NICAELLA CHARIZZE GUICO
CHAPTER IV
Pre-operative Requirement
1. Dental and Clear Oral Areas
 Insertion of guta-percha in
carious cavities
 Insertion of gold fillings in cc
 Insertion of methyl methacrylate
self-curing restorations
 Insertion of Silicate cement, zinc
oxide and other cement
 Treatment of Root Canal
 Use of Abrasive Technic
 Surgical Operation where the
field should be maintained
devoid of fluids which interfere
with a clear view
 Application of topical fluoride
2. Good Illumination
- There should be STRONG,
ARTIFICIAL LIGHT – from an
electric spotlight as a source of light.
- Natural light is only useful in the day
- Mirrors help too as mouth reflectors
- Light should be IN FRONT of the
patients mouth
- Fluorescent lamps – stimulate
daylight
When the CATHODE causes
electrons to pass through the vapor,
ultra violet lamp is emitted and this
in turn causes PHOSPOR to emit
visible light.
Systematic Office Arrangement (design)
 efficiency and ease of operation
 comfort of the people concerned
 hygiene
 sanitation
 pleasing interior decoration
Architectural and Engineering Design
- Most successful dental establishment
are constructed in such a way that
from the waiting room, the patient
may enter the business office, and
from there the clinic.( RIGHT SIDE)
MIDTERM REVIEWER
- Dental chair should be the FOCAL
point of the entire architectural and
engineering design.
Position of Operatory Equipment
- Dental Chair should be
CENTRALLY located, close to side
of the right arm of the assistant. Face
the window
- Dental Unit and Cuspidor are placed
to left of the dental chair.
- Spotlight and Swinging Bracket table
for the instruments are installed
beside the unit.
- The Sterilizer and Cabinet should be
at the Right Side.
Two Requisites for a healthy pleasing
atmosphere in a dental office:
GOOD LIGHT & VENTILATION
Position of the Dental Furnishings
- In the absence of a dentist’s nurse or
assistant, the companion of the
patient serves as witness to the
operation for both the protection of
the dentist and the patient.
- An adult companion receives home
care instructions for minor or aged
patients. Minor age should be
accompanied by a guardian or a
representative of the guardian.
The Dentist’s Chairside Positions
Convenience of the Dentist and Patient
The position of the dentist is important
because:
1. Dentist’s hands has a bearing on the
forces he exerts and therefore also on the
efficiency of his work.
2. The position of the instrument which
depends on the position of his hands is
related to correct technics.
3. The position of the patient relative to the
position of the dentist will affect the
patient’s comfort
NICAELLA CHARIZZE GUICO
4. The posture of the dentist over the chair
might affect his health.
- Hunched Shoulders: weakness of
lungs
- Leaning: flabby of abdominal muscle
- If the chair is not adjusted well for
the comfort of the patient and the
convenience of the operator,
incorrect angles of force would result
during instrumentation.
5. His body should not block the
illumination coming from the spotlight
or window.
Dignified Posture
General Rules
These recommended points are based on the
standing position:
1. He should not stoop from the shoulders
while working His shoulders should be
erect, his feet both on the floor.
2. He should avoid leaning on the sidearm
of the chair.
3. His forearms should be more or less
parallel with the horizontal
4. He should not need to bend too low to
see what he is doing or to crane his neck.
Basic Positions
McGehee (16) described 3 Fundamental
Operating Positions:
POSITION NUMBER 1:
Right side in front - 7:00
a. Right side in front for upper teeth
b. Right side in front for lower teeth
POSITION NUMBER 2:
Right side behind -11:00
a. Right side behind for the upper teeth
b. Right side behind for the lower teeth
POSITION NUMBER 3:
Left side behind – 1:00
a. Left side behind for upper teeth
b. Left side behind for lower teeth
MIDTERM REVIEWER
The operator should look down, not up, at
the field of work.
CHAPTER V
Records of Cases
Dental Recording System
- Dental practice is NOT confined to
the teeth alone. The gums, tongue,
throat, and the surrounding
structures, particularly the alveolar
bone are just as RELEVANT to
Dental Practice as teeth are.
- Recording must be done beginning
from original situation on complaint
as in case or fractured crown.
Through remedies like the crown
form attached.
To the final stage restoration
The Patients Rule
The Patient’s Complaint
- A patient will tell his present
complain and the reason for his visit
to the dentist without being asked.
- REASONS:
 Preventive
 Curative
 Cosmetic Consultation
Silicate Cement as permanent fillings
The Dentist’s Rule
Pre-treatment Consideration
- Dentist is responsible for evaluation,
it is up to the dentist to make the
diagnosis and prognosis and plan of
treatment.
- EXIGENCY: one plan of treatment
is possible, and the dental delay
thereof would surely destroy the
patient’s health.
- ORAL PROPHYLAXIS: need
consent
NICAELLA CHARIZZE GUICO
- Minor or Major the plan treatment to
obtain the patient’s voluntary
consent.
- Voluntary Consent: very request he
makes, impliedly or in so many
words when he goes to a clinic and
sits down in the dental chair of his
own accord.
Priority Data
Taking Data BEFORE treatment is done or
the case is not an emergency.
1. Full Name of the patient
2. Address
3. Whom Referred
4. Date of Admittance
5. Age of Patient
6. Sex
7. Roentgenograms: pictures of
laboratory findings dealing with
systemic conditions which may have
bearing upon dental treatment
8. The payment or installment fees, the
balance, together with dates when
these were made noted
9. Conditions of the mouth given
attention during routine oral
examination
Dental Charts
- Must be charted or indicated in the
patient’s record. Obtain his family
health history.
Local and Systemic Considerations
- An evaluation of the general and
systemic condition of the patient
should be done whenever possible.
- Important for the following reasons:
1. Findings pertaining to the
teeth and their surrounding
structures are not conclusive
of that oral conditions and
diagnosis cannot very well be
establish systemic findings
might aid in the evaluation of
the local data.
MIDTERM REVIEWER
2. Mouth is an integral part of
the human body and any
condition which affects the
system will also affect the
mouth.
3. A patient who visits a dentist
for oral treatment do not
suspect the existence of
pathology in his body of
mouth.
Routine Examinations
Routine examination in a dental office
should therefore include the following.
A. The General Physical Build – quick
arbitrary and cursory appraisal or
impression a dentist gets upon his
first acquaintance with a patient.
B. The mouth
C. The Systemic Conditions
Body Temperature
- Temperature of the individual
represents the balance between heat
production and heat loss in the body.
- Normal Temperature: 98.6’F or 37’C
- Rectal Temperature: degree lower
- Axillary Temperature: one degree
higher
- Internal organs have temperature
about 2 or 3 degrees higher than that
of the skin.
- Temp. Of the skin varies with the
type of clothing, physical exertion,
and environmental temp.
Fever or “Pyrexia”
High abnormal Temp. is called fever
or pyrexia.
Present in:
1. Severe infection
2. Reaction to post surgical
operations
3. Neurogenic Fever from
injury of the cns
NICAELLA CHARIZZE GUICO
4. Fever may be present in
dehydration due to reduction
of blood water.
5. Fever may be produced by
drugs and other chemical
substances.
- Fever is a manifestation of general
body reaction and mobilization of
forces of rehabilitation and therefore
greater heat production in an effort to
heal the injury.
The Use of the Thermometer
Conventional Sites: MOUTH, AXILLA, &
the RECTUM
- The MERCURY COLUMN of the
thermometer should be made sure to
be in the bulb.
- The body heat causes the mercury in
the bulb to expand and rise
- To clean Body thermometer by cold
sterilization never by means of heat.
Alcohol, 70% by volume will be a
good cleansing agent.
Special Considerations
Records ought also to show vital
information such as:
1. Adverse drug reactions
2. Prescription issued
3. Treatment in the past or present
whether systemic or dental
emergency or not
4. Health conditions when the patient
was still a child
5. Behavior problems laboratory
finding and other pertinent matters.
- Dental records also include
PLASTER CASES and impressions
of the teeth, old dentures, and
photographs, pertinent reports from
family members and close relations
and prognosis from colleague
consultant.
MIDTERM REVIEWER
- Minor of Age or Mentally
incompetent need parents or
guardian to be present or send
writing consent which be important
when doing surgery on a child.
- Financial accounting records are also
important.
CHAPTER VI
Home Care of the Patient
Tooth brushing – A Must
The Toothbrush
- It is not considered a dental
instrument; it is one of the
indispensable hand instruments for
the patient in home care.
- With proper tooth brushing the rate
of incidence of caries and
periodontal disease in a person can
be checked by controlling the
presence of virulent micro-organism
- By preventing HALTOSIS: in giving
the patient a pleasant smile and the
feeling of cleanliness in the mouth
- Idea of home care with the tooth
brush is not from dentist, but from
ADVERTISERS.
- The toothbrush cleans mechanically;
it cannot be expected to affect the
biochemical status of germs.
Several Methods of brushing teeth:
1. Mesio-Distal Stroke or Straight right
& left motions
2. Up & Down Motions
3. Rotary Stroke
4. Motion carrying the brush from
gums toward and over the teeth.
- McGehee,suggested the brush to be
placed at a 45 degree angle to the
surface of the tooth and extending
about 3 millimeters on the marginal
and cemental gingival.
NICAELLA CHARIZZE GUICO
- Brush is swept SLOWLY over the
teethtoward the incisal or occusal
margin.
- Sensitive gums; a very clean
forefinger may be passed firmly but
gently over the gums in an upward
stroke, several times.
- The first two methods are said to
cause gum injury. It will occur if the
bristles are too hard and the brushing
motion brusque.
- The third may be used with
accompanying strokes of the fourth
type.
Toothbrushing Aids – Optional
 Bacteriostatic: to inhibit the growth
of bacteria
 Bacterioscidal: to Kill
The action of Dentifrices, Mouthwashes,
and the Toothbrush
- Dentrifice contains emulsifying agents;
reason foam is produced when the brush,
laden with the dentrifice is rubbed against
the teeth and gums. Not bacteristatic or
bacteriocidal.
- Mouthwash gives the mouth a feeling of
freshness of the menthol and like ingredients
which they contain.
- Dentrifices aid in whitening of the tooth. It
should not be overused or else it will lead to
sensitiveness of the teeth.
Care of the Gums
Role of Systemic Conditions
- No matter how much care is given to
the gums by cleanliness, gum
massage and other factors of
localized nature, the over-all health if
the gums will depend on the general
conditions of the body.
Gum Massage
- Practice of massaging the gums in
order to stimulate good circulation
MIDTERM REVIEWER
and to avoid vascular congestion in
gums.
- Healthy rosy and firm gums do not
bleed easily with the normal use of
toothbrushes of ordinary hardness.
Fibrous, Coarse Food
- Fibrous foods help in maintaining
the integrity of the gum through the
mechanical stimulation which occur
during mastication.
Possible Injuries from Mouth Hygiene
- Methods to effect good hygienic
conditions of the mouth often lead to
either acute or chronic injuries.
Improper Use of the toothbrush
- Grevers of Amsterdam: did not find
a single case of cervical abrasion in
about 6000 human skulls dating from
times when toothbrushes were not
part of civilization.
Pathogenesis
- The untoward results from tooth
brushing occur from erroneous
manners in which it is used, or the
type of dentrifice used as an
accessory and on the vulnerability of
the oral tissue.
Abuse from Dental Floss and Toothpick
- Recommend dental floss and the
toothpick. Though toothpick is not
flexible this may hurt gums.
Etiology and Clinical Symptoms
- Dental Floss when pressed hard
against tissue may injure the
interdentally gingival, particularly
when the crowns of teeth are tight in
contact the silk floss may break
suddenly on the gingival, and cause
bleeding and inflammation.
NICAELLA CHARIZZE GUICO MIDTERM REVIEWER

- Pinz pointed out that soap is a strong

ASTRINGENT and that in
concentrated solution it is caustic
and has the tendency to lower the
resistance of the oral mucosa.
- Charcoal when included in some
tooth powders may abrade and cause
deposits in the gingival margins
which cannot be removed.
- The use of toothpastes or tooth
powders of great abrasive power
may certainly whiten the teeth but
may give rise to the formation of the
several kinds of abrasions.

Barotaxis
- One of the occupational hazard
experienced is stimulation of the
pulp of the tooth by changes in
altitude.

Danger from Dentrifices and Oral

Antiseptics
- Dentrifice in order to have effective
cleansing and stain-removing
properties should have abrasive
ingredients.

Etiology
- The rough ingredients of dentrifices
are pumices and siliceous materials.
- Abundant soap in toothpastes more
than 3 t0 5 % may not be tolerable to
mucous tissue,
- The use of toothpastes or tooth
powders of great abrasive power
may certainly whiten the teeth but
may give rise to the formation of the
several kinds of abrasions mentions.