Home' News Bulletin : ADA News Bulletin August 2016 Contents REGULAR | CLINICAL
Your Amanuensis has been compiling the
Clinical Hints column for 33 years, and thinks
that this TEASER is the most baffling he has
so far presented. It is a dental item, and has
been used clinically and successfully.
bracket irritation, but the betamethasone
dispropionate topical gel is usually rubbed
off before it solves the problem. The hinter
discovered that it is possible to knead the
paste into orthodontic wax, and apply the
mix to the affected area before sleep, or
during the day if symptoms persist. Kenelog
Orabase could perhaps be used instead.
An orthodontic retainer, when well-made,
can be used for several years on a reduced,
then intermittent basis. But any small
tooth movements which occur can cause
discomfort, the patient stops using it and
tooth alignment is not maintained. Any
areas of tightness can be identified by
interposing articulating paper between the
appliance base and the offending tooth.
This area can then be adjusted to restore
comfort, and wearing can resume.
Although some regard rubber dam as
too complicated to use routinely, this
hinter suggests making, or having made, a
stretching frame to accommodate a 6 x 6
inch sheet of dam. You can now mark the
desired location of the holes to be punched
without the ‘floppy’ corners of the dam
obscuring the view. This technique was
apparently suggested by a Dr Alan Belcher
If your F/F denture bases do not stay
seated at the try-in appointment, consider
relining them temporarily with ‘Fit-Checker’.
It sets quickly, provides a stable denture
base when re-aligning any teeth, and is
easily removed when adjustments have
This hint may be understood by
orthodontists, but is Greek to your Collator:
Use dental floss to help engage Ni-Ti wires
rather than brute force with a metal plastic
before shutting the gate (Damon Brackets
or self-ligation: the only way to go!)
A few specialists have provided clinical hints
recently. Thank you! Your Notary hopes this is
not a transient phenomenon. There was also
an excellent response to the June TEASER.
Please keep them both rolling in! Send them
to: Barrie Gillings, Phone: 02 9144 3787;
email: email@example.com; or post to
121 Bannockburn Road, Turramurra 2074.
The providers of this month’s clinical hints
were: D Anderson, N Bell, D Ellett, A Goss,
T LaMella, E Roberts and M Wang.
It was made in the UK, which might
give some readers an unfair advantage.
The winner of the handsome, inscribed,
antique metal ADA paperweight must
explain the purpose of the item, and in the
event of a tie, the name of the Institution
where it was used, and if still a tie, the
name of the person who made it. If no
one identifies it, the handsome, inscribed,
antique metal ADA paperweight goes to
the thoughtful person who supplied it,
but is not named at this time, as it might
provide a clue.
Shari Forbes is a professor at the Centre
for Forensic Science at Sydney’s University
of Technology, and directs the Australian
Facility for Taphonomic Experimental
Research. Don’t bother looking up
‘taphonomic’ in your dictionary, unless
you have the Supplement to the OED.
Taphonomy is the study of how fossils form
from animal remains.
Professor Forbes is in charge of the first
body farm outside the United States.
She opened Australia’s first such farm
in February 2016 and it already has six
occupants. The farm occupies 12 acres, and
has a high security fence and many CCTV
cameras. There is a small building on the
site, but most of it is just rough ground.
More than 100 people have signed up
to be accepted at the farm, which was
created to provide information on how the
human body undergoes the five separate
stages of decomposition, each of which
varies according to the environmental
conditions. These include climate, bacteria,
insects, scavengers and carnivores, which
have differing effects on the stages of
decomposition, and guide investigators
on the probable time since death. It is
also important to know how bodies decay
under different circumstances, such as in
a coffin, a motor vehicle or a well, and also
the body’s size and age at death.
Smell is particularly important. Police use
trained dogs to identify bodies, but there
is much to be discovered, and what the
limitations are. Human bodies are needed
for study, because animals such as pigs
decay differently from humans. It may
sound macabre, and clash with some folk’s
religious beliefs, but many sign up because
they like the idea of their body returning
to the earth in a natural way, and that it is
environmentally sustainable. Coffins and
crematoria don’t do this.
Share any favourite ways you have of
improving your dental health care delivery.
All hints are printed anonymously to preclude
any teasing. Thus, if a colleague mentions a
hint she/he approves of, you could say, (with
crossed fingers) that it was yours! (But you
would not, of course, even think of doing so).
Rubber dam is an invaluable aid to
dentistry, and certainly keeps the operating
area free of saliva. But when you use any
spray or water, it can run off the dam and
drip onto the patient’s neck. Give a thought
to pinning the lower edge of the dam up
to the frame using, say, small paper clips,
then evacuating any trapped water with
the saliva ejector. A dry patient is a happier
When searching for an elusive root canal
opening, dab some caries-detecting
dye into the pulp chamber, then wash
the chamber free of dye and examine it
carefully. You will probably see dyed soft
tissue at the pulp chamber opening/s, or a
line of pulp tissue leading to it/them.
Sometimes patients will telephone seeking
advice about post-extraction bleeding.
Before telling them to return to the surgery,
have them close (not bite! they might chew)
firmly on a pot-size tea bag (or maybe two
cup-size bags), and call back after, say, 30
minutes. In most cases, the bleeding will
have stopped, and more drastic action will
not be needed. The hinter added that he
was told about a person who was seeking
advice about his wife’s bleeding and
called his dentist, whose advice was firmly
rejected. It was eventually established that
the caller had mis-dialled, and was seeking
advice from his wife’s gynacologist.
This hint is from a recent graduate
undergoing orthodontic treatment. The
treating orthodontist urged her/him to
offer the self-treatment procedure as a
clinical hint. Wearers of orthodontic bands
can sometimes get ulcers from band or
ADA NEWS BULLETIN | AUGUST 2016 | 41
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