Clinical Textbook of Dental Hygiene and Therapy (eBook)

Suzanne L. Noble BDS, MFGDP, MDentSci, is Director of the Birmingham School of Dental Hygiene & Therapy, The University of Birmingham

Clinical Textbook of Dental Hygiene and Therapy 5
Contents 7
Author biographies 11
Preface 17
Acknowledgements 18
Section 1 Core Basic Science 19
1 Oral embryology, histology and anatomy 21
Introduction 21
Oral embryology 21
Early tooth development 22
Development of the dental tissues 23
Histology of oral tissues 26
Histology of dental tissues 29
Oral anatomy 33
Anatomy of the oral cavity 38
Tooth morphology 44
2 General pathology 50
Introduction 50
Inflammation and immunity 50
Wound healing 56
Hyperplasia, hypertrophy and atrophy 57
Neoplasia 59
Haemostasis 64
Atherosclerosis 66
Cardiac disease 67
Hypertension 69
3 Oral medicine and pathology 71
Introduction 71
Viral infections 71
Oral ulceration 72
White patches and premalignant lesions of the oral mucosa 74
Oral cancer 76
Soft tissue swellings of the oral mucosa 78
Cysts of the jaws 80
Conditions of the salivary glands 82
Oral manifestations of systemic disease 83
Common causes of facial pain 84
Disorders of the temporomandibular joint 85
Developmental tooth anomalies 85
Tooth wear 88
4 Dental caries and pulpitis 90
Introduction 90
Aetiology and microbiology of dental caries in relation to dental plaque 90
The epidemiology of caries 97
Features of enamel, dentine and root caries 98
Diagnostic methods for dental caries 101
Non-surgical management of dental caries 104
Surgical management of dental caries 104
The histopathology of pulpitis 106
Abscess formation 106
Section 2 Clinical 109
5 The periodontium, tooth deposits and periodontal diseases 111
Introduction 111
The normal periodontium 111
The classification of periodontal disease 114
Chronic gingivitis 114
Chronic periodontitis 116
Aggressive periodontitis 118
Histopathology of periodontal diseases 119
Gingival recession 120
Acute periodontal conditions 120
Microbiological aspects of periodontal disease 122
Principles of periodontal examination 123
Treatment of chronic periodontitis 129
Conclusion 141
6 Oral health education and promotion 143
Introduction 143
Meaning of health 144
Defining health education and health promotion 144
Promotion of oral health 145
Considerations while planning health education and health promotion 148
Planning a teaching session 151
Oral health promotion/education examples 154
Conclusion 156
7 Diet and nutrition 157
Introduction 157
The relationship between diet and disease 157
The current national dietary recommendations 158
Dietary requirements of groups with special needs 163
The effect of ethnicity and culture on nutrition 165
Dietary needs in specific states of disease 165
The principles behind the dietary control of dental caries 165
Classification of sugars in relation to dental caries 167
Alternative sweeteners 169
The relationship between diet and erosion 170
The relationship of diet to periodontal diseases 171
The role of the dental hygienist/therapist in dietary advice and counselling 173
8 Microbiology and infection prevention and control 176
Introduction 176
Requirement for a formal infection prevention and control policy 176
Microorganisms 177
Immunisation 179
Standard precautions 180
Hand hygiene 180
Aseptic techniques 182
Protective clothing 182
Processing and handling of dental instruments 184
Surgery design 188
General surface cleaning and disinfection 189
Waste management 189
The dental chair unit as a vehicle for cross-contamination and cross-infection 190
The dental laboratory 194
Diagnostic specimens 195
9 Materials in restorative dentistry 199
Introduction 199
Amalgam 199
Resin composite 201
Glass ionomer cements 205
Cermets 209
Compomers 209
Materials for the protection of fissures 210
Adhesion to tooth substance 210
Pulp protection regimes 213
Temporary dressing materials 214
Impression materials 215
Key points 216
10 Pharmacology and pain control 217
Introduction 217
Prescribing regulations and the use of the BNF 217
The use of antibiotics and antimicrobials in dentistry 219
The use of analgesics in dentistry 222
The relevance of other drugs that may affect oral health and dental treatment 223
Local analgesic agents 226
Techniques for local analgesia 227
Difficulties, complications and emergencies that can be associated with local analgesia 232
Equipment used in dental local analgesia 234
Conclusions 236
11 Preventive dentistry 237
Introduction 237
Definitions of prevention 237
Prevention of periodontal disease 239
Prevention of caries 242
Fluoride 243
Fissure sealants 247
Life-long prevention 249
Prevention for persons with special needs 250
Prevention and implantology 251
Oral cancer screening 253
Alcohol abuse 254
Smoking cessation 255
Smoking habits 255
Illegal drug abuse 258
The primary health care team 259
12 Paediatric dentistry 262
Introduction 262
Dental development 262
Tooth notation 262
Tooth eruption 263
Morphological differences between primary and permanent teeth 263
Disruption in the number of teeth 263
Disruption of tooth form 264
Abnormalities of tooth structure 265
Dental caries 266
Tooth wear in children 271
Treatment of dental caries in the primary dentition 272
Soft tissue problems in children 278
Anxiety and pain control 280
Trauma in children 285
13 Adult restorative dentistry 287
Introduction: the importance of the treatment plan 287
Charting the adult dentition 288
Classification of cavities 288
Preparation of cavities 290
Pulp protection 294
Moisture control 295
Direct restoratives: clinical properties, handling and placement 297
Polishing and finishing restorations 306
Replacing and repairing restorations 306
Temporary restorative materials and their placement 307
Temporary crowns 307
The clinical aspects of taking impressions 308
The management of discoloured teeth 308
Management of trauma 311
The principles of advanced restorative care 311
Care of instruments and handpieces 314
The ergonomic environment 315
Management of anxiety 315
14 Exodontia 317
Introduction 317
Indications for tooth extraction 317
Contraindications for tooth extraction 318
Relevant anatomical structures 318
Preparation of the patient 318
Obtaining local analgesia 319
Clinical assessment 319
Extraction instruments 320
Extraction technique 322
Postoperative care 325
Complications of exodontia 325
15 Gerodontology 329
Introduction 329
Physiological age changes 329
Pathological change 332
Nutritional disturbance 336
The dentate elderly 336
Domiciliary care 336
Treatment of the terminally ill 339
16 Medical emergencies and their management 343
Introduction 343
Management considerations 343
The role of the hygienist/therapist 345
Avoidance of a medical emergency 345
Assessment of the sick patient using the ‘ABCDE’ approach 347
Medical emergencies 348
Patient discharge 363
Conclusion 364
17 Health and safety at work 365
Introduction 365
Working environment 365
Materials 366
Equipment 366
First aid 368
Waste disposal 368
Accident book 369
Fire prevention 370
Radiation protection 371
Personal protection 372
Clinical governance 377
Risk assessment 377
18 Complementary and alternative medicine 379
Introduction 379
Acupuncture 380
Herbalism 381
Aromatherapy 381
Chiropractic 382
Osteopathy 382
Hypnosis 382
Homeopathy 383
Biological medicine for the twenty-first century 387
Section 3 Non-clinical 389
19 Primary care services 391
Introduction 391
The framework of UK primary dental care service provision 392
The provision of NHS dental services 392
The primary dental care team 394
The public health agenda and an introduction to epidemiology 397
Summary 400
20 Law, ethics and professionalism 401
Introduction 401
Regulation of dental practice 401
Professional duties and obligations towards patients 403
Patient consent to treatment 406
Relationships with professional colleagues 408
Relationships with the public 409
Clinical governance 410
Employment law 412
Sources of advice 412
Index 414