Antibiotic Prophylaxis

So essentially there are 4 main talking points.
1) the chance of getting Infective Endocarditis is higher for all the chewing and tooth brushing we do than for a dental procedure.
2) therefore maintenance of dental health is more important than prophylactic antibiotics.
3) we are more likely to die from the antibiotics over the infective endocarditis.
4) the antibiotics has never been shown to work.

Who still get is?
1) congenital heart defects.
2) prothetic heart valves.
3) past history of infective endocarditis.
4) aboriginals in australia.
5) cardiac transplant patients.

What about joint replacement patients?
1) Nope.(British Dental journal 2003.)

How do you make a great contact when the sectional matrix doesn't fit?

Option 1
- build up the buccal and lingual with a tofflemire or even freehand.
- Then use the sectional matrix.

Option 2
- you should be doing a crown anyway.

Option 3
- hawe contoured matrices.

Option 4
- Kerr Supermat

Option 5
- build up with a tofflemire
- Then cut a class II restoration and use your sectional.

Composite resin

Check out my composite resin free hand crown on the 12.  Not as shiny as empress but very satisfactory I think. 

Healing after a horizontal root fracture

This is a great example that horizontal root fractures can heal.  This xray of a 90 year old lady who fell over when she was in her 20s.  70 years of success.
 Wow

Crying children

Ahhh..... how do you stick a needle in a child without them crying?

Calcified canals.

Normally I wouldn't bother with searching for calcified canals.  However I am pretty happy that I found 3 canals in this upper right first molar.

I'm trying not to think of the MB2.

It took 1.5 hours and I think the patient's wife wasn't happy about it.  I guess on a new patient, I needed to manage the expectations better.  I feel like I did him a good service but because I didn't sell it, he didn't appreciate it.

Composite resin polishing - Method 1

Assuming your filling sticks, I imagine the percieved quality of my filling is based on my polishing. So here is what I do.

Quick method
1. red band fine diamond to smooth.
2: white rubber in a high speed.
3: Occlubrush(Kerr)

Getting it really smooth.
1: red band fine diamond to smooth.
2: soflex disks, purple, then green, then pink,
3: then the Occlubrush(Kerr)

That's it.  I get it pretty smooth this way.  It feels like glass but I think if I used polishing paste, it would be shinier.  The shine doesn't last too long

Things I can't do

So M is a little girl who is too scared of needles to have anything done.  So there are lots of strategies that I could try.

1: reasoning - "Take a look at your stinky tooth,  we need to give it back to the tooth fairy otherwise it will get really stinky and other kids won't play with us"
2: parental pressure. - "We no longer force children into having treatment done.  Please have a talk with your child and we'll see her in the next week and try again.
3: bribes - "Get this done and we'll got  McDonalds".

Alot of the time, I think it's just got to do with having a child who is ready developmentally.  Or having a persuasive personality.

Right now, I can usually get one procedure done, but coming back later is always tough.  And it's quite predictable.  So my pedo referral pad gets alot of action.

Welcome all

So I'm not really sure what I want from this blog.  I suppose it is just a public history of the way I think about dentistry stuff because I like what I do. Yet improving my skills is proving more difficult than expected.

I'll try to fill this with techniques and summaries.