Know How on First Aid Provisions

In order  to  determine  what  first aid  equipment and facilities are required,  an assessment of need must be carried out. The assessment should  consider the following:

  -  Hazards   currently  present  and  extent  of  the risks

   - Control  measures in place to reduce risks

    - Size of the practice, number of people employed and present at any one time

    - Individual  competencies of employees

   -  Accident  history  and  statistics,  any  patterns and trends identified

   -  Systems in place to manage health and safety

   -  The need for additional  facilities in the case of lone workers

   -  Exceptional circumstances which  could increase,  for example,  if construction work  is taking place.

First aid box

Minimum contents  of a first aid box include the following:

-    General guidance leaflet

 -   Twenty  individually  wrapped  sterile adhesive dressings

 -   Two sterile eye pads

 -   Four  individually   wrapped   sterile  triangular bandages

 -   Six safety pins

 -   Six medium and two large-sized individually wrapped  sterile un-medicated wound dressings

  -  One pair of disposable  gloves

First aid boxes must not contain  any medicinal products  such as tablets,  inhalers,  ointments  or creams.  If the assessment  of need identifies  that eye wash is required  then this should  be located at a designated  eye wash station.  First aid boxes must be clearly identified by a green background with a white St. George’s cross, and the location communicated  to employees. More than one box may be needed to ensure that  adequate  facilities are provided  according  to the number  of people employed at any one time. Boxes must be checked regularly  to ensure  that  contents  are not  out  of date and are replaced after use.

Travelling first aid kits

For dental professionals  who provide regular and routine  domiciliary  care for patients, there  may be the need for such a kit. The minimum contents of the kit should be as described earlier.

Scope of Dental Forensic

Human identification is the forensic odontologist's primary duty: Who is the victim? This involves the dentist as a team member working along with law enforcement agencies. This team is charged with the responsibility of investigating the evidence from cases involving violent crime, child abuse, elder abuse, missing persons, and mass disaster scenarios. In each cases, dental evidence produce compelling associations to aid victim and suspect identity and to establish facts that can affect the direction and ultimate outcome of investigative casework. Dental evidence can be used to identify both the people who were present during the commission of a crime or witnesses to an accident. The forensic dentist interacts with other forensic and medical disciplines like anthropology, pathology, human anatomy, and biological science. The best international source for forensic dental information and international forensic certification is available at Forensic Dentistry Online.

Forensic dentistry (aka forensic odontology in Europe) has a two-and-one-half century history in the United States. It is the science and practice of dentistry and its role in modern society. Dental injuries from accidents or assaults must be assessed and treated. Occasionally, the treating dentist or attending

forensic dental expert testifies in court proceedings for parties involved in civil litigation. Criminal cases use dentists to testify on dental evidence obtained from a crime scene or crime victims. Occasionally, a perpetrator of a crime leaves evidence at a scene. Bitten food, gum, or chewed objects may be recovered by law enforcement. Autopsy investigations may notice bite marks on the skin of a deceased victim. Dental experts also testify regarding the quality of dental care  (professional negligence) and in cases where dental fraud is an issue.

Management of Missing Teeth

The teeth are usually absent from the dental arch congenital or as a result of the disease, including tooth decay and periodontal breakdown are the most common. While it is not axiomatic that a missing tooth must always be replaced, there are many occasions it is desirable to improve the appearance, chewing or speech function, or sometimes to avoid damaging changes in the dental arches, as overeruption or tilt / drifting of the teeth. Tooth loss is also followed by alveolar bone resorption, which aggravates resulting tissue deficits.

In most countries with an oral care services is considerable component of the work of the dental team directed toward the prevention of tooth loss, repair damaged teeth, and replacing those missing, along with its supporting tissues. When patients are toothless, treatment for teeth loss has been largely restricted to the use of complete dentures, however, the timing, the potential treatments are more numerous, since a large variety of techniques can be used to stabilize prosthesis linking them to natural teeth. Removable partial dentures (DPR) are widely used due to
versatility and can yield long-term effective appropriate circumstances. They do, however, suffer from still relatively bulky, often require metal components can be difficult to hide are patient removable, and are inherently less stable than a fixed bridge that is secured permanently to one or more teeth. These can be both traditional designs on the extensive preparation pillars, or more modern and less destructive adhesive techniques. In general, DPR are used to management of missing teeth or alveolar significantly extended resorption and where there are advantages in relative simplicity of manufacture and replacement. Fixed restorations are usually less versatile and more expensive to provide, but have advantages related to stability and reduced volume.

Doctors have long sought to provide their patients with an artificial analogue of natural teeth and variety of materials and techniques have been used to it. However, it was not possible to replicate the periodontal tissues and alternatively strategies have therefore been adopted. These have was based on the principles of the creation and maintenance an interface between the implant and the surrounding bone, which is capable of transmitting the load, associated with healthy tissue adjacent predictable results and high success rate. This result proved elusive until the discovery of the phenomenon of osseointegration.As i will discuss osseointegration in my next blog post.

Work Equipments in Dentistry

In dentistry, the range of equipment is vast; however, it can be consolidated into two groups, namely equipment and instruments. Equipment is fixed or portable and manually or power operated. Examples of both groups appear below:

. Decontamination equipment

. Dental chair, unit and light

. Disposables

. Gas cylinders

. Hand-held dental instruments

. Office equipment

. Portable electrical appliances

. Pressure vessels

. Radiography equipment

. Rotary or air-driven instruments

. Suction units

The above is not an exhaustive list as it is impractical to list everything. However, the requirements of the Provision and Use of Work Equipment Regulations and other associated legislation must be applied to everything that comes under the definition of work equipment.

Hazards associated with work Equipment

An appreciation of the hazards presented by work equipment is important in order to effectively implement the safety precautions. The hazards range from relatively minor consequences to more serious and, in some cases, potentially fatal ones. The following list provides an overview of the more generic hazards:

. Electric shock

. Fire

. Faulty design or installation

. Entanglement with moving parts

. Entrapment from equipment falling over

. Impact from the release of particles ejecting

. Biological, chemical or radioactive contamination

. Noise or vibration

. Dusts, vapours or fumes

. Burns or scalds from contact with heating

systems

. Transmission of infectious disease through

sharps

. Upper limb disorder from poor posture

. Uncontrollable release of stored energy under pressure resulting in explosion

Everyone is exposed to the above hazards; therefore, the safety of users, operators, others in the immediate vicinity and the outcome of instrument malfunction or failure which may adversely affect patient care must be addressed.

OSSEOINTEGRATION

OSSEOINTEGRATION

Extensive work by the Swedish orthopaedic surgeon P.-I. Brånemark led to the discovery that commercially

pure titanium (CPTi), when placed in a suitably prepared site in the bone, could become fixed in place

due to a close bond that developed between the two, a phenomenon that he later described osseointegration (OI). This state has anatomical and functional dimensions, as it requires both a close contact between the implant and surrounding healthy bone and the ability to transmit functional loads over an extended period without deleterious effects either systemically or in the adjacent tissues. OI is defined in terms of the extent of the bone-implant contact, provided that functional requirements met and the tissues are healthy. Many of the factors that predispose to the development of OI are now known, and where these exist a successful outcome will probably follow the placing of a suitable implant. Similarly, failure is more likely where factors known to predispose to an unsuccessful outcome exist. 

Occasionally,implants fail for no apparent reason, sometimes in groups in one patient - the so-called 'cluster phenomenon'. It is therefore important to advise patients that a satisfactory outcome cannot be

guaranteed.OI is currently viewed as the optimum implantbone interface, without which success cannot be

obtained, and great emphasis has been placed on its production and maintenance. Nevertheless, it is only

one component of successful dental implant treatment and does not in itself prevent that treatment from

failing. While the absence of OI is equated with treatment failure, its achievement does not guarantee

success, which is dependent on the design and performance of the final prosthesis. This may be

precluded by an inappropriately placed implant, even if it is integrated.

While the osseointegrated interface and associated soft-tissue cuff where the implant penetrates the oral

mucosa are often thought of as dental analogues, they have a number of important differences. In particular, the interface is more rigid and less displaceable than the periodontal ligament, and behaves essentially elastically as opposed to the viscoelasticity of the periodontal ligament. The stability of the interface also precludes implant repositioning by orthodontic manoeuvres, but may permit dental implants to be used as anchorage for fixed orthodontic appliances. The osseointegrated interface is also associated with a slow rate of loss of crestal alveolar bone, typically less than 0.1 mm per annum after the first year of implantation. As a result, most implants can be expected to be functional throughout adult life.

Inflammation of the tissues around an endosseous implant is sometimes observed; it is described as

peri-implant mucositis when it involves only the soft tissues and peri-implantitis where loss of the bone

interface occurs. While the microorganisms associated with these lesions are similar to those seen in periodontal disease, it is currently unclear whether they cause the lesion or colonize the region subsequently.

Partial Dentate case scenario

Partial Dentate case scenario
The major benefits achieved with implant treatment the edentulous patients transferred early partially solve specific problems dentate patients, where shown to be very effective in appropriate cases. The situation, However, more complex than in the case of edentulous, since there are often several treatment modalities
could be used, and the status of existing teeth and additional support structures
difficulties. Dental implants are not an alternative oral hygiene or inadequate treatment of poor planning, and if improperly inserted in Patients can present a major problem partially dentate when extra teeth are lost.

THE SINGLE-TOOTH BASELINE
Missing teeth are single, especially because of trauma, with Not an uncommon problem, which can in many cases easily solved using traditional restorative techniques. However, there are some cases where this is not it produces technically feasible or fewer results. Recognizing these cases, planning and implementation implant-based treatment to discuss.

OTHER APPLICATIONS
The ability to develop interfaces in osseointegrated various locations resulted in a wide range  of potential applications for dental and skull implants.

PROBLEMS
A treatment with dental implants can be very complex procedure for planning enforcement, and management of subsequent problems. Despite the high success rate of the technique, not the unknown and managed by avoiding the best place than corrected after the event. Emphasis on this approach from the front consultation on, and covering different techniques may need to be employed when difficulties arise.

Health and safety in the dental practice

Health and safety in the dental practice
When drugs are referred, it is the use of controlled substances and the misuse
of over-the-counter or prescription drugs which is meant. Controlled substances include class A,B and C drugs such as cannabis, cocaine, lysergic acid diethylamide (LSD), etc. The term ‘drugs’ is also used to include the abuse of other substances such as solvent abuse. The use of such drugs is illegal and it may seem surprising, includes alcohol and smoking when alcohol and tobacco are not in themselves illegal substances. However, all have the potential for addiction and all can have a substantial effect on the workplace. In the context of work, the misuse of drugs and alcohol in particular, can not only damage the health of the user, but also have an impact on the workplace in respect of absenteeism and reduced efficiency. Smoking, while certainly not an illegal activity in itself, is illegal in the workplace.

While there are no firm statistics on the effects of drug misuse in the workplace, there is evidence
to show that the misuse of alcohol is associated with increased costs to the business
and an increased risk of injury to the individual concerned and his/her colleagues and patients.

20–25% of patients in acute hospital beds have alcohol as a contributory factor in their
admission.
. 20% of fatal accidents at work involve people with blood alcohol levels over the legal drink
drive limit.
. Between 8 and 14 million working days are lost every year because of alcohol-related absenteeism.
. Costs to industry are estimated at over £2 billion per year in United Kingdom
. Smoking costs the National Health Service (NHS) in United Kingdom around £1.5 billion per year.

The effects of alcohol
The misuse of alcohol and drugs can have a significant effect on the behaviour of an individual as well as on his/her health and well-being. However, smoking will also affect the health and well-being of a person, particularly if he/she has been smoking for some time. All three can also have an impact on colleagues and on patients. All three types of substances could be said to be taken for their narcotic or stimulant effect and can lead to addiction if misused.

Alcohol abuse
Many people regard alcohol as a positive and pleasurable part of their lives. It is only when
alcohol is abused that it will impact on an individual’s behaviour and on his/her ability to work
safely. While there are no known figures on the number of workplace accidents where alcohol
consumption is a factor, alcohol is known to affect both judgement and physical coordination.
How costly alcohol abuse can be in the workplace and the effects on the individual are
not only quantifiable in terms of money. It may be difficult for employers to be sure
when they spot the signs of alcohol abuse and when observed it can also be a daunting
prospect to deal with the situation. Some of the indications might be. decreased productivity;
. higher rates of absenteeism;
. being late for work regularly;
. increased aggression;
. bad decision-making.

Some physical signs might be
. slurred speech, increased clumsiness or unsteadiness;
. blackouts;
. weight loss (those dependent often drink rather then eat);
. redness in face;
. complaining of tingling in hands and feet.

Observable ‘mental’ signs might be
. increased irrationality, agitation or anger;
. excessive weeping or emotional display;
. unexplained absences during the day.

Of course, the above signs and symptoms could be an indication of a number of illnesses; so care
is needed when confronting someone.

General Treatment with Dental Implants

Treatment with dental implants has significantly extended range of care that we provide to patients, but in spite of its applications to a new for example, facial prosthetics, anchoring hearing aids and orthodontic treatment used primarily for prosthetic rehabilitation. If the potential benefits of their use is maximized, then it is important that the implant is selected
is a logical basis, and located within full range of treatments available restorative dentistry.

Treatment planning
Treatment should not be based on hope, it is in the mind of the dentist or the patient, but accurate information, understanding the patient's problems, the recognition of appropriate care options and agreed on the selection of one of the most will be necessary. This is not necessarily the most complex procedures or used as an aid Dental Implants. Their use is likely to succeed if it is selected as a sound basis.

Dental Implant Surgery
Real increase in dental implants, it is essential their optimal use and a lot more than only the surgical creation of an internal bony defect installation and the implant body. The technique requires proper planning and consultation with Dental team, even though the surgeon and prosthodontist are the same person. Although the integrated dental implant is the key to success, it is of little use if it is misplaced.

Edentulous CASE
Although the number of edentulous individuals is falling in many countries, which are often the mouth cripples. It is for this reason, treatment of such patients was one of the priorities of the early pioneers Dental implantology. The procedure may bring Using easily solved traditional restorative techniques. But there are some situations where this is not technically feasible, or produce inferior results. Identification of these cases, the planning and implementation of appropriate implant treatment.