17. To make a topical anesthesia

Topical anesthetics are used to reduce the sensation of needle penetration prior to local infiltration, or to reduce the sensation of gums mucosa when dental calculus is going to be removed.

Available materials are: aerosols, gels, pastes, ointments. (Benzocaine gel is manufactured with attractive tastes, such as bubble gum, and so is more popular.)

Technique of applying: The mucosa should be dried and topical agents left in contact with the tissues for a period of time as indicated by the manufacturer’s instructions. Adequate time (approximately 2–3 minutes) should be allowed for the topical analgesic to take effect before starting an infiltration or regional block analgesia.

The topical analgesic should be applied to as small an area as possible. This means that they are less effective on palatal mucosa and attached gingivae. This reduces potential toxicity and prevents excessive numbness in the tongue and soft palate which may be unpleasant for the patient.

18. To put devitalizing paste during the treatment of pulpitis.

Devitalizing paste is placed to disclosed pulp horn in the cases when anesthesia is contraindicated to the patient (allergy, heart attack in anamnesis). Materials: paraformaldehyde paste – is placed for 10 days; arsenic paste is placed for 3 days (provide toxic influence to periodontium). Technique: small amount of paste is placed to open pulp horn, after it is covered by small cotton ball and then temporary filling.

19. To disclose a tooth cavity.

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Stages of tooth’ cavity disclosure: 1) un roofing of pulp chamber; 2) gaining straight line access to root canal orifices; 3) final forming of carious cavity and tooth’ cavity. The access to tooth cavity in anterior teeth should be midway between incisal edge and the cingulum (from palatal or lingual surface). Tooth’ cavity disclosure of posterior teeth is better to do from occlusal surface in the projections of pulp horns, with the round-shaped burs. The turbine handpiece should be used to gain initial access, reverting to slow speed for removal of the pulp chamber roof and subsequent preparation.

20. To do pulp amputation.

Amputation treatment procedure by which the coronal pulp tissue is surgically removed with the aim of preserving the remaining tissue. Pulp amputation is done with round-shaped burs for slow-speed handpiece (pulp is removed only from pulp chamber). Indications: root on the stage of its formation, sclerosed root canals. Calcium hydroxide paste- “Sealapex”, “Calasept” (when root on its formation), paraformaldehyde paste (for sclerosed root canal) are placed to root canal orifices.

21. To do pulp extirpation.

Extirpation treatment procedure by which entire pulp tissue (often inflamed) is surgically removed. (The most used technique, is done under anesthesia)

22. To do the medicament treatment of root canal.

Irrigants dissolves organic debris and act against bacteria. Medicament treatment of root canal is done simultaneously with instrumental treatment of root canal. Delivery of irrigants: 1) by using endodontic needle and syringe; 2) by coating endodontic instrument in antiseptic solution every time it is inserted into root canal. Antiseptic solutions: Sodium hypochlorite – 3 %; Chlorhexidine - 0,2%, “Dikamfen”, “Formokrezol”.