DH 410: Emergencies in Dental Practice

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Questions and Answers

What should a clinician do if a broken instrument tip is not located through radiographs?

Notify the patient that the tip is lost

Refer the patient for a chest x-ray (correct)

Attempt to remove the tip with forceps

Document the incident without further action

Which of the following is a recommended preventive measure for avoiding broken instrument tips?

Skip maintenance checks on instruments

Use thinner instruments for all procedures

Use instruments correctly (correct)

Avoid using ultrasonic scalers

What action is advised after removing a broken instrument tip?

Hide the incident from the patient

Document it in the patient record (correct)

Only inform the dental assistant

Dispose of the tip without explanation

What should a clinician do if a broken instrument tip is visible on a radiograph but cannot be removed?

Refer the patient to an oral surgeon Signup and view all the answers

What should a clinician ensure about instruments to prevent them from breaking?

Instruments should be replaced if they appear thin Signup and view all the answers

What should the patient do after the broken tip has been removed?

Sign a document confirming they saw the tip removed Signup and view all the answers

What is one common cause of a broken instrument tip?

Excessive force during instrumentation Signup and view all the answers

What should be done first when a broken instrument tip is suspected?

Terminate the procedure Signup and view all the answers

How should the patient be positioned after a broken instrument tip is identified?

Upright position Signup and view all the answers

What should not be done when a broken instrument tip is suspected?

Use suction to clear debris Signup and view all the answers

Which instrument can be used to remove a broken tip if it is located?

Curette Signup and view all the answers

What is an important step after successfully removing the broken instrument tip?

Document thoroughly in the patient's chart Signup and view all the answers

What should the patient be instructed to avoid doing while the area is being managed?

Swallowing Signup and view all the answers

Why is it important to reassure and not alarm the patient during this process?

To reduce the patient’s anxiety Signup and view all the answers

Study Notes

Broken Instrument Tip: Overview

Broken instrument tips are a common occurrence in dental practice.
Causes include excessively thin instruments, excessive force, tenacious calculus, and rarely, defective instruments.

Signs and Symptoms

Abrupt absence of instrument tip.
Patients may report a sensation of something lodged between teeth.

Immediate Response to a Broken Instrument Tip

Stay calm and inform the patient soothingly.
Cease the procedure immediately.
Gradually position the patient upright.
Isolate the working area using gauze or cotton rolls.
Maintain cheek and lip retraction when possible.
Instruct the patient not to swallow or move their head, using a cup if they need to spit.
Avoid alarming the patient by remaining composed.
Do not use suction, rinse, or air during this time.
Carefully inspect the area to locate the broken tip.

Treatment Protocol

If the Tip is Visible:
- Remove the tip using a curette or a perioretriever, which is an autoclavable and magnetized tool designed for this purpose.
- Show the patient the removed tip and verify it matches the original instrument.
- Document the incident thoroughly in the patient's chart and have the patient sign to acknowledge the removal.
If the Tip is Not Visible:
- Perform a thorough examination of the dry gingival area and sulcus, taking care not to push the tip further.
- Obtain radiographs to locate the tip if necessary.
- If found, communicate the removal to the patient and document the procedure comprehensively.
- If the tip cannot be retrieved and is visible on the radiograph, refer the patient to an oral surgeon.

Further Actions if the Tip Remains Missing

Refer the patient for a chest x-ray to check if the tip has been swallowed or aspirated.
If found in the chest x-ray, surgical removal is required.

Prevention Strategies

Ensure the integrity of instruments by regularly checking for wear.
Replace excessively thin instruments to mitigate breakage risk.
Select appropriate instruments for specific treatment areas.
Use instruments correctly to avoid unnecessary stress.
Utilize ultrasonic scalers for patients with heavy calculus deposits to reduce manual instrument usage.

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Description

This quiz covers Lecture 8 of DH 410, focusing on the emergencies related to broken instrument tips in dental practice. It discusses common causes such as excessive sharpening, force, tenacious calculus, and instrument quality control. Prepare for practical scenarios and enhance your understanding of safe dental practices.