Rubber dam

I have difficulty on applying rubber dam before this. Tomorrow will be a root canal treatment for my second patient. So I have to learn carefully, just dont want make my patient suffer. What a unlucky day. Hopefully tomorrow gonna be alright. Come on! Its all about my requirement, just bear with it. Treat my patient well yeah. So, let's enjoy doing it tomorrow. go go fighting!

Indications

• Firstly, it provides an aseptic operating field, isolating the tooth from oral and salivary contamination. It cannot be stressed enough that contamination of the root canal with saliva introduces new microorganisms to the root canal which may prolong treatment and reduce prognosis.
• Secondly, rubber dam facilitates the use of the strong medicaments necessary to clean the root canal system.
• Finally, it protects the patient from the inhalation or ingestion of endodontic instruments

p/s- all return to Allah.. Hopefully, tomorrow gonna be alright.. Insyallah =)

Tooth eruption chart

Tomorrow will be pedo session, quite nervous because this is my  first session. Don't know whether able to manage my pedo patient or not. Need extra revision before enter clinic. Make sure, OPG and bitewing radiograph done and mounted properly, must labeled name, RN patient, date and which tooth. Try not to missed any early carious lesion, know anatomy and eruption  of the mix dentition. Hopefully, tomorrow will be ok. This morning, my prosto patient for full full denture had been rejected! doctor ask me to transfer patient to post grad doctor, huhu.. never mind la.. be motivated!

p/s- let's go to clinic with big smile although will be sad later.. why? haha..

Next is restoration

Tomorrow GDP wait for me.. as usual, examine patient teeth and then do treatment plan. Based on the record, suspected carries class one and two tomorrow,. So, I need to prepare on cavity preparation. How to do proximal box on my cavity preparation later on. If you all don't want to have carries in between tooth, you need to floss rather than only brush your teeth ok? Carries may worsen and next will be root canal treatment or extraction.. Like this morning, I had done my extraction of 37 tooth due to unrestorable carries.. 1st time did administration of local anesthesia.. very difficult to extract that tooth.. 

p/s- try to do the best to all my patients.. =)  but sorry because anything could be happen.. amateur 

Post extraction instruction

Indication for tooth extraction

• Periodontal disturbances
• Dental caries
• Pulp pathology 
• Apical pathology 
• Orthodontic reasons 
• Prosthetic considerations 
• Impactions
• Supernumerary teeth 
• Tooth in the line of fracture 
• Teeth in relation to bony pathology 
• Root fragments 
• Teeth prior to irradiation 
• Focal sepsis 
• Esthetics 
• Economic considerations 

Contraindication for tooth extraction

• Diabetes & Hypertesion 
• Steroid therapy 
• Pregnancy 
• Bleeding disorders 
• Medically compromised patient 
• Active infections 
• Teeth in recently irradiated patient 

Post extraction instruction

1. DO NOT DISTURB THE WOUND: In doing so you may invite irritation, infection and/or bleeding. Be sure to chew on the opposite side for 24 hours and keep anything sharp from entering the wound. Don't play with tongue. 
2. DO NOT SMOKE FOR 12 HOURS: Smoking will promote bleeding and interfere with healing. 
3. BRUSHING: Do not brush your teeth for the first 8 hours after surgery. After, you may brush your teeth gently, but avoid the area of surgery. 
4. MOUTH WASH:Avoid all rinsing for 24 hours after extraction. This is to ensure the formation of a healing blood clot which is essential to proper wound healing. 
5. DO NOT SPIT OR SUCK THROUGH A STRAW: This will promote bleeding and may dislodge the blood clot causing a dry socket. 
6. BLEEDING: A rolled up gauze pad will be placed on the extraction site and change this dressing every 20 minutes. 
7. PAIN: Prescription medication 
8. SWELLING: To prevent swelling, apply an ice pack or a cold towel to the outside of your face in the area of the extraction during the first 12 hours. Apply alternately, 20 minutes on then 20 minutes off, for an hour or longer if necessary. 
9. DIET: Cold, soft food such as ice cream or yogurt may be the most comfortable for the first day. It is also important to drink plenty of fluids.

Administration of local anesthesia

Inferior alveolar nerve block
 - palpate coronoid notch , felt the pterygomandibular raphae/fold, there is pterygotemporal depression between these two structure. Inject at this area.
- positioning the syringe, put it on contralateral bicuspid of between 2 premolar, then inject the area palpate just now until hit the bone (about 2/3 of the needle inserted) and withdraw 1mm and inject half of the cartridge.
- move the syringe ipsilaterally, slowly withdraw the needle and at the same time inject half from the cartridge left.

Long buccal nerve block
- insert the needle at distobucally of the 3rd molar until hit the bone (about 2mm) and inject the rest of the cartridge

What's going on? requirement!

All about requirements. Its begin here...
This week start my pack dental schedule.. this week, first attempt to do tooth extraction.. what a nervous feeling.. hurmm... last week, I accidently, injured my patient's lip with scaler.. horrible! learn from experience I thought..   felt guilty.. so much..

Now, here I come.. be motivated.. organised.. no more dreaming, no more hanging.. lets do it.. come on..
feel wanna shout loudly...