Practice to Practice
With patients, connection is the most crucial step. I start by personally greeting my patient and escorting them to the operatory. Once there, I take 5 minutes to find out what brought them in, and, most importantly, how it is affecting their life. In learning about their life, I try to understand how family, work, hobbies, travel, etc, affect their dental decision-making. Once I understand the dental need from their perspective, it is easy to express confidence in my team’s ability to provide solutions that fit their life.
Richard I. Ashton II, DMD
You can carve composite restorations with hand instruments much like amalgam. A great instrument for interproximal and gingival margins on posterior composites, as well as anterior composite restorations, is the 12 blade scalpel. Being dull on one side and sharp on the other, it allows the dentist to press the gingiva down and slip the thin blade under the overhanging or bulky gingival margin, then gently carve upwards, much like shaving. This is an excellent instrument for facial and lingual embrasures, as well as incisal embrasures on anterior teeth. To have maximum safety and control of the sharp scalpel, it is best remove the portion of the blade where a thumb rest might be used. This scalpel avoids trying to use a high-speed finishing bur, which often opens the embrasure too much or damages the root surface and creates sensitivity.
Van B. Haywood, DMD
There are times when making an impression with PVS or polyether impression materials for older patients with large gingival embrasures that you are worried about the tray with the impression locking into some embrasures. I mix some fast-setting alginate with warm water, use an impression syringe, and squirt some alginate into the gingival embrasures I have some concerns about. The alginate sets fast and acts as an anatomic block-out of the embrasure to prevent impression lock-ins. This also works well for patients with existing fixed bridges under the pontic areas.
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