I thought of a good analogy as to why pulpitis pain can be so severe for our patients. I don't know how useful this will be in a clinical scenario but it may come in handy in the future. Have you ever put a ring on that was too tight and you were scared because you knew that if you couldn't get it off at first then it would be harder and harder to get off? The problem is that as the finger is irritated and compressed, the blood flow increases to the area and the soft tissue swells. On top of that, The ring is a hard material and doesn't expand in response to the swelling tissue. The same ..read more

 I had a mishap just a couple of days ago where I had to remove a crown to perform endodontic therapy as the crown eventually required replacement. It was a lower central incisor and all the lower teeth had been crowned with the same white, monotone, textureless ceramic.I was very paranoid about cutting into the wrong tooth as all the teeth appeared the same. I counted mesial to distal, correlating the tooth to the xrays, counted, and then counted again. Finally, I made a bur mark into the tooth to mark it and got into cutting. Somehow, I still managed to cut into the wrong tooth and ende ..read more

I have recently been getting back into endos after spending the past year referring them to the principal dentist who was an endo aficionado. I find endos quite difficult, therefore time consuming and draining. Logically I know that the less I like something, the more I should do of it to become proficient but I thought that I had reached a point in my career where I could focus on my special interests. However, due to changes in my work circumstances, I have to take on these procedures again.  I have recently gone through the All things endo online course from Ashley Mark in the US (http ..read more

It has been a turbulent year from my end. Lots of changes at work as earlier in the year, the principal dentist and my mentor at the practice I started at suddenly passed away. I stayed on to help the transition after this but have now become the main practitioner at this practice. After building the practice for over 30 years, there was a significant and loyal patient base with a large amount of complex prosthodontic and implant work. As a result, there is a lot of complex work for me to maintain and inevitably a lot of complications and periimplantitis. Luckily we have arranged for an experi ..read more

I have borrowed the book: "Mastering digital dental photography" by Wolfgange Bengel (2006) as it was one of the recommended books from the Szabi Hant dental photography course.  It is a fairly extensive book and covers in depth very technical aspects of photography and aspects relevant to dentistry. I will not be reading the whole book as it goes deep into certain topics such as how camera sensors work and camera recommendations that are fairly dated. However I will try to extract the more useful points form this text and summarise them on this blog. I find that after taking photographs ..read more

Grey cards are reference cards that are used to calibrate camera software. It ensures that pictures produced by the camera have colours that match the object being photographed. Many factors can affect the colour of the object, the camera sensor just captures the light reflected through the lens so mainly, factors that affect the light source affect the colour. For non dental photography, ambient lighting e.g flourescent lights, weather conditions etc can introduce colours that affect the object. In dental photography, due to the strong flash needed for illumination, most of these external fac ..read more

 Recently my contract at the hospital dental clinic ended and I decided not to pursue renewal. This means I have ceased employment there and passed on my patient care and headaches to other clinicians. I have stayed on for a couple of days with the university clinics on a casual basis but I am not sure how long I will keep that up. It is not a bad job to have but I find it extremely tiring and I am learning very little from it. What I do learn is how to fix clinical mistakes and I am thinking quite a bit deeper about the 'why'  of how I do my dentistry. I have started a couple of day ..read more

 I have previously heard about vertical crown preparations and have watched some lectures on them but today I had a go for the first time to prepare a tooth with a vertical margin. Essentially a vertical preparation lacks a horizontal margin and therefore there is no defined stop for the prosthesis at the margin. The fit of the crown works on a slip principle where there is close adaptation of the crown and the tooth preparation. When there is shrinkage of the porcelain at the margins, a horizontal margin will have marginal discrepancies whereas a vertical preparation crown will just shri ..read more

 Recently I attended an anterior waxup course and photography course run by Szabi Hant, a technician from Perth who works with Tony Rontondo, a Brisbane based prosthodontist. Overall, I could tell he was a very knowledgeable and skilled technician but not the best lecturer and demonstrator. Over the two days, this manifested in different ways.  The hands on component of the waxup course were him waxing up 3 anterior teeth on a stone model projected in a screen for the class. I think there was a lot of muscle memory involved and he proceeded through the waxup with some explanation as ..read more

Ensure the teeth are relatively clean of food and plaque prior to impressions. I can't count the number of times I have taken an impression and bits of interproximal food come out with the impression. Usually in perio patients and usually in posterior teeth. Really heavy plaque will affect your surface detail capture and food will affect your accuracy and look gross for the lab an on the model. It will also affect your impression disinfection.  If there is really heavy plaque, give the teeth a good prophy or teach the patient how to use a toothbrush and reschedule. If the patient has rece ..read more