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News Bulletin : ADA News Bulletin February 2011
45 FEBRUARY 2011 TEASER The first TEASER is an item that a well-equipped dentist of 1912 might have. The instructions read: '...the waxed end of the tube is broken off, a sharp-edged file being used to nick it. After the application is made, the end is again sealed with wax'. A box of six cost $1, but we don't know how big they are. What is the item, and how was it used? The second TEASER also dates from 1912, and sales of more than 5,000 of this device were claimed in America and Europe. What is it, and how was it used? Respondents who provide its actual name get a bonus point. Your correct answer gets your name on a slip, and if your slip is drawn from the hat, you win an inscribed ADA paperweight. You get an extra slip in the hat for every clinical hint accompanying your answer. We are always looking for clinical hints, stories with health, hobby or dental relevance and TEASERS. Please take the time to send yours to: Barrie Gillings, Phone: (02) 9144 3787 Fax: 02 9440 9159 e-mail: firstname.lastname@example.org You too can join the ranks of those of your colleagues who selflessly forsake their golf/tennis games to prepare stories and clinical hints. This bi-monthly bunch are: A Bell, V Bird, A Dent, B Diebert, R Darcy, M Geisel, M Knapp, J Rourke, A Timmerman and S Zahedi. minus is that the patient may elect to stay with the surrogate. This could be a bad thing, but sometimes, perhaps, not. We have received a flurry of injection hints. It is important to keep the needle tip stationary, and pull the tissue over it, rather than push the tip through the tissue. When injecting the palate, palpate the tissue with the end of a mirror handle to locate a soft, thick area, and apply pressure for 10 seconds. Now slide the mirror end distally and stroke the area to stimulate the touch fibres and inhibit the pain fibres. Keep doing this while injecting at the initial pressure site. Warm the injection carpule before injecting, but warm also the needle tip. If it is cold, the patient can flinch because of the temperature differential. If you place dental floss gingival to the contact point before restoring a Class II cavity, you can use it to pare away any amalgam overhangs. Use the same technique when cementing a bridge to remove excess cement before it sets. But if the restoration, resin or amalgam is set, the floss is inoperative, but using an interproximal finishing strip to do the job may reduce the contact point if pushed past it. Avoid this possibility by cutting the strip into a thinner strip which can be inserted gingival to the contact point. Now you can reduce any overhangs without abrading the contact point. One of the challenges of root canal treatment is to find the openings of the canals. Holding the reamer, file or probe in your fingers obscures your view of the cavity floor. 'Locking tweezers' allow a better view, as do straight haemostats, but curved haemostats are better still. With them, it is easy to see the tip of the instrument entering the canal, and the firm grip allows excellent control of instrument insertion and removal. Despite improvements in general dental health, we are still called upon to extract teeth, and for the lower jaw, the patient has to provide some stabilizing muscular effort while you carry out the extraction. Consider placing a mouth prop between the molars on the opposite side. Now the patient can stabilize their jaw by closing on the mouth prop, thereby preventing undue stress on the temporomandibular joints. Extraction forceps and elevators should have sharp edges to facilitate insertion around tooth crowns and roots. Consider sharpening yours if they have become blunt with use. When faced with a badly broken-down crown on a tooth to be extracted, inject fast-setting GIC cement into the cavity, to provide some internal support during extraction. And if your forceps are blunt, and don't penetrate along the tooth root, use a No 11 or 15 scalpel to sever the coronal periodontal fibres. The GIC and the disposable scalpel are a small price to pay for avoiding a surgical extraction to remove a tooth root. Pictures on the surgery ceiling are a welcome distraction for patients. This hinter has extended the idea. He/she has mounted an LCD TV screen on the ceiling of the surgery to show TV programs, or better still, a memory stick to scroll a sequence of 300 of his/her best pictures. This keeps the patients interested and provides topics for conversation. Some appear to 'switch off' and are then easier to treat. BLACK HOLES These are the flavour of the decade for astronomers, and are a region of spacetime from which matter and energy cannot escape, (except, apparently, Hawking radiation) and may be caused when a star or galactic nucleus has collapsed to a point where its escape velocity exceeds the speed of light. A quick visit to the internet will reveal that the concept of black holes is not as recent as you might think. The first person recorded as having suggested their existence was a Yorkshire parson, John Mitchell, a great scientific thinker of the 18th century. In a letter he wrote to Henry Cavendish and the Royal Society in 1783, he suggested that a body falling towards another body 500 times the size of the sun from an infinite distance would be travelling at a speed faster than that of light, and thus deduced that light could not escape from such a body. How's that for advanced thinking! JAMES PARKINSON Another advanced thinker was James Parkinson, a surgeon, geologist, paleontologist and political activist, who in 1794 was nearly sent to Australia for a suspected involvement in the assassination of King George III. He is also probably the only person ever to win a natural history museum in a raffle. But his main claim to fame is that he wrote papers on gout and peritonitis, but especially, his report of his study of six individuals he observed suffering from what he called 'The Shaking Palsy'. Sixty years later, Frenchman Jean Charcot named the condition 'Parkinson's Disease'. We know a lot more about it now, but the name has been retained. clinical hints
ADA News Bulletin December 2010
ADA News Bulletin March 2011