper standard occlusal. | 187 | ||
| Upper true (vertex) occlusal. | 187 | ||
| Upper oblique occlusal. | 187 | ||
| Lower standard occlusal. | 187 | ||
| Lower true occlusal. | 187 | ||
| Lower oblique occlusal. | 187 | ||
| Extraoral projections | 188 | ||
| Panoramic | 188 | ||
| Oblique lateral | 188 | ||
| Posteroanterior (PA) jaw | 188 | ||
| Reverse Towne’s projection | 188 | ||
| Occipitomental (OM) | 188 | ||
| Submentovertex (SMV) | 190 | ||
| Lateral cephalometric view | 190 | ||
| Advanced imaging techniques | 190 | ||
| Computed tomography (CT) | 190 | ||
| Cone beam computed tomography (CBCT) | 190 | ||
| Magnetic resonance imaging (MRI) | 190 | ||
| Ultrasonography (US) | 191 | ||
| Radiographic contrast techniques in the head and neck | 191 | ||
| Sialography | 191 | ||
| Indications. | 191 | ||
| Contraindications. | 191 | ||
| Angiography | 192 | ||
| TMJ arthrography | 192 | ||
| Radionuclide imaging | 192 | ||
| Indications. | 192 | ||
| Guidelines for the prescription of radiographs | 192 | ||
| Patients in pain (Table 8.7) | 193 | ||
| Diagnosis of caries | 194 | ||
| Periodontal assessment | 194 | ||
| Oral surgery | 194 | ||
| Radiography before routine extractions | 194 | ||
| Surgical procedures | 195 | ||
| Third molar assessment | 195 | ||
| Trauma | 195 | ||
| Salivary gland disease | 197 | ||
| Interpretation of radiographs | 197 | ||
| Differential diagnosis of radiographic lesions | 199 | ||
| References | 199 | ||
| 9 Pain and anxiety management | 201 | ||
| Local anaesthesia (LA) | 201 | ||
| What are the general properties of local analgesics? | 202 | ||
| Why vasoconstrictors? | 202 | ||
| What dose of local analgesic is ‘safe’? | 203 | ||
| Which LA techniques and where? | 203 | ||
| Topical | 203 | ||
| Infiltration | 203 | ||
| Regional nerve block | 204 | ||
| ID nerve block | 204 | ||
| Tissues anaesthetized | 204 | ||
| ID nerve. | 204 | ||
| Lingual nerve. | 205 | ||
| Not anaesthetized fully. | 205 | ||
| Assessment of effect of the block | 205 | ||
| Mental nerve block | 205 | ||
| Tissues anaesthetized. | 205 | ||
| Infraorbital nerve block | 206 | ||
| 10 Drug prescribing and therapeutics | 223 | ||
| Hypersensitive (allergic) reactions | 224 | ||
| Anaphylaxis (see also Chapter 21) | 224 | ||
| Recognize, treat, reassess | 224 | ||
| Recommendations | 224 | ||
| British National Formulary | 225 | ||
| Controlled drugs | 225 | ||
| CD3. | 226 | ||
| CSM (Committee on Safety of Medicines). | 226 | ||
| POM (Prescription-Only-Medicine). | 226 | ||
| Prescription writing | 226 | ||
| Note | 226 | ||
| Warnings to patients | 227 | ||
| Patients at particular risk from drugs | 227 | ||
| Children. | 227 | ||
| Older people. | 228 | ||
| Pregnancy. | 228 | ||
| Breastfeeding. | 228 | ||
| Liver disease. | 228 | ||
| Kidney disease. | 228 | ||
| Therapeutics | 228 | ||
| Dental and orofacial pain | 228 | ||
| Chronic orofacial pain | 229 | ||
| Neuropathic pain | 229 | ||
| Anxiety | 230 | ||
| Infections | 230 | ||
| Drugs commonly used in primary care dentistry | 234 | ||
| Areas of recent controversy | 234 | ||
| Infective endocarditis | 234 | ||
| Anticoagulants. | 235 | ||
| 11 Dental materials | 237 | ||
| Properties of materials | 237 | ||
| Metals. | 237 | ||
| Polymers. | 237 | ||
| Ceramics. | 237 | ||
| Composites. | 237 | ||
| Mechanical properties | 237 | ||
| Stress. | 237 | ||
| Strain. | 237 | ||
| Elastic modulus (E). | 238 | ||
| Elastic deformation. | 238 | ||
| Plastic deformation. | 238 | ||
| Brittleness. | 238 | ||
| Ductility. | 238 | ||
| Malleability. | 238 | ||
| Hardness. | 238 | ||
| Fracture toughness. | 238 | ||
| Fatigue strength. | 238 | ||
| Physical properties | 238 | ||
| Electrical conductivity. | 238 | ||
| Thermal conductivity. | 238 | ||
| Thermal expansion. | 238 | ||
| Radio-opacity. | 238 | ||
| Optical properties. | 238 | ||
| Chemical properties | 238 | ||
| Corrosion. | 238 | ||
| Solubility. | 238 | ||
| Oxide layer formation. | 238 | ||
| Biocompatibility properties and safety procedures | 239 | ||
| Testing materials | 240 | ||
| Problems with testing | 240 | ||
| Dental amalgams | 240 | ||
| Basic properties | 240 | ||
| Components and metallurgy | 241 | ||
| Silver (Ag). | 241 | ||
| Tin (Sn). | 241 | ||
| Copper (Cu). | 241 | ||
| Mercury (Hg). | 241 | ||
| Setting reaction (low Cu-content amalgams) | 241 | ||
| Setting reaction (high Cu-content single-phase amalgams) | 241 | ||
| Alloy formation | 241 | ||
| Lathe cut. | 241 | ||
| Spherical. | 241 | ||
| Dispersion. | 242 | ||
| Uses | 242 | ||
| Practical tips | 242 | ||
| Safety and biocompatibility | 242 | ||
| Safety concerns, because of mercury release | 242 | ||
| Environment | 242 | ||
| Amalgam allergy (to mercury, ammoniated mercury or amalgam) | 243 | ||
| Disposal | 243 | ||
| Resin-based composites | 243 | ||
| Basic properties | 243 | ||
| Components | 243 | ||
| Filler. | 243 | ||
| Resin. | 243 | ||
| Setting | 243 | ||
| Two paste (base and catalyst system). | 243 | ||
| Visible light cure. | 244 | ||
| Resin composite types | 244 | ||
| Coarse. | 244 | ||
| Heterogeneous microfills. | 244 | ||
| 12 Implantology | 269 | ||
| Introduction | 269 | ||
| Dental implant materials (see also Chapter 11) | 269 | ||
| Types of dental implant | 269 | ||
| Subperiosteal. | 270 | ||
| Blade. | 270 | ||
| Ramus frame. | 270 | ||
| Osseointegrated. | 270 | ||
| Uses | 270 | ||
| Materials | 270 | ||
| Surfaces | 271 | ||
| Connection | 271 | ||
| Platform | 272 | ||
| Clinical use of dental implants | 272 | ||
| Uses | 272 | ||
| Case selection | 272 | ||
| Consent | 273 | ||
| Restorative aspects | 274 | ||
| Restorative planning | 274 | ||
| Radiological investigations | 275 | ||
| Prosthesis design | 276 | ||
| Removable implant-retained prostheses | 276 | ||
| Fixed implant-retained prostheses | 278 | ||
| Surgical aspects | 279 | ||
| Surgical planning | 281 | ||
| Patient-specific factors | 281 | ||
| Site-specific factors | 281 | ||
| Implant placement surgery | 282 | ||
| Surgical complications | 283 | ||
| Interim restoration | 283 | ||
| Maintenance | 284 | ||
| Technical complications | 284 | ||
| Biological complications | 285 | ||
| Peri-implant diseases | 285 | ||
| Implant loss or removal | 286 | ||
| Current developments in implant treatment | 286 | ||
| Immediate placement of implants into extraction sockets | 286 | ||
| Immediate loading of implants | 287 | ||
| Short or narrow implants | 287 | ||
| Flapless implant surgery | 287 | ||
| CAD-CAM framework manufacture and design | 287 | ||
| Full-arch immediate tooth replacement | 288 | ||
| References | 288 | ||
| 13 Oral medicine | 289 | ||
| Oral infections | 289 | ||
| Bacterial infections | 290 | ||
| Tuberculosis | 290 | ||
| 14 Oral and maxillofacial surgery | 337 | ||
| Tissue healing | 337 | ||
| Phases of wound healing | 337 | ||
| Inflammatory phase (0–4 days after injury) | 337 | ||
| Proliferative phase (3–21 days after injury) | 338 | ||
| Remodelling phase (21 days after injury onwards) | 338 | ||
| Healing by primary and secondary intention | 338 | ||
| Primary intention | 338 | ||
| Secondary intention | 338 | ||
| Bone healing | 338 | ||
| Healing by primary intention. | 338 | ||
| Healing by secondary intention. | 338 | ||
| Extraction socket healing | 338 | ||
| 1st week. | 339 | ||
| 2nd week. | 339 | ||
| 4-6 weeks. | 339 | ||
| After 10 weeks. | 339 | ||
| Factors influencing healing | 339 | ||
| Tissue factors. | 339 | ||
| Infection. | 339 | ||
| Operator. | 339 | ||
| Exodontia | 339 | ||
| Local anaesthesia (Chapter 9) | 339 | ||
| Extraction technique | 339 | ||
| Complications of exodontia | 341 | ||
| Potential complications | 341 | ||
| Prevention | 342 | ||
| Preoperatively | 342 | ||
| Perioperatively | 342 | ||
| Postoperatively | 342 | ||
| Dry socket (focal alveolar osteitis) | 343 | ||
| Incidence. | 343 | ||
| Aetiology. | 344 | ||
| Diagnosis. | 344 | ||
| Treatment. | 344 | ||
| Dentoalveolar surgery | 344 | ||
| Surgical removal of teeth | 344 | ||
| Principles of flap design | 344 | ||
| Elevators | 345 | ||
| Bone removal | 347 | ||
| Impacted third molars | 347 | ||
| Indications for removal | 347 | ||
| Pericoronitis. | 347 | ||
| Caries. | 347 | ||
| Orthodontic. | 347 | ||
| Associated pathology. | 347 | ||
| Radiographs in third molar diagnosis | 348 | ||
| Position | 348 | ||
| Angulation | 348 | ||
| Depth of impaction. | 348 | ||
| Tooth morphology. | 348 | ||
| Root morphology. | 348 | ||
| Surrounding structures. | 348 | ||
| Trabeculation of bone. | 348 | ||
| Pathology. | 348 | ||
| Other structures. | 348 | ||
| Access. | 348 | ||
| Removal of impacted third molar | 348 | ||
| Elevation of a buccal flap. | 348 | ||
| Elevation of a lingual flap. | 349 | ||
| Surgical removal. | 350 | ||
| Nerve damage. | 350 | ||
| Closure. | 350 | ||
| Postoperative care. | 350 | ||
| Maxillary canine exposure/removal | 350 | ||
| Assessment | 350 | ||
| History. | 350 | ||
| Examination. | 350 | ||
| Radiography. | 351 | ||
| Treatment | 351 | ||
| Palatal flap. | 351 | ||
| Labial flap. | 351 | ||
| Canine exposure. | 351 | ||
| Surgical removal. | 351 | ||
| Apicectomy (Apical end or root end surgery: Chapter 19) | 351 | ||
| Indications for apicectomy | 352 | ||
| Technique (see Figure 14.6) | 352 | ||
| Biopsy technique | 353 | ||
| Excisional biopsy. | 353 | ||
| Incisional biopsy. | 353 | ||
| Punch biopsy. | 353 | ||
| Technique. | 353 | ||
| Suturing | 354 | ||
| Suture materials | 354 | ||
| Resorbable. | 354 | ||
| Non-resorbable. | 354 | ||
| Needles | 354 | ||
| Suture techniques | 354 | ||
| Interrupted suture. | 354 | ||
| Suture removal. | 354 | ||
| Laser surgery, cryosurgery and piezosurgery | 355 | ||
| Laser surgery | 355 | ||
| Cutting lasers | 355 | ||
| Non-cutting lasers | 355 | ||
| Carbon dioxide (CO2) laser | 355 | ||
| Cryosurgery | 355 | ||
| Piezosurgery | 356 | ||
| Infections | 356 | ||
| Infection of dental origin | 356 | ||
| Localized infections | 356 | ||
| Apical (dental) abscess. | 356 | ||
| Periodontal abscess. | 357 | ||
| Pericoronitis. | 357 | ||
| Spreading infection | 357 | ||
| Other infections of the head and neck region | 358 | ||
| Facial cellulitis. | 359 | ||
| Osteomyelitis. | 359 | ||
| Ludwig’s angina. | 359 | ||
| Necrotizing fasciitis. | 359 | ||
| Cavernous sinus thrombosis. | 359 | ||
| Cancrum oris/noma. | 359 | ||
| Infection of non-dental origin | 359 | ||
| Salivary gland. | 359 | ||
| Skin. | 359 | ||
| Bone. | 359 | ||
| Other. | 359 | ||
| Patient assessment in infection | 360 | ||
| 15 Orthodontics | 391 | ||
| Introduction | 391 | ||
| What is orthodontics? | 391 | ||
| What is malocclusion? | 391 | ||
| Prevalence of malocclusion | 392 | ||
| Based on morphology. | 392 | ||
| Based on need for treatment. | 392 | ||
| Who provides orthodontic care? | 392 | ||
| Timing of orthodontic intervention | 393 | ||
| Primary dentition. | 393 | ||
| Early mixed dentition. | 393 | ||
| Late mixed/early permanent dentition. | 393 | ||
| Later treatment. | 393 | ||
| Why do orthodontic treatment? | 393 | ||
| Scope of orthodontic treatment | 393 | ||
| Risk/Benefit considerations in orthodontic treatment | 394 | ||
| Potential benefits of orthodontic treatment | 394 | ||
| Improved dental health/function | 394 | ||
| Masticatory function. | 394 | ||
| Dental caries. | 394 | ||
| Periodontal disease. | 394 | ||
| Overjet. | 394 | ||
| Temporomandibular joint dysfunction (TMD). | 394 | ||
| Tooth impaction. | 394 | ||
| Overbite. | 394 | ||
| Anterior crossbite. | 395 | ||
| 16 Paediatric dentistry | 429 | ||
| Organizing dental treatment for children | 429 | ||
| Aims of treating children | 429 | ||
| History | 429 | ||
| Examination | 430 | ||
| Extraoral. | 430 | ||
| Intraoral. | 430 | ||
| Treatment planning | 430 | ||
| First visit. | 430 | ||
| Second visit. | 430 | ||
| Third and subsequent visits. | 430 | ||
| Preventive versus restorative care | 430 | ||
| Choice of preventive regimen | 430 | ||
| Practical points | 431 | ||
| Role of parents or carers | 431 | ||
| Remember | 431 | ||
| Managing behaviour in children | 432 | ||
| Behaviour management techniques | 432 | ||
| Tell–show–do. | 432 | ||
| Enhancing control. | 432 | ||
| Modelling. | 433 | ||
| Behaviour shaping and positive reinforcement. | 433 | ||
| Distraction. | 433 | ||
| Desensitization. | 433 | ||
| Hypnotherapy and neuroLinguistic programming (NLP) | 434 | ||
| Development of the dentition | 434 | ||
| Pre-teeth | 434 | ||
| Development of primary dentition | 434 | ||
| Mixed dentition to permanent dentition | 434 | ||
| Late changes | 435 | ||
| Maintenance of the dental operating field | 435 | ||
| Retractors. | 435 | ||
| Saliva ejector. | 435 | ||
| High-volume aspirator. | 435 | ||
| Cotton-wool rolls. | 435 | ||
| Absorbent pads. | 435 | ||
| Dental dam (Rubber dam) | 436 | ||
| Advantages | 436 | ||
| Technique | 436 | ||
| Pit and fissure sealants | 437 | ||
| Sealants | 437 | ||
| Selection of patients | 437 | ||
| Children at high caries risk. | 437 | ||
| Children with additional modifying factors. | 437 | ||
| Teeth at high risk. | 437 | ||
| Intermediate fissure sealants | 438 | ||
| Technique for application of fissure sealant | 438 | ||
| Restoration of carious primary teeth | 438 | ||
| Primary molars | 438 | ||
| Anterior primary teeth | 439 | ||
| Materials (see also Chapter 11) | 439 | ||
| Preformed metal crowns (PMC). | 439 | ||
| Hall technique versus conventional preparation | 439 | ||
| Conventional procedure: | 440 | ||
| Hall technique procedure: | 440 | ||
| Atraumatic Restorative Treatment (ART) | 440 | ||
| Chemomechanical caries removal | 440 | ||
| Pulp therapy | 441 | ||
| Pulp therapy in primary teeth | 441 | ||
| Advantages of pulp therapy | 441 | ||
| Pulp therapy is contraindicated when | 441 | ||
| Pulpal pain diagnosis and choice of therapy | 441 | ||
| Transient pain. | 441 | ||
| Spontaneous pain. | 442 | ||
| Pulp therapy techniques | 442 | ||
| Indirect pulp capping. | 442 | ||
| Direct pulp capping. | 442 | ||
| Pulpotomy. | 442 | ||
| Technique | 442 | ||
| Pulpectomy | 442 | ||
| Difficulties with analgesia and cooperation | 443 | ||
| Review and follow-up | 443 | ||
| Pulp therapy in immature permanent teeth (open apices) | 443 | ||
| Caries | 443 | ||
| Trauma | 443 | ||
| Vital permanent teeth with open apices | 444 | ||
| Indirect pulp cap. | 444 | ||
| Direct pulp cap. | 444 | ||
| Coronal pulpotomy. | 444 | ||
| Partial coronal (Cvek) pulpotomy. | 444 | ||
| Technique | 444 | ||
| Full coronal pulpotomy. | 444 | ||
| 17 Periodontology | 461 | ||
| Periodontal health and disease | 461 | ||
| Gingivitis | 461 | ||
| Necrotizing ulcerative gingivitis (NUG) | 462 | ||
| Desquamative gingivitis | 463 | ||
| Chronic periodontitis | 464 | ||
| Contemporary microbiology of periodontitis | 466 | ||
| Contemporary immunology of periodontitis | 467 | ||
| Systemic risk factors for periodontitis | 469 | ||
| Lifestyle risk factors for periodontitis | 470 | ||
| Impact of systemic diseases on periodontitis | 471 | ||
| Impact of periodontitis on systemic diseases | 471 | ||
| Atherogenic cardiovascular disease | 471 | ||
| Diabetes | 472 | ||
| Adverse pregnancy outcomes | 472 | ||
| Diagnosis and risk assessment for periodontal diseases | 472 | ||
| Management of periodontal diseases | 473 | ||
| Reference | 474 | ||
| 18 Removable prosthodontics | 475 | ||
| Introduction | 475 | ||
| Treatment planning | 476 | ||
| History taking | 476 | ||
| Factors required in prosthodontic history | 476 | ||
| Patient complaints. | 476 | ||
| Denture history. | 476 | ||
| General dental history. | 476 | ||
| Medical history. | 476 | ||
| Social history. | 476 | ||
| Examination | 476 | ||
| Extraoral examination | 476 | ||
| Intraoral examination | 477 | ||
| Mucosa. | 477 | ||
| Periodontal health. | 477 | ||
| Caries. | 477 | ||
| Restorations. | 477 | ||
| Occlusion. | 477 | ||
| Endodontic status. | 477 | ||
| Support of edentulous areas. | 477 | ||
| Mouth and peri-oral opening. | 477 | ||
| Aesthetics. | 477 | ||
| Denture examination | 477 | ||
| With existing dentures in situ consider | 478 | ||
| With existing dentures out of the mouth, consider | 478 | ||
| Radiographic examination | 478 | ||
| Additional features of prosthodontic examination | 478 | ||
| Study casts. | 478 | ||
| Surveying. | 479 | ||
| Full occlusal assessment. | 479 | ||
| Diagnostic wax-up. | 479 | ||
| Digital photography. | 479 | ||
| CBCT and three-dimensional printing. | 479 | ||
| Diagnosis and management | 479 | ||
| Diagnosis in edentulous patients | 479 | ||
| Good denture wearers whose dentures require replacement because they are worn, lost, broken, aesthetically poor or loose. | 479 | ||
| Good denture wearers with poor dentures. | 479 | ||
| Poor denture wearers who, if provided with very well designed and constructed dentures, may tolerate their dentures. | 479 | ||
| Poor denture wearers who do not tolerate dentures despite very well designed and constructed dentures. | 479 | ||
| Diagnosis in partially dentate patients | 480 | ||
| Design changes. | 480 | ||
| Denture alternatives. | 480 | ||
| Management | 480 | ||
| Preprosthetic management. | 480 | ||
| Management options in prosthodontics | 480 | ||
| Who? | 480 | ||
| What? | 480 | ||
| When? | 480 | ||
| Where? | 480 | ||
| How? | 481 | ||
| Changes following extraction of teeth | 481 | ||
| Facial changes. | 481 | ||
| Intraoral changes. | 481 | ||
| Psychological changes. | 481 | ||
| Complete dentures | 481 | ||
| Principles | 481 | ||
| Aims | 481 | ||
| Features of complete dentures | 481 | ||
| Retention | 481 | ||
| Support | 482 | ||
| Muscle balance | 482 | ||
| Occlusal balance | 483 | ||
| Stability | 484 | ||
| Design | 484 | ||
| Maximal extension of denture base. | 484 | ||
| Peripheral seal. | 484 | ||
| Postdam. | 484 | ||
| Fraena. | 484 | ||
| Relief areas. | 484 | ||
| Retruded contact position. | 484 | ||
| Balanced articulation. | 484 | ||
| Freeway space. | 484 | ||
| Tooth position | 484 | ||
| Upper anterior. | 484 | ||
| Lower anterior. | 485 | ||
| Upper posterior. | 485 | ||
| Lower posterior. | 485 | ||
| Aesthetics. | 485 | ||
| Materials. | 485 | ||
| Clinical stages | 485 | ||
| 1. Examination, diagnosis and treatment | 485 | ||
| 2. Primary impressions | 485 | ||
| 19 Operative dentistry | 513 | ||
| Restorative dentistry | 513 | ||
| Diagnosis of pulpal pain | 513 | ||
| Types and features of pulpal and related pain | 513 | ||
| Reversible pulpitis. | 513 | ||
| Irreversible pulpitis. | 513 | ||
| Periapical periodontitis. | 514 | ||
| Cracked tooth/cusp syndrome. | 514 | ||
| History | 514 | ||
| Pain quality | 514 | ||
| Sharpness. | 514 | ||
| Dullness. | 514 | ||
| Throbbing. | 514 | ||
| Duration | 514 | ||
| Short. | 514 | ||
| Constant. | 514 | ||
| Stimuli | 514 | ||
| Reaction to heat. | 514 | ||
| Reaction to cold. | 514 | ||
| Reaction to pressure. | 514 | ||
| Reaction to sweet stimuli. | 514 | ||
| Site and radiation | 514 | ||
| Timing | 515 | ||
| Clinical examination | 515 | ||
| Visual | 515 | ||
| Probing | 515 | ||
| Percussion | 515 | ||
| Special tests | 515 | ||
| Sensibility testing | 515 | ||
| Vitality testing | 515 | ||
| Radiographs | 516 | ||
| Periapical radiographs. | 516 | ||
| Bitewing radiographs. | 516 | ||
| Transillumination | 516 | ||
| Tooth ‘slooth’/FracFinder | 516 | ||
| Problems in diagnosing pulpal pain | 516 | ||
| The mouth is heavily restored. | 516 | ||
| Multiple pathology. | 516 | ||
| Non-odontogenic pain. | 516 | ||
| Dual pathology. | 516 | ||
| Anxious patient or one with learning disability. | 516 | ||
| Treatment planning | 517 | ||
| History taking | 517 | ||
| Factors required in history | 517 | ||
| Patient complaints. | 517 | ||
| History of treatment to teeth. | 517 | ||
| General dental history. | 517 | ||
| Medical history. | 517 | ||
| Social history. | 517 | ||
| Examination | 517 | ||
| Extraoral examination | 517 | ||
| Intraoral examination | 517 | ||
| Soft tissues. | 517 | ||
| Periodontal health. | 518 | ||
| Caries. | 518 | ||
| Restorations. | 518 | ||
| Tooth wear. | 518 | ||
| Occlusion. | 518 | ||
| Symptomatic teeth. | 518 | ||
| Endodontic status. | 518 | ||
| Saddles. | 518 | ||
| Removable prostheses. | 518 | ||
| Radiographic examination | 518 | ||
| Useful radiographs in fixed prosthodontics: | 519 | ||
| Useful radiographs in endodontics: | 519 | ||
| Additional in the dentate patient | 519 | ||
| Diagnosis in the dentate patient | 519 | ||
| Management | 519 | ||
| Prevention and Stabilization Phase Care | 520 | ||
| Control aetiology of problem. | 520 | ||
| Stabilization phase. | 520 | ||
| Reassess response to treatment. | 520 | ||
| Definitive Reconstructive Phase Care | 520 | ||
| Management options in operative dentistry | 520 | ||
| Who? | 520 | ||
| What? | 520 | ||
| When? | 520 | ||
| Where? | 520 | ||
| How? | 520 | ||
| Occlusion | 521 | ||
| Border (Posselt’s) movements of the mandible | 521 | ||
| Retruded Contact Position (RCP) | 521 | ||
| Mandibular movements | 522 | ||
| Protrusive movement | 522 | ||
| Retrusive movement | 522 | ||
| Lateral movement | 523 | ||
| Occlusal interferences | 523 | ||
| Examination of the occlusion | 523 | ||
| Aids to occlusal examination. | 523 | ||
| Features to be noted in occlusal examination. | 523 | ||
| Occlusal aims in fixed prosthodontics | 523 | ||
| Principles of cavity preparation | 524 | ||
| Objective of cavity preparation | 524 | ||
| Basic principles of cavity preparation | 524 | ||
| 1. Outline form | 524 | ||
| 2 & 3. Resistance and retention forms | 524 | ||
| Resistance form. | 524 | ||
| Retention form. | 524 | ||
| 4. Management of remaining caries | 525 | ||
| 5. Enamel margin finishing | 525 | ||
| 6. Cavity cleansing | 525 | ||
| Classification of cavities | 525 | ||
| Class I cavity | 526 | ||
| Preventive resin preparation/enamel biopsy | 526 | ||
| Class I cavity – amalgam or composite resin | 526 | ||
| Class II cavity | 526 | ||
| Occlusal approach – composite | 526 | ||
| Occlusal approach – amalgam | 527 | ||
| Alternatives | 527 | ||
| Traditional MO/DO (mesio-occlusal/disto-occlusal) amalgam | 527 | ||
| Tunnel preparation | 527 | ||
| Direct access | 527 | ||
| Class III cavity – composite resin | 528 | ||
| Alternative | 528 | ||
| Class IV cavity | 528 | ||
| Alternative technique | 529 | ||
| Class V cavity (cervical caries) | 529 | ||
| Core restorations | 529 | ||
| Vital teeth | 529 | ||
| Slots and grooves | 529 | ||
| Adhesive approach | 530 | ||
| Dentine pins | 530 | ||
| Technique | 530 | ||
| Root-filled teeth | 530 | ||
| Technique. | 530 | ||
| Choice of restorative material | 530 | ||
| Management of the deep carious lesion | 531 | ||
| Techniques for management of the deep carious lesion | 531 | ||
| Indirect pulp capping | 531 | ||
| Technique | 531 | ||
| Direct pulp capping | 532 | ||
| Technique | 532 | ||
| Mode of action of tricalcium silicate based cements in pulp capping. | 532 | ||
| 20 Special care dentistry | 577 | ||
| Disability and impairment | 577 | ||
| UK disability facts and figures | 578 | ||
| Capacity to make decisions about treatment | 579 | ||
| Clinical holding (or planned physical intervention) | 579 | ||
| Vulnerable adults | 580 | ||
| Barriers to oral health care | 580 | ||
| Patient/carer barriers | 580 | ||
| Physical barriers | 581 | ||
| Patients with physical disabilities | 581 | ||
| Muscular dystrophies | 581 | ||
| Spina bifida | 581 | ||
| Impact of physical disabilities on oral health | 582 | ||
| Patients with learning disabilities | 583 | ||
| Causes of learning disability | 584 | ||
| Down syndrome | 584 | ||
| Characteristics | 584 | ||
| Fragile X syndrome | 584 | ||
| Epilepsy and learning disabilities | 584 | ||
| Communication with people with learning disabilities | 586 | ||
| Impact of learning disabilities on oral health | 586 | ||
| Treatment modalities for patients with learning disabilities | 587 | ||
| Prevention for patients with learning disabilities | 587 | ||
| Patients with mental ill health | 587 | ||
| Depression | 587 | ||
| Anxiety and phobia | 588 | ||
| Bipolar disorder | 588 | ||
| Schizophrenia | 589 | ||
| Dementia | 589 | ||
| Management | 589 | ||
| Impact of mental ill health on oral health | 590 | ||
| Medically complex patients | 590 | ||
| ASA Physical Status Classification System | 591 | ||
| Risk analysis | 592 | ||
| Risk control | 592 | ||
| Medical conditions of relevance to dental practice | 593 | ||
| Cardiovascular disease | 593 | ||
| Ischaemic heart disease | 593 | ||
| Cardiac failure | 593 | ||
| Hypertension | 593 | ||
| Infective endocarditis (IE) | 594 | ||
| Respiratory disease | 594 | ||
| Asthma | 594 | ||
| Infection and chronic obstructive pulmonary disease (COPD) | 595 | ||
| Bronchial carcinoma | 595 | ||
| Cystic fibrosis | 595 | ||
| Sarcoidosis | 595 | ||
| Gastrointestinal (GI) disease | 596 | ||
| Primary. | 596 | ||
| Secondary. | 596 | ||
| Dysphagia | 596 | ||
| Gastro-oesophageal reflux disease (GORD) | 596 | ||
| Gastric carcinoma | 596 | ||
| Gastritis and peptic ulceration (PU) | 597 | ||
| Coeliac disease | 597 | ||
| Irritable bowel syndrome | 597 | ||
| Crohn’s disease | 598 | ||
| Ulcerative colitis | 598 | ||
| Colorectal cancer | 598 | ||
| Antibiotic-associated pseudomembranous colitis | 598 | ||
| Liver disease | 599 | ||
| Acute viral hepatitis. | 599 | ||
| Chronic hepatitis. | 599 | ||
| Chronic liver disease. | 599 | ||
| Pancreatic disease | 599 | ||
| Acute pancreatitis. | 599 | ||
| Chronic pancreatitis. | 600 | ||
| Haematological system | 600 | ||
| Anaemia | 600 | ||
| Causes. | 600 | ||
| Types | 600 | ||
| Microcytic anaemia (MCV < 80 fl). | 600 | ||
| Normocytic anaemia (80 fl > MCV < 100 fl). | 600 | ||
| Macrocytic anaemia (MCV > 100 fl). | 600 | ||
| Haemoglobinopathies | 601 | ||
| Variation in Hb structure. | 601 | ||
| Defective synthesis of Hb. | 601 | ||
| Persisting foetal haemoglobin. | 601 | ||
| Sickle cell anaemia. | 601 | ||
| Thalassaemias | 601 | ||
| Haematological malignancy | 601 | ||
| Bleeding disorders | 602 | ||
| Blood vessel defects | 602 | ||
| Hereditary haemorrhagic telangiectasia. | 602 | ||
| Vascular purpuras. | 602 | ||
| Platelet defects and anti-platelet drugs | 602 | ||
| Thrombocytopenia | 602 | ||
| Thrombocythaemia. | 602 | ||
| Other defects | 603 | ||
| Thrombasthenia. | 603 | ||
| Anti platelet drugs | 603 | ||
| Coagulation cascade defects | 603 | ||
| Hereditary | 603 | ||
| Acquired | 603 | ||
| Hereditary | 604 | ||
| Haemophilia A (factor VIII deficiency). | 604 | ||
| Haemophilia B (factor IX deficiency; Christmas disease). | 605 | ||
| von Willebrand’s disease. | 605 | ||
| Acquired | 605 | ||
| New Oral Anticoagulants (NOACs) | 606 | ||
| Renal disease | 606 | ||
| Infections | 606 | ||
| Chronic Kidney Disease (CKD)/Chronic renal failure (CRF) | 606 | ||
| Haemodialysis, peritoneal dialysis and transplantation | 607 | ||
| Endocrine disorders | 607 | ||
| Diabetes mellitus | 607 | ||
| Management of patients taking insulin to treat DM | 608 | ||
| 21 Emergencies | 621 | ||
| Introduction | 621 | ||
| Emergency equipment and drugs | 622 | ||
| Emergency equipment | 622 | ||
| Airway and breathing | 622 | ||
| Circulation | 622 | ||
| Appendices | 637 | ||
| Appendix A Average dates of mineralization and eruption of the primary dentition | 638 | ||
| Appendix B Tooth notation | 640 | ||
| FDI | 640 | ||
| Index | 643 | ||
| A | 643 | ||
| B | 646 | ||
| C | 648 | ||
| D | 655 | ||
| E | 660 | ||
| F | 662 | ||
| G | 664 | ||
| H | 666 | ||
| I | 668 | ||
| J | 670 | ||
| K | 670 | ||
| L | 670 | ||
| M | 672 | ||
| N | 675 | ||
| O | 676 | ||
| P | 679 | ||
| Q | 684 | ||
| R | 684 | ||
| S | 687 | ||
| T | 691 | ||
| U | 695 | ||
| V | 695 | ||
| W | 695 | ||
| X | 696 | ||
| Y | 696 | ||
| Z | 696 |