DTUK1910

21Endo TribuneJuly 19-25, 2010United Kingdom Edition D entistry often involves a battle against bacteria – the invisible invaders that wreak havoc with our oral health, infiltrating into gums and teeth causing tenderness, pain and sensitivity. The basic premise of endodontic procedures is to re- move inflamed and infected tis- sue from the tooth, to clean the root canal system and to seal the tooth back up again. In short, en- dodontics is all about infection control;one of the fundamental elements of good dentistry. The rubber dam It goes without saying that main- taining cleanliness throughout the endodontic procedure should be key to a successful outcome. Nevertheless, teeth are incred- ibly complex structures and it is impossible to get the tooth suffi- ciently clean for it to be consid- ered completely sterile. The endodontist needs to carry out everything within their powers to facilitate infec- tion control to reduce the risk of failure. For this reason, placing a rubber dam during treatment is mandatory. This thin square of latex rub- ber serves to isolate the tooth from its environment, in par- ticular from bacteria in the oral cavity, permitting a clean, dry operative field and enabling the treatment of the appropri- ate tooth without contamination from blood or saliva. I actually find that most patients prefer to have a rubber dam in place as a protective barrier. Medico-legal- ly, one of the first questions to be asked following a mishap is whether a rubber dam was used during the procedure, so this de- vice not only protects the tooth and the patient but also the prac- titioner. Single-use instruments The roots of teeth contain very fine, narrow and tortuous chan- nels, some of which can be eas- ily missed or undetected. Despite continuing advances in dental technology, the equipment at the dentist’s disposal is hopelessly inadequate for the job it has been designed to do. Relying on a small, stainless steel file or even super flexible nickel titanium files to successfully clean, shape and decontaminate the nooks and crannies within the tooth is really quite unrealistic. Nevertheless, they are vital for opening up the canals so that they are accessible to our chemi- cals for disinfection. Surprisingly, despite the rec- ommendations that files should be for single-use only, the sales of such instruments for endo- dontics have actually fallen over the years, suggesting that some practitioners are reusing the same instrument on more than one patient. Aside from the obvi- ous risks this poses to patients’ health and cross infection con- trol, this also contravenes De- partment of Health legislation which states: “Dentists should ensure that Endodontic ream- ers and files are treated as single use in order to reduce the risk of prion transmission in dentistry”. If we are to protect the health of our patients and their teeth, reusing single use items is simply not an option. Chemical options Most endodontists use chemi- The fight against bacteria Dr Michael Sultan discusses the importance of cleanliness in the field of Endodontics page 22DTà www.dentsplymaillefer.com My life, my job and my Easy • Cordless & lightweight increasing your freedom of movement • Small contra-angle head improving visibility & access • Simple to use featuring LCD screen for clear display of settings • Speed: 100-800 rpm — Torque: 0.6-4 Ncm • Auto reverse print_Mise en page 1 03.06.10 11:59 Page1