Chapter 23. Dental: Diagnosis, Equipment, Blocks, and Treatment

"Love conquers everything except poverty and toothaches." Mae West, Irish Times

Unlike much of the rest of this book that assumes health care professionals already have the skills and knowledge to provide treatment, but not their normal equipment, this section describes dental diagnoses and basic treatments in considerably more detail. Treating dental emergencies is a critical skill, especially in situations of resource scarcity. Even though these emergencies are common, painful, and may occur with little or no warning, non-dentists rarely have in-depth knowledge about these problems.

Describing Teeth

When annotating the patient's medical record or communicating with another health care provider, such as a dentist, use a picture in the medical record. When communicating with another provider by phone or radio, describe the type and position of the tooth.

Teeth are either baby or adult teeth.

They are either maxillary or mandibular, and are on either the right or the left side of midline. Midline is defined as the space between the front two teeth (incisors).

There are four types of teeth (Fig. 23-1).

Those with one root:

• Incisors
• Canines
• Premolars

Those with two or more roots:

• Molars

Tooth Surfaces

The following names are used for the surfaces of the teeth. The number corresponds to those in Fig. 23-2.

1. Occlusal surface: the chewing surface of molars and premolars.

2. Mesial surface: the surface nearest the midline of the body (medial).

3. Lingual surface: the surface nearest to the tongue in the lower jaw; it is called the palatal surface in the upper jaw.

4. Distal surface: the surface furthest from the midline.

5. Buccal surface: the surface nearest to the lips and cheek.

6. Incisal edge: the incisors and canines have a cutting edge instead of an occlusal surface.

7. (Not shown) Proximal surfaces: surfaces that are close together, that is, the mesial surface of one tooth may touch the distal surface of the next tooth. The two surfaces are described as proximal surfaces.

A Tooth's Three Layers

Tooth problems may involve any of the tooth's three layers or their supporting structures (Fig. 23-3).

Crown

The part of the tooth above the gum line is the crown. Covered with hard enamel, the crown protects the other layers. Do not confuse the ...