Preventive dentistry

Preventive dentistry includes instruction in oral hygiene; regular inspection; and any necessary treatment for prevention and removal of stagnation areas. Instruction in oral hygiene is best given at the chairside, whilst posters and pamphlets in the waiting room serve as an extra reminder.

Patients must therefore be told how to clean their teeth when a toothbrush is not available. The best substitute in such cases is a detergent food or plain water mouth rinse.

Prevention is better than cure. Patients should be encouraged to have a regular inspection twice a year. Bite X-rays are taken at the same time for early diagnosis of caries. Early treatment of caries enables affected teeth to be conserved rather than extracted.

Pulpotomy and Apicectomy

In adults, conservative treatment of an exposed vital pulp is by root filing. But in children, growth of the root yet complete and an exposed tooth may still have a wide open apex, instead of the minute apical foramen.

The infected part of the pulp in the pulp chamber is remover a procedure know a pulpotomy. Apicectomy is an operation for removal of an infected apex and the surrounding alveolar abscess. The purpose of apicectomy is to save the tooth in cases where root filling is unsuccessful or impossible.

It is done for the following reasons :

1) Root filling unsuccessful .

(a) Incomplete filling of inaccessible canal .

(b) Escape of irritant cement through apex.

2) Root filling impossible .

(a) Canal blocked by broken instrument .

(b) Alveolar abscess on tooth with post crown.

Scaling and Gingivectomy

Scaling and Gingivectomy are performed for the treatment of periodontal disease. Scaling, which is removal of calculus and plaque, is the most important means of treatment, Regular periodic scaling can help prevent the onset of periodontal disease and will cure established cases with shallow gingival pockets.

Gingivectomy is the surgical removal of gum to eliminate pockets. It is minor oral surgery. A local anesthetic is injected and the gum incised with a gingivectomy.

Conservative treatment of periodontal disease by scaling and gingivectomy is a waste of time unless patients are prepared to cooperate by cleaning their teeth and massaging the gums after meals

Filling (Стр 183)

Conservative treatment of caries, when the pulp isvital and unexposed, is by filling. If the pulp is exposed or dead, root canal therapy is usually necessary before the filling is done. Fillings are inserted in teeth to replace the part destroyed thereby restored, prevented, and the vitality of the pulp is preserved.

The temporary fillings are:

zinc oxide and eugenol cement,

zinc phosphate cement

zinc polyacrylate cement,

gutta-percha.

Permanent fillings are also various. Permanent fillings are meant to stay put permanently and the cavity must be specially prepared to provide maximum retention. It is necessary to considerthe types of fillings used. There are only two types available plastic and pre-constructed.

Plastic fillings are soft and plastic on insertion but set hard in the cavity.

Pre-constructed restorations are gold inlays and crowns.