B750 Dental Nursing : Outcome of Endodontic Resurgery

Introducation:

Endodontic treatment is a treatment procedure that takes care of the inner healthiness of a tooth i.e. it treats the inside of the tooth. Some of the most sensitive parts of the inside of a tooth are involved, they are: the pulp which contains the tooth nerves, roots, blood vessels and connective tissues (Saatchi, 2007). Therefore, endodontic treatment is necessary when the pulp, which is the soft tissue inside the root canal, becomes infected with bacteria. This may be caused by several things like deep tooth decay itself, repeated dental procedures, cracks and chips and trauma to the tooth (Peterson et al, 2009). With this information I can say that endodontic treatment is a better solution for tooth removal, tooth replacement as well as the need for tooth bridges or implants.

Since endodontic treatment involves the physical structure of the tooth, a dentist and the nurse in charge therefore has to have knowledge on the tooth anatomy to be able to perform this kind of treatment. They have to know and clearly differentiate between the different type of tooth treatment alternatives to this treatment, its effects to the patient and the complications that may arise after the treatment.

Unit 310

LO1 1.2: Some of the instruments, equipment and materials used during the endodontic treatment are: syringes and needles used to inject the anesthesia into the patient’s blood stream to help them relax and relieve pain, irrigation solution (Salehrabi et all, 2004) e.g. Sodium hypochlorite are used to remove the infected tissues along the root canal, kill the bacteria around the canal and prevent further recontamination of the tooth. Paper points are used for measuring the length of the canal. Furthermore, a rubber dam is used to help in choosing the best irrigant solution for the treatment (Öztan, 2002). For personal protection, the dentists and nurses use personal protective clothing like plastic aprons and gloves among others.

LO2 2.4: However, complications may occur during the treatment such as: accidental sodium hypochlorite extrusion which causes a lot of pain to the patient. In case of such a situation an urgent treatment should be done to prevent long-term effects. Other complications may be caused by things like excess removal of the tooth structure, failure to get the right canal line which may cause perforation (Mann, 2010; 2011).

LO2:Non-surgical endodontic treatment involves some process like pulp capping which is a process used to prevent the pulp from dying after it has been exposed into the air, pulpotomy which can be defined as the removal of the pulp cavity that is infected from both the tooth and the roots with an aim of leaving it completely clean and pulpectomy which is a process needed only when the pulp cavity is detached completely from the tooth (Regan et all, 2005).

Unit 311

Minor oral surgery refers to the small operations that are conducted to remove minor teeth like the wisdom or the broken ones (Hepworth et al, 1997).  However, there are many operations involved in these kinds of surgeries like:

During dental implant surgery there are many activities to be carried out e.g. taking x-rays, making models for the teeth and their mouth, removing the damaged tooth or teeth, bone grafting in case it is needed, placing of the dental implant metal post, placing the abutment and placing the artificial tooth or teeth.

e)When removing buried roots the processes are the same as those taken when removing impacted teeth but the only difference is that at the end is the root that is removed.

2.5) a)During the process of minor oral surgery there are some complications that may occur like nerve damage which is simply pain of the body nerves.

3.1) Some of the general instructions to give a patient with xla extractions include: should have clean mouth before extraction, eat soft food before and after, patients under 18 to be accompanied by parents, to wear comfortable and loose cloth, take little water if possible among others (Ørstavik et all, 1998).

2.7) Placement of Sutures

Sutures are surgical devices that are used to hold or stitch body tissues together whenever they are damaged or injured. They are usually divided into two categories which are: either absorbable or non-absorbable sutures, synthetic or natural sutures, coated or non-coated sutures to name just but a few classifications (Chan et al, 2009). The absorbable ones become part of the body tissue with time which means they are entirely organic while the non-absorbable remain exactly as they are if they are not removed. In addition to that, they can be placed either inside the skin (in the body) or outside on the skin which is a better scenario. Apparently, they are placed using a needle and a thread which are always of different sizes, shape and material. Surgical knots are used to make sure that the suture are secure and well placed.

However, during a dental surgery that involves suture placement, it is important for the dentist to involve a team of people to offer assistance, like nurses (Vetere et al, 2012). Therefore, there are helpers like the nurses and probably other doctors to help. Their work can be to:

• Be aware of the surgery and what is needed for its success
• Passing the instruments to the dentist
• Cleaning the patients teeth in preparation for surgery
• Helping with the tying of the sutures
• Helping with the retraction of the tissues which may be by either the use of bare hands or forceps
• Following and cutting sutures
• Giving anesthetics to reduce pain

2.8) Recording of Sutures on Patients’ records

Recording is the act of putting down any information may it be in electronic form of or writing manually. Record keeping is storage of information for future use. In hospitals, it is important to keep patient records in case of further clarification or reference by another doctor (Beach et al, 2014). The records should however, be true, correct and clear as well as updated especially if they are being stored in electronic form. There is no limit of information that can be recorded in general.

In that case, it is important for every surgery detail is recorded for future or further reference. Therefore, every suture placement must be recorded in details and kept for patient or doctor referral. However, the kind of information recorded should be an exact account of the activities that took place which may include even the drugs used. During a suture dental surgery, there is a lot of information needed to be collected about the patients and especially regarding the condition of the teeth. Also, the age, gender, drugs every used before, effects of certain drugs to the body (if any), the hygienic status of the patient (brushing and eating of sugary foods) among others (Bonfim et al, 2013). All this information is certainly very useful for the success of any suture surgery success.

Therefore, it becomes very vital for every hospital to record and document every possible information about a patient and especially if they are to refer the patient to another doctor.

Unit 312

LO1 1.1) Oral health is one of the most important aspects of health in a person’s life. Therefore, it is important for a person to improve their oral or dental health whenever they get the chance to. This can be achieved through, coming up with mobile dental units, developing the oral health workforce initiatives, establishing awareness for parents and children on ways to improve and maintain oral health, providing leaflets in the dental clinics for the patients to read, come up with a variety of advertisements according to age to improve awareness to name just but a few ways.

1.2/1.3) The Department of Health have come up with new programs that support the campaigns for better health and especially the dental health. The DOH relies mostly on the campaigns from the internet websites because they are very effective. Also there are activities and documents like brochures, leaflets and booklets given to patients in most of the hospitals that teach people how keep their teeth healthy. However there are the television advertisements that have proven to be very helpful as well.

2.8) External referrals are done especially if the hospital cannot deal with the treatment fully while the internal referrals are done when a nurse or dentist cannot perform the treatment to the end (Del et al, 2007). This therefore ensure that every patient and problem is treated by the right physician. Also sharing information with the patient varies according to understanding and the problem. However, the methods of delivering the information should be right, effective and reliable especially by the patient.

3.2) (b). The medication that is given by nurses after an oral surgery have effects like: numbness of the mouth and the surrounding areas, swelling accompanied by pain, dryness of the mouth and bleeding.

Advice for dental healthcare for special needs people

• For people with disability, it may become somehow difficult when it comes to their teeth health and hygiene. However, the following methods can make the process easier:
• Make their tooth brushing easier maybe by enlarging the toothbrush handle, using electric toothbrushes instead, enlarging the tooth brush using a sponge or soft material to name a few.
• Another advice is to offer frequent encouragement and support during their teeth brushing.
• Another advice is to offer health care education to them especially one related o teeth maintenance and cleanness.

Advice to a person with special choice

The advice that can be given to a person with a special choice like smoking is certainly different from any other advice given to other ordinary people or patients. Therefore, some of the advices include:

• Brushing of the teeth after smoking at any time of the day.
• No smoking before going to sleep because it will lead to bad breath and accumulation of toxic substances in the teeth which causes tooth decay and unhealthiness.

Advice to someone with a habit like chewing tobacco includes:

• Should also not sleep without brushing their teeth. Especially people chewing tobacco always have the poisonous tobacco material left in their teeth which can cause tooth decay and bad breath. Through brushing they will be able to remove the substances that may cause tooth decay and other teeth illnesses and conditions.

Advice to a person with a diabetic history

• They should make sure that their tooth health status does not affect their medical condition progress. And therefore to be sure of that, they should take great care of their teeth’s health. That includes brushing the teeth, taking fruits that can improve their diabetic condition and teeth healthiness, eating foods that do not cause harm to either their condition or their teeth’s healthiness.

Advice to a person with a specific culture

• The cultural practices should not affect the healthiness of their teeth but should ensure that whatever cultural foods they feed on, do not cause any harm to their teeth but instead keep them healthy and strong. This applies especially to Muslim culture whereby the foods they take contain a lot of spices and chemicals which may affect the healthiness of the teeth if not taken out (brushed off).

Advice to a person with a poorer background

• No matter the status of their economic status, they should always take the health of their teeth as a priority. This includes brushing the teeth, eating healthy foods that make them strong and clean.

Principles of Preventive Care 

After a dental treatment or dental surgery, a patient needs to undergo future preventive process against the same kind of problem or a different one. In addition to that, every person also needs to keep their teeth healthy and strong by practicing preventing care process of their teeth. This is a process to be carried out or given by a nurse or a dentist to the patient or any other person who would want and need that information. Therefore, for them to come with the best preventive healthcare program, they have to follow the following principles:

• Research on preventive recommendation sources that are well updated, reliable and current. Additionally, they should be relevant to the nurse’s or dentist’s practice and potential preventive issue.
• Also, after every process of preventive care process, they should conduct a review on the recommendations to ensure that they are updated and still sill scientifically relevant.
• Dentists should also involve the patients during the process and especially at a point where they are not sure of what choice to make for the success of the process. This involves letting them know of the risks and consequences related to the process if any.
• The preventive care process should be viewed as a bundle of recurring services that are dependent on each other at any moment.

Conclusion:

To conclude, I can say that for a person to have a good and healthy oral health they have to do much more than eat less sugary foods. There should be doctor check-ups, better teeth treatment and maintenance. Also, it is important for all the dentists and nurses involved in dental surgeries to have knowledge, experience and skills on their job.

Reference:

Chan, J. L., Miller, E. K., Jou, R. M., & Posten, W. (2009). Novel surgical technique: placement of a deep tip stitch. Dermatologic Surgery, 35(12), 2001-2003.

Vetere, P. F., Wayock, C. P., Muscat, J., & Sicuranza, G. (2012). A novel approach to teaching placement of a B-Lynch suture: description of technique and validation of teaching model. Journal of graduate medical education, 4(3), 367-369.

Beach, J., & Oates, J. (2014). Maintaining best practice in record-keeping and documentation. Nursing Standard, 28(36), 45-50.

Bonfim, D., Laus, A. M., Fugulin, F. M. T., & Gaidzinski, R. R. (2013). Comparison of nursing interventions performed and the records in a computerized system for primary health care. Acta Paulista de Enfermagem, 26(4), 401-408.

Hepworth, M.J. and Friedman, S., 1997. Treatment outcome of surgical and non-surgical management of endodontic failures. Journal (Canadian Dental Association), 63(5), pp.364-371.

Del Fabbro, M., Taschieri, S., Testori, T., Francetti, L. and Weinstein, R.L., 2007. Surgical versus non?surgical endodontic re?treatment for periradicular lesions. The Cochrane Library.

Saatchi, M., 2007. Healing of large periapical lesion: A non?surgical endodontic treatment approach. Australian Endodontic Journal, 33(3), pp.136-140.

Ng, Y.L., Mann, V. and Gulabivala, K., 2010. Tooth survival following non?surgical root canal treatment: a systematic review of the literature. International endodontic journal, 43(3), pp.171-189.

Ng, Y.L., Mann, V. and Gulabivala, K., 2011. A prospective study of the factors affecting outcomes of non?surgical root canal treatment: part 2: tooth survival. International endodontic journal, 44(7), pp.610-625.

Salehrabi, R. and Rotstein, I., 2004. Endodontic treatment outcomes in a large patient population in the USA: an epidemiological study. Journal of endodontics, 30(12), pp.846-850.

Öztan, M.D., 2002. Endodontic treatment of teeth associated with a large periapical lesion. International Endodontic Journal, 35(1), pp.73-78.

Ørstavik, D. and Ford, T.R.P., 1998. Essential endodontology: prevention and treatment of apical periodontitis. Oxford: Blackwell Science.

Regan, J.D. and Fleury, A.A., 2005. Irrigants in non-surgical endodontic treatment. Journal of the Irish Dental Association, 52(2), pp.84-92.

Reit, C. and Hirsch, J., 1986. Surgical endodontic retreatment. International endodontic journal, 19(3), pp.107-112.

Allen, R.K., Newton, C.W. and Brown, C.E., 1989. A statistical analysis of surgical and nonsurgical endodontic retreatment cases. Journal of Endodontics, 15(6), pp.261-266.

Peterson, J. and Gutmann, J.L., 2001. The outcome of endodontic resurgery: a systematic review. International Endodontic Journal, 34(3), pp.169-175.