(inferior alveolar nerve block) a type of injection to anaesthetize the inferior *dental nerve. Inferior dental block is routinely performed to allow dental procedures to be carried out on the lower teeth on one side of the mouth.
Causes: myocardial infarction, atherosclerosis, coronary thrombosis or other heart disorder.
Symptoms: slow feeble heart beats down to 36 beats per minute with fainting and collapse, breathlessness, Stoke Adams syndrome.
Treatment. Intensive care. Until the doctor comes: 1-5 drops Oil of Camphor in honey on the tongue or taken in a liquid if patient is able to drink. Freely inhale the oil. On recovery: Motherwort tea, freely. OR, Formula of tinctures: Lily of the Valley 2; Cactus 1; Motherwort 2. Mix. Dose – 30-60 drops in water thrice daily. A fitted pace-maker may be necessary.
Spartiol. 20 drops thrice daily. (Klein) ... heart block
Verapamil, the longest-available, is used to treat angina and hypertension. It is the only calcium-channel blocker e?ective against cardiac ARRHYTHMIA and it is the drug of choice in terminating supraventricular tachycardia. It may precipitate heart failure, and cause HYPOTENSION at high doses. Nifedipine and diltiazem act more on the vessels and less on the myocardium than verapamil; they have no antiarrhythmic activity. They are used in the prophylaxis and treatment of angina, and in hypertension. Nicardipine and similar drugs act mainly on the vessels, but are valuable in the treatment of hypertension and angina. Important di?erences exist between di?erent calcium-channel blockers so their use must be carefully assessed. They should not be stopped suddenty, as this may precipitate angina. (See also HEART, DISEASES OF.)... calcium-channel blockers
be replaced by unrelated new ones.
(See also psychotherapy.)... blocking
The result is that patients who need inpatient care cannot always be admitted. The term ‘bedblockers’ is derogatory and should not be used.... bed-blocking
They work by blocking the stimulation of beta adrenergic receptors by the neurotransmitters adrenaline and noradrenaline, which are produced at the nerve endings of that part of the SYMPATHETIC NERVOUS SYSTEM – the autonomous (involuntary) network
– which facilitates the body’s reaction to anxiety, stress and exercise – the ‘fear and ?ight’ response.
Beta1 blockers reduce the frequency and force of the heartbeat; beta2 blockers prevent vasodilation (increase in the diameter of blood vessels), thus in?uencing the patient’s blood pressure. Beta1 blockers also affect blood pressure, but the mechanism of their action is unclear. They can reduce to normal an abnormally fast heart rate so the power of the heart can be concomitantly controlled: this reduces the oxygen requirements of the heart with an advantageous knock-on e?ect on the respiratory system. These are valuable therapeutic effects in patients with ANGINA or who have had a myocardial infarction (heart attack – see HEART, DISEASES OF), or who suffer from HYPERTENSION. Beta2 blockers reduce tremors in muscles elsewhere in the body which are a feature of anxiety or the result of thyrotoxicosis (an overactive thyroid gland – see under THYROID GLAND, DISEASES OF). Noncardioselective blockers also reduce the abnormal pressure caused by the increase in the ?uid in the eyeball that characterises GLAUCOMA.
Many beta-blocking drugs are now available; minor therapeutic di?erences between them may in?uence the choice of a drug for a particular patient. Among the common drugs are:
| Primarily cardioselective | Non-cardioselective |
| Acebutolol | Labetalol |
| Atenolol | Nadolol |
| Betaxolol | Oxprenolol |
| Celiprolol | Propanolol |
| Metoprolol | Timolol |
These powerful drugs have various side-effects and should be prescribed and monitored with care. In particular, people who suffer from asthma, bronchitis or other respiratory problems may develop breathing diffculties. Long-term treatment with beta blockers should not be suddenly stopped, as this may precipitate a severe recurrence of the patient’s symptoms – including, possibly, a sharp rise in blood pressure. Gradual withdrawal of medication should mitigate untoward effects.... beta-adrenoceptor-blocking drugs
Over the past four decades the ?nancial outlay on NHS dental services has been around 5 per cent of total NHS funding. This contrasts with 10 per cent during the service’s early years, when the NHS was coping with decades of ‘dental neglect’. The population’s dental health has, however, been steadily improving: in 1968 more than one-third of people had no natural teeth; by the late 1990s the proportion had fallen to 13 per cent.
Dentistry is divided into several groupings.
General dental practitioners Concerned with primary dental care, the prevention, diagnosis and treatment of diseases of the gums and teeth – for example, caries (see TEETH, DISORDERS OF). They also deal with diffculties in biting and the effects of trauma, and are aware that oral disorders may re?ect disease elsewhere in the body. They will refer to the hospital dental services, patients who require treatment that cannot be satisfactorily carried out in a primary-care setting.
Most routine dental prevention and treatment is carried out in general dental practitioners’ surgeries, where the dentists also supervise the work of hygienists and dental auxiliaries. Appliances, such as dentures, crowns, bridges and orthodontic appliances are constructed by dental technicians working in dental laboratories.
There are around 18,800 dentists providing general dental services in the UK. These practitioners are free to accept or reject any potential patient and to practise where they wish. Those dentists treating patients under an NHS contract (a mixture of capitation fees and items of service payments) can also treat patients privately (for an appropriate fee). Some dentists opt for full-time private practice, and their numbers are increasing in the wake of changes in 1990 in the contracts of NHS general dental practitioners.
Community dental practitioner Part of the public-health team and largely concerned with monitoring dental health and treating the young and the handicapped.
In the hospitals and dental schools are those who are involved in only one of the specialities.
Around 2,800 dentists work in NHS hospitals and 1,900 in the NHS’s community services. In some parts of the UK, people wanting NHS treatment are having diffculties ?nding dentists willing to provide such care.
Restorative dentist Concerned with the repair of teeth damaged by trauma and caries, and the replacement of missing teeth.
Orthodontist Correction of jaws and teeth which are misaligned or irregular. This is done with appliances which may be removable or ?xed to the teeth which are then moved with springs or elastics.... dental surgeon
Alternatives. Teas. Plantain leaves, Nasturtium leaves, Marigold flowers (Calendula), Thyme. Tablets/capsules. Garlic, Goldenseal, Iceland Moss.
Tinctures. Formula. Echinacea 2; Goldenseal 1. Mix. 30-60 drops in water thrice daily. Practitioner. Ephedra.
Topical. Decongestants. Olbas oil. Oils of Aromatherapy: Eucalyptus, Garlic, Thyme. Supplementation. Vitamins A, C.
Bedtime: 2-3 Garlic capsules. ... blocked-up nose
(2) Non-depolarising neuromuscular blocking agents: these drugs occupy the receptor and prevent acetylcholine from becoming attached to it. However, in su?ciently high concentrations, acetylcholine will compete with the drug and dislodge it from the receptor; the e?ect of these drugs is reversed by giving an anticholinesterase, which allows the amount of acetylcholine at the neuromuscular junction to build up. These drugs have varying durations of action, but all are slower in onset and of longer duration than the depolarisers.... neuromuscular blockade
The affected tooth aches or throbs, and biting or chewing is usually extremely painful. The gum around the tooth is tender and may be red and swollen. An untreated abscess eventually erodes a sinus (channel) through the jawbone to the gum surface, where it forms a swelling known as a gumboil. As the abscess spreads, the glands in the neck and the side of the face may become swollen, and fever may develop. Treatment may consist of draining the abscess, followed by root-canal treatment of the affected tooth, but in some cases extraction of the tooth is necessary. Antibiotics are prescribed if the infection has spread beyond the tooth.
An abscess in a periodontal pocket can usually be treated by the dentist scraping away infected material.... abscess, dental
For minor procedures, a local anaesthetic (see anaesthesia, local) is injected either into the gum at the site being treated or into the nerve a short distance away (called a peripheral nerve block).
In addition, topical anaesthetics are often used on the gums.
For more complicated procedures, such as periodontal (gum) surgery and multiple tooth extractions, general anaesthesia is carried out (see anaesthesia, general).... anaesthesia, dental
The surface of the affected tooth is painted with oxidizing agents and then exposed to ultraviolet light.... bleaching, dental
There are 2 types of beta receptor: beta 1 and beta 2. Beta 1 receptors are present in the heart and blood vessels, and beta 2 in the lungs. Some betablockers (such as acebutolol, atenolol, and metoprolol) are termed cardioselective and, because they act mostly on beta 1 receptors, are used mainly to treat heart disease such as angina, hypertension, and cardiac arrhythmia. The drugs are sometimes given after a myocardial infarction (heart attack) to reduce the likelihood of further damage to the heart muscle.
Other types of beta-blocker, such as oxprenolol, propranolol, and timolol, may be given to prevent migraine attacks by acting on blood vessels in the head; reduce the physical symptoms of anxiety; or control the symptoms of thyrotoxicosis. Beta-blocker drugs such as timolol are sometimes given in the
form of eye drops to treat glaucoma and work by lowering the fluid pressure in the eyeball.
Beta-blockers may reduce an individual’s capacity for strenuous exercise. The drugs may worsen the symptoms of asthma, bronchitis, or other forms of lung disease. They may also reduce the flow of blood to the limbs, causing cold hands and feet. In addition, sleep disturbance and depression can be side effects of beta-blockers.... beta-blocker drugs
It is sometimes used as an alternative to crowning (see crown, dental) and may also be used as a preventive technique to protect the teeth.... bonding, dental
at the tooth’s core. Advanced decay causes toothache and bad breath.
Treatment consists of drilling away the area of decay and filling the cavity (see filling, dental). In advanced decay, it may be necessary to remove the infected pulp (see extraction, dental).
Water fluoridation and the use of fluoride toothpaste helps prevent caries.
The risk of caries is also reduced by cutting sugar consumption, practising good oral hygiene, and visiting the dentist regularly.... caries, dental
Caudal block may be used for obstetric and gynaecological procedures.... caudal block
A crown may be fitted by filing the natural tooth to form a peg and cementing the crown over the top. If the tooth is... crown, dental
Dental curettage is one method used to remove the lining of periodontal pockets and diseased tissue from root surfaces in periodontitis.... curettage, dental
(See also caries, dental.)... decalcification, dental
During a routine dental examination, the dentist uses a metal instrument to
probe for dental cavities, chipped teeth, or fillings. Dental X-rays are sometimes carried out to check for problems that may not be visible. Dentists also check how well the upper and lower teeth come together. Regular examinations in children enable the monitoring of the replacement of primary teeth by permanent, or secondary, teeth. Referral for orthodontic treatment may be made. dental extraction See tooth extraction. dental X-ray An image of the teeth and jaws that provides information for detecting, diagnosing, and treating conditions that can threaten oral and general health. There are 3 types of dental X-ray: periapical X-ray, bite-wing X-ray, and panoramic X-ray.
Periapical X-rays are taken using X-ray film held behind the teeth. They give detailed images of whole teeth and the surrounding tissues. They show unerupted or impacted teeth, root fractures, abscesses, cysts, and tumours, and can help diagnose some skeletal diseases. Bite-wing X-rays show the crowns of the teeth and can detect areas of decay and changes in bone due to periodontal disease. Panoramic X-rays show all the teeth and surrounding structures on one large film. They can show unerupted or impacted teeth, cysts, jaw fractures, or tumours. The amount of radiation received from dental X-rays is extremely small. However, dental X-rays should be avoided during pregnancy.... dental examination
outer surfaces of the front teeth is most frequently caused by excessive intake of fruit juices and carbonated drinks. Erosion of the inner surfaces of the molars may be a result of the regurgitation of stomach acid, as occurs in people suffering from acid reflux or bulimia. (See also caries, dental.)... erosion, dental
For most extractions, local anaesthesia is used (see anaesthesia, dental). Teeth are usually extracted with dental forceps, which grasp the root of the tooth. In difficult extractions, some gum and bone may also need to be removed from around the tooth.... extraction, dental
using soft nylon or silk thread or tape.
Dental floss may be waxed or unwaxed.
Flossing should be carried out as an adjunct to toothbrushing.... flossing, dental
Fractures may involve the crown or the root of a tooth, or both.
Fractures of the enamel can usually be repaired by bonding (see bonding, dental); in some cases, a replacement crown may be fitted (see crown, dental).
Pulpotomy may be performed if the pulp of a tooth is damaged.
Fractures of the root may be treated by splinting (see splinting, dental), root-canal treatment, or removing the tooth (see extraction, dental).... fracture, dental
Impacted wisdom teeth are common, and, if symptomless, may not need to be removed.
In some cases, however, symptoms necessitate their removal.... impaction, dental
A quick-setting material, such as alginate, is placed in a mould over the teeth.
The mould is removed, and plaster of Paris is poured into it to obtain a model of the area.
This model is then used as a base on which to build a denture, bridge, or dental inlay.
Dental impressions are also used in orthodontics to study the position of the teeth and to make orthodontic appliances to correct irregularities.... impression, dental
An inlay may be needed for the back teeth or to protect a weakened tooth.... inlay, dental
It is the chief cause of tooth decay (see caries, dental) and gingivitis, and forms the basis of a hard deposit (see calculus, dental).
Some of the microorganisms in plaque, particularly STREPTOCOCCUS MUTANS, break down sugar in the remains of carbohydrate food that sticks to the mucus, creating an acid that can erode tooth enamel.... plaque, dental
Overcrowded teeth may lead to malocclusion or may prevent certain teeth from erupting through the gum (see impaction, dental). They can be difficult to clean, increasing the risk of dental decay (see caries, dental) and periodontal disease.
Teeth may need to be extracted to allow room for others. Usually an orthodontic appliance is fitted to the remaining teeth to position them correctly.... overcrowding, dental
protease inhibitors A type of antiviral drug used to delay the progression of HIV infection (see AIDS).... prosthetics, dental
A local anaesthetic (see anaesthesia, local) is injected into either side of the vagina near the pudendal nerve.... pudendal block
Internal resorption is rare, occurring in about 1 percent of adults.... resorption, dental
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