Smile Care Dental Clinic and Implant Centre

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Retreatment case!!
01/05/2021

Retreatment case!!

Narrow canal case management wrt 37!!
01/05/2021

Narrow canal case management wrt 37!!

28/04/2021

India begins it's third phase of vaccination on the 1st of May 2021.
Here is a thread to help you with the process.

1. At present there are two vaccines available in India Covishield manufactured by the Serum Institute of India and Covaxin by Bharat Bio-Tech

2. The dosing interval for Covishield is 6-8 weeks while the dosing interval for Covaxin is 4-6 weeks.

3. If you have tested positive or are showing symptoms you should NOT take the vaccine and defer your jab by atleast 4 weeks from the day your symptoms resolve.

4. If you have taken the first dose and test positive or are showing symptoms before the second dose defer the second jab by atleast 4 weeks (even if it defies the preset interval limit of 4-8week)

5. If you are pregnant/lactating, The International Federation of Obstetrics and Gynaecology vide their letter on the 2nd of March 2021 advices that the patient can take both the doses of the vaccine in consultation with her treating obstetrician after explaining all the risks and benifit but at present the MoHFW_INDIA advices not to take the vaccine.

6. Can you get infected even after taking both the doses of the vaccine? - Yes! BUT the recently published data by ICMR DELHI shows the chances of acquiring the infection is 0.03% after both the doses of Covishield and 0.04% after both the doses of Covaxin and even among those who go on to develop the infection, the severity of disease/risk of hospital admission and death is next to 0

7. Possible side effects ? - Pain at the vaccination site/fever for 24-72 hours and YES you can take a PCM for the same.

8. Blood clots after Covishield ? It has a name! TTS (Thrombotic thrombocytopenia syndrome) - it is very very rare (1 in 2,50,000 participants in the UK where the study was done) side effect which should absolutely not be a concern. (Benefits far outweigh risks)

9. Can you get COVID from the vaccine ? - No, ABSOLUTELY NOT!

So I request all of you to register and get vaccinated! Together we can and will defeat this disease.

Dr. Abhishek Tandon
DM Resident
Department of Pulmonary, Critical Care and Sleep Medicine
AlIMS Jodhpur

Case of open apex!!Stage A: Pack the MTA at apical partStage B: Fill the rest of the canal with tailor made gp (after 24...
14/07/2020

Case of open apex!!
Stage A: Pack the MTA at apical part
Stage B: Fill the rest of the canal with tailor made gp (after 24 hrs)

Bypassing!!! It's a game of patience and perseverance..
09/07/2020

Bypassing!!! It's a game of patience and perseverance..

Radix entomolaris #46Clinicians should be aware of these unusual root morphologies in the mandibular first molars. The i...
03/07/2020

Radix entomolaris #46

Clinicians should be aware of these unusual root morphologies in the mandibular first molars. The initial diagnosis of radix entomolaris (extra root on lingual) or paramolaris (extra root on buccal) before root canal treatment is important..

Really a good step to protect Doctors and Health workers!! 👍👍
22/04/2020

Really a good step to protect Doctors and Health workers!! 👍👍

03/04/2020

*Covid 19-What should a dentist do?*

There are a lot of perplexing questions dentist are facing.
These are my solutions for the same...

*1) When should I resume work?*

Preferably wait till the entire thing blows over. *Do not be in a hurry to start clinical practice.* Remember you are in high risk category.
Some of us might feel we have EMI s running and we are in good health, so max I will fall ill for a few days.. *sorry to burst your bubble, you run the risk of transmitting it to your near and dear ones* especially THE ELDERS who are most susceptible.

*2) Should I use PPE ?*

Yes without any doubts and so should your staff working with you.

*3)Should i change after every patient?*

Ideally you and your staff should change after every case as fomites can be spread through you to next patient

*4) Will my patients pay for it?*
*Yes,* Unless you are willing to act like the government and subsidize it for them... of course they have to. It's for their safety too.

*5) Do I need to fumigate the clinic?*

*Yes you do* unless your operatory and consulting/ reception are well ventilated from both sides. Even then once a day is mandatory as the fomites can settle on surfaces and stay for upto 3 days ( in some studies they stayed for 17 days)

*6) At what interval should it be done?*

After every patient.

*7) Do I check the patient for covid 19 before we start any treatment?*

If tests are available you can but reports as of today suggest that you need 2 consecutive negative tests with a time interval between them ( also you can't quarantine the patient till 2nd test so I am not too sure about this)

*8) Do I run the risk of being sued if patient tests positive after dental work?*

In today's world you do. Hence the PPE and fumigation after every patient.

*9) Should I wait for the vaccine?*

Yes you can, if you are willing to wait for atleast 12 to 18 months.

*10) How do I charge existing patients whose work is on hold?*

You have to tell them that circumstances have changed and it is for their benefit.
You are charging only for material cost

*11) What about new cases?*

You have to charge them for the loss of EFFICIENCY ( read reduced working hours due to fumigation) in addition to cost incurred for the PPE. So charges have to be upped substantially eg you did 10 patients in one session in 2 operatories. Now you can do only 4. So you have to bill the four for the 10 you would have done. Then only you would maintain the same paycheck at the end of the month.

*12) Do I need to make changes in my operatory?*

*Yes.* if your two chairs are in one room then you can't work simultaneously on two patients. Similarly consulting should not be shared with operatory.

*13) What about lab work?*
You need to disinfect the lab work before you send it to the lab.

*Most importantly you need to train your assistants for the massive changes involved.*

Protocols will need to be put in place before you start work.
Practice runs need to be undertaken before you see a single patient.
If your assistant goofs up all the PPE will be of no use. Imagine you have done a crown prep and made impressions with PPE. After the patient has left the assistant comes to take away impression material without disinfecting it 😳 and she keeps it with bare hands with other materials. What just happened is not fiction but quite possible.

Hope you find these thoughts of mine useful.

*Take care. Stay at home Stay safe.*

Work with passion!! Direct restoration.
01/04/2020

Work with passion!! Direct restoration.

Do not take a drill even on an emergency patients!! This virus is aerosol transmitted and emergency treatments shud not ...
22/03/2020

Do not take a drill even on an emergency patients!!
This virus is aerosol transmitted and emergency treatments shud not be done without N95 masks and proper PPE.
REGULAR SURGICAL MASKS ARE NOT ADEQUATE!!

Do not visit your Dentist unless there is a Dental Emergency!!
19/03/2020

Do not visit your Dentist unless there is a Dental Emergency!!

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Nabha
147201

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