Analgesia, anaesthesia, and sedation

This chapter summarizes the different techniques available for analgesia, anaesthesia, and sedation in dentistry. This includes the use of benzodiazepines while highlighting the indications and contraindications for each technique and approach. The varying methods of administration of local analgesia are outlined, with information on the commonly used preparations and techniques. The use of both oral and intravenous sedation is discussed, including important points on drug interactions and reversal agents. This chapter considers the triad of unconsciousness, muscle relaxation, and analgesia that makes up general anaesthesia and details the drugs used to achieve this in a hospital setting.

Maxillofacial surgery

Oral and maxillofacial surgery is largely a post-graduate subject. This chapter begins with a section on advanced trauma life support and goes on to include details of the diagnosis and management of facial trauma, orthognathic surgery, as well as head and neck surgery and reconstruction. Only basic aspects of this specialty have been included here as advanced techniques are beyond the scope of this chapter. However, this chapter provides enough information so as to ensure success for final year dental students but it can also be of use to those working in oral and maxillofacial units.

Oral surgery

This chapter provides a comprehensive overview of several aspects of oral surgery. It starts with some general principles that are applicable to all types of surgery and gradually includes details of common dental procedures. There is emphasis on suturing and dento-alveolar surgery including third molar surgery. More specialized procedures such as an apicectomy and a coronectomy are also described. The aim is to provide guidance that will help with the pre-operative assessment, as well as details of the specific oral surgery techniques. Clinicians in general dental practice and dental core trainees in hospitals often encounter patients with dento-alveolar infections as well as benign soft tissue or bone pathologies. This chapter provides the foundations of management of these conditions.

Paediatric dentistry

This chapter introduces the principal aims of treatment in paediatric patients, detailing examination, treatment planning, and prevention. Various approaches to behaviour management are discussed including tell, show, do; behaviour shaping; reinforcement; and desensitization. The emergency management of children with toothache is also discussed alongside developmental abnormalities (including abnormalities of tooth eruption and exfoliation, tooth number, tooth structure, tooth form, and tooth colour) local anaesthesia, and restorative techniques. Injuries to primary teeth and to permanent teeth are discussed. The chapter also provides advice on the management of dental trauma, with information on safeguarding children.

Useful information and addresses

This final chapter contains useful information and contact addresses, including diagrams explaining tooth notation, a list of some qualifications in medicine and dentistry, and file sizes for endodontic therapy. There is a section on commonly used intoxicants (including alcohol, nicotine, and caffeine), both prescription and illegal, and their pros and cons. e-learning, Internet searching, and social media and its relevance to dentistry are also included within this chapter of the book. Finally, advice is given on preparation for and passing different types of exams and lists of useful contacts, websites, and email addresses are provided.

Law and ethics

This chapter considers the legal and ethical aspects under which we work as dental professionals. In an increasingly litigious society, it is important to be aware of the processes that are involved with complaints and recourse to the law and our Regulator. This chapter briefly outlines the differences and also similarities between those legal processes and those of the General Dental Council. The processes that are involved in fitness to practise are also discussed, and the different types of indemnity are briefly considered. Important changes to the law concerning consent are outlined, and how these might affect how and when treatment is provided to an individual. Some simple ethical principles to consider are outlined, and the reader should perhaps develop these concepts further throughout their careers in dentistry.

Therapeutics

This chapter contains a brief guide to the clinical use of some of the more commonly used and useful drugs in hospital and general dental practice. Doses are for healthy adults. There is also information on prescribing guidelines and adverse reactions which may be encountered. The chapter includes local contact details for the Medicines Information Service as well as details on how to report adverse reactions to drugs to the Medicines and Healthcare products Regulatory Agency (MHRA). Contraindications of common drugs are outlined and updated information on oral anticoagulants and antiplatelets is included, as well as details on medication-related osteonecrosis of the jaws.

Medicine relevant to dentistry

This chapter provides the details of systemic conditions that may be relevant to the dental team. Emphasis is given towards the management of medical emergencies. The dental practice can be a ‘lonely place’ during medical emergencies. The clinician will find the guidance from this chapter helpful. Practical tips are included as well as diagrams that can be easily referred to at the time of an emergency. This chapter includes details of common procedures that are essential during inpatient care. Some procedures are not performed often during the initial dental training.

Restorative dentistry 2: repairing teeth

This chapter covers the broad topic of repairing teeth, from the basics of composite and amalgam restorations, to the more advanced concepts of occlusion, veneers, and the management of tooth wear. Occlusion is a topic of paramount importance when planning restorative treatment and is something that is often overlooked. The updated chapter includes detailed definitions and occlusal considerations for restorative procedures, such as occlusal record taking, deciding between a confirmative or reorganizational approach to care, and articulation of study models. Indications for various techniques and materials are discussed, including necessary tooth preparation and cementation advice where relevant. Although its use is reducing, amalgam still plays a part in the day-to-day dentistry of many clinicians, therefore its indications, applications, and the use of liners is included. Temporary restorations are considered including preformed, laboratory custom-made, and chair-side techniques.

Orthodontics

This chapter discusses the growth of the face, development of the dentition, and prevention and correction of occlusal anomalies, providing a concise overview of the fundamentals of orthodontics. Definitions relevant to orthodontics are outlined as well as a structured approach to orthodontic assessment. The Index of Orthodontic Treatment Need is explained, and its implications highlighted. The chapter also simplifies cephalometrics before detailing the management of increased overbite, anterior open bite, increased overjet, and various other dental and skeletal malocclusions. A further area included in this chapter is orthognathic surgery. The section includes diagnosis and treatment planning in these cases, surgery, and distraction osteogenesis.