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Chapter 22 Dental Care Health Care Science Technology Copyright © The McGraw-Hill Companies, Inc. Objectives Identify the members of the dental team and their responsibilities, education, and credentialing. List the dental specialty areas. 2 Copyright © The McGraw-Hill Companies, Inc. Chapter 22 Objectives (cont.) Name the teeth in the primary dentition and in the permanent dentition. Name and locate surfaces, tissues, and anatomical features of the teeth and related structures. 3 Copyright © The McGraw-Hill Companies, Inc. Chapter 22 Objectives (cont.) Demonstrate the use of the universal and Palmer’s notation. Identify the causative factors of dental disease. 4 Copyright © The McGraw-Hill Companies, Inc. Chapter 22 Objectives (cont.) Describe aseptic techniques and maintenance of equipment in the dental treatment room. Chart conditions of teeth and record the treatment rendered. Successfully complete 4 dental care procedures. 5 Copyright © The McGraw-Hill Companies, Inc. Chapter 22 Careers in Dental Care 22-1 The Dental Assistant The Dental Laboratory Technician The Dental Hygienist The Dentist 6 Copyright © The McGraw-Hill Companies, Inc. Chapter 22 The Dental Assistant Employed with: – – – – – 7 – Dental offices of general dentists and dental specialists. Dental school clinics. Private and government hospitals and clinics. Insurance companies. Dental laboratories. Dental suppliers. Copyright © The McGraw-Hill Companies, Inc. Chapter 22 The Dental Assistant (cont.) Job Responsibilities – – – – 8 Expose and process radiographs (X rays). Provide clients with instructions on oral care following treatments. Teach clients how to brush and floss properly. Make impressions of clients’ teeth for study models. Copyright © The McGraw-Hill Companies, Inc. Chapter 22 The Dental Assistant (cont.) Job Responsibilities (cont.) – – – – – 9 Assist the dentist in a variety of treatment procedures. Manipulate dental materials. Make dental appliances. Develop infection control protocol. Perform office management tasks. Copyright © The McGraw-Hill Companies, Inc. Chapter 22 The Dental Laboratory Technician Works independently to create dental prostheses, replacements for natural teeth, and dental appliances. Uses a variety of materials to fabricate: – – – – 10 Full or partial dentures. Artificial crowns and bridges. Veneers. Orthodontic appliances and splints. Copyright © The McGraw-Hill Companies, Inc. Chapter 22 The Dental Hygienist 11 Assesses and charts oral conditions and reviews the client’s health and dental history. Exposes and processes dental radiographs (X rays). Instructs clients in oral hygiene techniques. Provides nutritional counseling in relation to dental health. Removes calculus and plaque. Applies preventive materials such as fluoride and sealants to the teeth. Copyright © The McGraw-Hill Companies, Inc. Chapter 22 The Dentist Diagnoses and treats diseases of the teeth and their supporting tissues, the tongue, lips, and jaws. Restores teeth damaged by decay or trauma. Replaces missing teeth with artificial materials. 12 Copyright © The McGraw-Hill Companies, Inc. Chapter 22 The Dentist (cont.) 13 Carries out cosmetic procedures to improve a client’s appearance. Performs corrective surgery on the jaws and supporting tissues. Straightens teeth. Performs oral hygiene procedures and provides instructions to clients. Copyright © The McGraw-Hill Companies, Inc. Chapter 22 The Dentist (cont.) Specialty Areas of Dental Practice – – – – – – – – 14 Dental public health. Endodontics. Oral and maxillofacial pathology. Oral and maxillofacial surgery. Orthodontics and dentofacial orthopedics. Pediatric dentistry. Periodontics. Prosthodontics. Copyright © The McGraw-Hill Companies, Inc. Chapter 22 Section 22-1 Apply Your Knowledge Which dental health specialist removes calculus and plaque? Answer: Dental hygienist. 15 Copyright © The McGraw-Hill Companies, Inc. Chapter 22 Dental Care Procedures 22-2 16 Basic Dental Anatomy Brushing and Flossing Tooth Numbering Systems The Dental Treatment Area Stress and the Dental Client Dental Instruments and Tray Setups Instrument Transfer and Oral Evacuation Copyright © The McGraw-Hill Companies, Inc. Chapter 22 Dental Care Procedures 22-2 (cont.) 17 Dental Anesthesia Impressions and Models Amalgam and Resin Restorative Materials Dental Cements Dental Records Dental Radiographs Copyright © The McGraw-Hill Companies, Inc. Chapter 22 Basic Dental Anatomy The Primary Teeth – also known as deciduous dentition, consist of 20 teeth arranged in two Ushaped patterns. – 18 There are 10 teeth in the maxillary arch and 10 in the mandibular arch. Copyright © The McGraw-Hill Companies, Inc. Chapter 22 Basic Dental Anatomy (cont.) The Permanent Teeth – replace the primary teeth between the ages of 6 and 12. – – – 19 Roots are resorbed. Are also known as the permanent dentition and consist of 32 teeth. All have erupted by the age of 14, except the third molars. Copyright © The McGraw-Hill Companies, Inc. Chapter 22 Basic Dental Anatomy (cont.) Tooth Divisions – – – 20 The 2 main parts of the tooth are the root and the crown. The apex is the end of the root furthest from the crown. The cervical line is formed by the junction of the crown and the root. Copyright © The McGraw-Hill Companies, Inc. Chapter 22 Basic Dental Anatomy (cont.) Surfaces of the Tooth – – – 21 The surfaces of the tooth are: mesial, distal, facial, buccal, labial, incisal, occlusal, and lingual. Other terms related to the surfaces of the root are: proximal surface, contact area, and interproximal space. Structural features of the occlusal surface are: cusp, marginal ridges, developmental grooves, fissures, pit, and fossa. Copyright © The McGraw-Hill Companies, Inc. Chapter 22 Basic Dental Anatomy (cont.) Tooth Tissues – A tooth is made up of 4 tissues: 22 Enamel. Cementum. Dentin. Pulp. Copyright © The McGraw-Hill Companies, Inc. Chapter 22 Basic Dental Anatomy (cont.) Adjacent Tissues – – 23 Gingiva is a soft tissue that surrounds the neck of the tooth. The space between the free gingiva and the tooth is known as the gingival sulcus. Copyright © The McGraw-Hill Companies, Inc. Chapter 22 Basic Dental Anatomy (cont.) D. Types of Teeth – – – – 24 C. Incisors. Canines. Premolars. Molars. A. B. Can you identify the type in each picture? Copyright © The McGraw-Hill Companies, Inc. Click for answers. Chapter 22 Brushing and Flossing 26 Plaque must be removed at least once every 24 hours. It is preferable to brush after each meal. Brushing removes plaque from the facial, lingual, and occlusal surfaces. Flossing removes plaque from between teeth on the mesial and distal surfaces. Copyright © The McGraw-Hill Companies, Inc. Chapter 22 Tooth Numbering Systems The Universal System – used commonly in the United States. – – 27 Each permanent tooth is numbered from 1 to 32. Deciduous teeth are lettered from A to T. Copyright © The McGraw-Hill Companies, Inc. Chapter 22 Tooth Numbering Systems (cont.) Palmer’s System – used in some orthodontic and pediatric practices. – – 28 Permanent teeth are numbered from 1 to 8, according to quadrants. Deciduous teeth are lettered from A to E, according to quadrants. Copyright © The McGraw-Hill Companies, Inc. Chapter 22 The Dental Treatment Area 29 Consists of a dental chair, a dental assistant’s chair, an operator’s chair, a dental unit, an operating light, fixed and mobile cabinets, a sink, and an X-ray unit. Copyright © The McGraw-Hill Companies, Inc. Chapter 22 The Dental Treatment Area (cont.) The dental unit contains: – – – – – – 30 Master on/off switch. Handpiece tubing. Rheostat. Air-water syringe. Suction tubing for oral evacuator. Suction tubing for saliva ejector. Copyright © The McGraw-Hill Companies, Inc. Chapter 22 Stress and the Dental Client Follow these steps to reduce client stress: – – – – – – – 31 Wear a name tag. Listen to the client. Use the client’s name frequently. Take a personal interest in the client. Patiently explain procedures to the client. Respect individual differences. Always maintain client privacy and confidentiality. Copyright © The McGraw-Hill Companies, Inc. Chapter 22 Dental Instruments and Tray Setups 32 Hand Instruments – the 3 parts of a hand instrument are the handle or shaft, blade or nib, and shank. Copyright © The McGraw-Hill Companies, Inc. Chapter 22 Dental Instruments and Tray Setups (cont.) – – Basic hand instruments include: mouth mirror, explorer, cotton pliers, periodontal probe, saliva ejector tip, oral evacuator tip, and aspirating anesthetic syringe. Restorative instruments are included in the composite tray setup and resin tray setup. Cavity preparation instruments. Amalgam instruments. Composite and other instruments. 33 Copyright © The McGraw-Hill Companies, Inc. Chapter 22 Dental Instruments and Tray Setups (cont.) Dental Handpieces and Rotary Instruments – – – May be either high or low speed. Can be powered by air or electricity. Burs or diamonds are used with the handpieces. assorted burs assorted diamonds 34 Copyright © The McGraw-Hill Companies, Inc. Chapter 22 Instrument Transfer and Oral Evacuation The dental assistant: – – – 35 Prepares materials and instruments. Transfers them to the dentist. Maintains a clear working area with effective oral evacuation and tissue retraction. Copyright © The McGraw-Hill Companies, Inc. Chapter 22 Instrument Transfer and Oral Evacuation (cont.) 36 Instrument Grasps – The pen grasp is used with most instruments. – The palm grasp is used when the instrument has two handles, such as the extraction forceps. Copyright © The McGraw-Hill Companies, Inc. Chapter 22 Instrument Transfer and Oral Evacuation (cont.) Instrument Transfer – – 37 The instrument transfer zone is over the client’s chest, in the 4 to 7 o’clock position. The assistant brings the instrument to the dentist when the dentist signals for it. Copyright © The McGraw-Hill Companies, Inc. Chapter 22 Instrument Transfer and Oral Evacuation (cont.) Oral Evacuation – – 38 The oral evacuator removes fluids and retracts tissue during treatment procedures. Benefits include: • Improved visibility. • Reduced amount of airborne microbes. • Prevention of swallowing of debris. • Prevention of moisture from adversely affecting dental materials. Copyright © The McGraw-Hill Companies, Inc. Chapter 22 Dental Anesthesia Local Anesthesia – injected near the nerves, blocking the conduction of nervous impulses to the central nervous system. Topical Anesthesia – applied to the surface or mucosa to minimize the discomfort of the needle used for local anesthesia. 39 Copyright © The McGraw-Hill Companies, Inc. Chapter 22 Impressions and Models 40 Models are positive reproductions or 3-dimensional duplicates of a client’s teeth and surrounding tissues. They are used for study and diagnosis of orthodontic and prosthodontic cases. The first step in making a model is to take an impression of the teeth and surrounding tissues. Copyright © The McGraw-Hill Companies, Inc. Chapter 22 Impressions and Models (cont.) Impression Materials – The two classifications of the most commonly used impression materials are: 41 Alginate – an irreversible hydrocolloid. Elastomeric materials, including polysulfide or rubber-base materials, silicone, and polyether. Copyright © The McGraw-Hill Companies, Inc. Chapter 22 Impressions and Models (cont.) Alginate – 42 Water is mixed with a powder, then inserted into a perforated impression tray and placed in the mouth. Copyright © The McGraw-Hill Companies, Inc. Chapter 22 Impressions and Models (cont.) Electromeric Materials – – 43 Used for very precise procedures, such as fabricating crowns, bridges, and dentures. Available in both light-bodied and heavy-bodied forms. Copyright © The McGraw-Hill Companies, Inc. Chapter 22 Amalgam and Resin Restorative Materials 44 Cavity preparation and placement of a restorative material are processes that remove disease and restore tooth health, function, and appearance. Amalgam and composite material are the two most commonly used materials for direct restoration of cavities. Copyright © The McGraw-Hill Companies, Inc. Chapter 22 Dental Cements Dental cements are used as: – – – 45 Bases and liners. Luting agents. Temporary restorations. Copyright © The McGraw-Hill Companies, Inc. Chapter 22 Dental Records Charting symbols are used to indicate: – – – – – 46 Caries. Amalgam. Composite. Missing tooth. Teeth to be extracted. – – – – – – Impacted tooth. Gold crown. Porcelain crown. Root canal. Periapical abscess. Fracture. Copyright © The McGraw-Hill Companies, Inc. Chapter 22 Dental Radiographs Radiolucent areas – darker or black areas on the film. Radiopaque areas – lighter or white areas on the film. 47 Copyright © The McGraw-Hill Companies, Inc. Chapter 22 Dental Radiographs (cont.) Types of Dental Radiographs – – – – 48 Periapical – includes the entire length of the tooth and the tissues. Bitewing – includes the crowns of both the maxillary and the mandibular teeth on 1 film. Occlusal – includes the entire maxillary or mandibular arch on 1 larger film. Panoramic – shows all the maxillary and mandibular teeth and supporting structures. Copyright © The McGraw-Hill Companies, Inc. Chapter 22 Dental Radiographs (cont.) Intraoral Dental Film – – – – 49 Size 0 – used for children up to age 5. Size 1 – used for children age 5 to 10 and adults in narrow anterior areas. Size 2 – used for adults. Size 4 – used for occlusal film. Copyright © The McGraw-Hill Companies, Inc. Chapter 22 Section 22-2 Apply Your Knowledge What o’clock positions are used for transfer of instruments? Answer: 4 to 7 o’clock positions. 50 Copyright © The McGraw-Hill Companies, Inc. Chapter 22 Procedures in Student Text 22A1 22A2 22B 22C 22D 51 Demonstrating the Bass Toothbrushing Technique Demonstrating Correct Flossing Technique Maintaining the Dental Treatment Area Positioning the Client and the Dental Assistant Dental Tray Setups Copyright © The McGraw-Hill Companies, Inc. Chapter 22 Additional Procedures in Lab Activity Manual LM22-1 LM22-2 LM22-3 LM22-4A 52 One-Handed Instrument Transfer Using the Oral Evacuator Preparing the Anesthetic Syringe and Assisting with the Administration Preparing Alginate and Assisting with an Alginate Impression Copyright © The McGraw-Hill Companies, Inc. Chapter 22 Additional Procedures in Lab Activity Manual (cont.) LM22-4B LM22-4C LM22-5A LM22-5B 53 Mixing and Assisting with an Elastomeric Impression Mixing Dental Plaster and Stone and Fabricating a Model Preparing Amalgam and Assisting with an Amalgam Restoration Preparing Composite and Assisting with a Composite Restoration Copyright © The McGraw-Hill Companies, Inc. Chapter 22 Additional Procedures in Lab Activity Manual (cont.) LM22-6A LM22-6B LM22-6C LM22-6D LM22-7A LM22-7B 54 Mixing Zinc Oxide Eugenol Cement Mixing Calcium Hydroxide Cement Mixing Polycarboxylate Cement Mixing Glass Ionomer Cement Manual Processing of Dental Radiographs Mounting Dental Radiographs Copyright © The McGraw-Hill Companies, Inc. Chapter 22 Chapter 22 Credits Slide 7 Slide 29 Slide 34 Slide 37 Slide 40 Slide 42 55 CORBIS A-dec (top) Midwest Dental Products Corp. (bottom) Brasseler USA Aaron Haupt James Stevenson/Photo Researchers Aaron Haupt Copyright © The McGraw-Hill Companies, Inc. Chapter 22