Lecture #1: Introduction to dentistry

(1) The personal profile of the patient includes (Name, age, gender, occupation,
address & phone number and marital status).

(2) The history of the patient includes:
1. History of chief complaint main complaint/recorded in patient's language.
2. Medical history diseases and medical problems e.g. consider anticoagulants
taking when extracting teeth in patients with heart surgeries + People with
artificial heart valves should receive antibiotics before any kind of dental
treatment is done, to prevent infective endocarditis.
3. Dental history reporting the treatments the patient received in his/her teeth.

(3) Dental Caries is the most common problem in dentistry.

(4) If caries (reversible pulpitis) is left untreated irreversible pulpitis
occurs treated by RCT or extraction.

(5) If irreversible pulpitis is left untreated pulp necrosis occurs treated
by RCT/posts-crowns/extractions).

(6) Loss of teeth is the second most common problem in dentistry caused by
(the action of the dentist, congenital and trauma) and treated by (bridges,
dentures, implants and full mouth rehabilitation).

(7) Periodontal disease occurs in the form of gingivitis or periodontitis and is
treated by scaling & polishing, root planning and tissue regeneration.

(8) Pericoronitis is the inflammation of the gingiva surrounding the partially
erupted tooth and treated by irrigation and extraction.

(9) Dental trauma is an injury causing problem to the dentition and treated by
restorative dentistry or oral surgery.

(10) Tooth wear could be in the form of (abrasion, attrition, erosion) and is
treated by conservative dentistry or prosthodontics.

(11) Malocclusion means that teeth aren't well aligned or aren't biting
together nicely and is treated by orthodontics.

(12) Soft and hard tissues lesion include:
1. Developmental lesions oral pathology and surgery are needed.
2. Swellings and tumors (benign or malignant) oral medicine is needed.
3. Infections oral medicine is needed.
4. Bone lesions oral pathology and surgery are needed.
5. Odontogenic lesions oral pathology and surgery are needed.
6. TMJ and orofacial disorders oral medicine and surgery are needed.

(13) Individuals younger than 12 year are treated by Pediatric dentistry.






















Lecture #2: History of dentistry

(1) Dentistry is concerned with the prevention, diagnosis, and
treatment of diseases and abnormalities of the teeth, jaws, oral cavity,
and adjacent structures.
(2) The dentist is a person who is trained and licensed to practice
dentistry.
(3) Teeth as old as 9000 years that show clear signs of having undergone
drilling during their owner's lifetime.
(4) 5000 B.C: a Sumerian text of this date described "tooth worms" as
the cause of dental decay.
(5) The earliest known reference to a person identified as a dental
practitioner is Hesy-Re "an Egyptian scribe".

(6) The Egyptian earliest evidence of simple retentive dental prosthesis
was found 2500 B.C.
(7) Code of Hammurabi established the civil and penal responsibility of
the physician, dental penalties as to the extraction of teeth.
(8) The first evidence of a denture was the Phoenician denture.
(9) The first book in literature about dentistry was written by
Hippocrates "father of medicine" and Aristotle in 500 300 B.C.
(10) The first evidence of dentistry that aimed to improve
appearance/esthetics of people was the Mayan dentistry.

(11) The first evidence of amalgam fillings in dentistry was introduced
by Chinese dentistry.
(12) Galen "the prince of physicians" was the earliest to mention the
nerves of teeth.
(13) Prophet Mohammad (PBU) strongly recommended the use of
Miswak.
(14) Abu Al-Qasim Al-Zahrawi "Abulcasis" was the "father of modern
surgery" and "Islam's greatest medieval surgeon".
(15) The first one to differentiate between molars and premolars was
Leonardo DaVinci.
(16) Pierre Fauchard "Father of Modern Dentistry" was the founder
of modern dentistry and developed dentistry as an independent
profession from medicine.
(17) In 1759 A.D the designation dentist first began to be used.
(18) French apothecary introduced porcelain into dentistry.
(19) James Snell designed the first dental chair in 1832 A.D.
(20) The first school in the world for the training of dentists was the
Baltimore College of dental surgery.

(21) Horace Wells discovered that nitrous oxide can be used as an
anesthesia.
(22) Dr. Morrison invented the "first foot-engine"; Dr. Green invented
the "first electric dental engine" and Wilkinson invented the "first
hydraulic chair".
(23) G.V Black (Grand Old Man Of Dentistry) achievements:
1. Invented "extension for prevention cavity preparation".
2. Invented "system of dental nomenclature".
3. Developed the "balanced amalgam alloys".
(24) Rontgen discovered x-rays in 1895.











Introduction to dental anatomy Lecture #3:

(1) Human dentition is diphyodont because they have two successive sets of teeth,
first is the deciduous set and second is the permanent set.

(2) Primary/deciduous teeth are 20 teeth in number with 5 teeth in each quadrant.

(3) Secondary/permanent teeth are 32 teeth in number with 8 teeth in each quadrant.
Thus, 12 permanent teeth erupt by themselves without having any deciduous
teeth before them.

(4) We have 2 sets of dentition because bone surrounding teeth grows in 3
dimensions (up-down, right-left and forward-backward).

(5) For Deciduous teeth we have: (DI) 2/2 (DC) 1/1 (DM) 2/2 = 10 teeth in upper
and lower arches in one side only.

(6) For Permanent teeth we have: (I) 2/2 (C) 1/1 (PM) 2/2 (M) 3/3 = 16 teeth in
upper and lower arches in one side only.

(7) Humans have the maximum number of molars and canines seen in mammals.

(8) The maximum number of teeth in mammals is 44 teeth.

(9) Quadrants in permanent dentition have the numbers (1 4) and in deciduous
dentition have the numbers (5 8).

(10) Each tooth in a quadrant takes a letter (A E for deciduous) or a number (1
8 for permanent) indicating its order when counting from the midline.

(11) In palmer notation system, the tooth is represented by a number 1 8
(permanent) or a letter A E (deciduous) with 2 lines, horizontal line
representing the occlusal plane and a vertical line representing the midline. E.g.
Maxillary right permanent lateral incisor

(12) Palmer notation system is so easy to learn and simple but it is so hard to type
the two lines in computers and thus we need a more simple system.

(13) Universal numbering system uses consecutive letters from A to T (for
deciduous teeth) and consecutive numbers from 1 to 32 (for permanent teeth)
following a clockwise order from maxillary right second molar to mandibular
right second molar. E.g. Mandibular permanent left 1
st
premolar 21 (Twenty
one).

(14) In FDI numbering system each tooth is allocated a two-digit number where
the left designates the quadrant the tooth belongs to and the right designates
the tooth order (starting from the midline). E.g. Mandibular deciduous right 2
nd

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1. What is Oral Medicine?
2. the discipline of dentistry concerned with the oral health care of medically complex
patients--including the diagnosis and management of medical conditions that affect
the oral and maxillofacial region
3. Oral medicine specialists are trained to diagnose and manage patients with
disorders of the orofacial region, essentially as a "physician of the mouth."
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Problems Seen in Oral Medicine:

4. Mucosal abnormalities (e.g. aphthous ulcers, autoimmune diseases, allergic
reactions)
5. Bacterial infections (tuberculosis, Syphilis, Gonorrhea )
6. Viral infections (Herpes simplex, herpes zoster, Ebstein Barr virus induced
conditions)
7. (Herpes viridae) is the most common group of viruses and can affect the mouth

8. ** Herpes simplex:
- It is very common and it's recurrent every month
- clinically present as itchy burning vesicles that erupt fast at the lip area
(herpes labialis)
9. ** Herpes zoster is another viral lesion that manifests in the mouth regions
10. ** systemic laboratory investigations are useful to select the definitive diagnosis and
exclude the other differential diagnosis.
11. Fungal infections (oral candidosis, mucormycosis)
12. Premalignant conditions (white and red lesions.)
13. Lip lesions (angular cheilitis, lip fissure..)
14. Tongue lesions and conditions (atrophic glossitis, median rhomboid glossitis)
15. Candidosis can affect both oral mucosa and skin
16. Premalignant or potentially malignant means it has a likelihood of transforming into
malignancy( Cancer)
17. In Atrophic glossitis, the tongue becomes smooth due to the loss or shrinkage of
papillae
18. Oral medicine deals with systemic not dental diseases affecting the oral mucosa
unless teeth are causing a problem that is affecting the oral mucosa
19. Oral Candidosis affecting labial mucosa, gingiva and soft palate
20. Hairy Tongue (a benign condition in which the papillae on the dorsum of the tongue
grow ad elongate giving the tongue a hairy appearance
21. Geographic tongue (Migratory glossitis) which is a harmless common condition in
which papillae are totally lost at certain areas only (red spot areas)
22. Atrophic glossitis in which there's complete atrophy of lingual papillae (papillae
shrink "decrease in size" or lost)
23. plaque-induced gingival lesions (gingival lesions that are caused by plaque, calculus
or poor oral hygiene) are examined by periodontists
24. ** Non-plaque induced gingival lesions (gingival lesions that are not related to
plaque
25. accumulation) and patients with gingival lesions that didn't respond to periodontal
treatment are examined by oral medicine experts.
26. ** Actinic Chelitis which is a premalignant Angular Chelitis & lip fissuring
27. Salivary gland disorders (Sjgren syndrome, viral and bacterial infections of salivary
glands)
28. An example of viral infection of salivary gland is Mumps which is a swelling of
parotid gland
29. Temporomandibular joint (TMJ) disorders (TMJ osteoarthritis, subluxation)
- Radiographs are taken bu oral medicine experts to reach the final diagnosis .
- Examples of TMJ disorders : patients cannot open their mouth , sounds
while TMJ joints move(chew) , TMJ inflammation , TMJ dislocation (the disc
that joins the mandible to the skul is in not in the proper location )

30. Facial pain (e.g. neuralgia ..)
- Facial pain can be caused by problems related to teeth (odontogenic pain) or
by problems
31. not related to teeth (non-odontogenic pain)
- Oral Medicine deals with non-odontogenic pain
- Neuralgia: Neur means nerve, algia means pain, so Neuralgia means pain of
the nerve

32. Taste and smell disorders
33. People who cannot smell and taste food well are seen in Oral Medicine, but those
who only have smell disorder without taste disorder or have a problem only in the
nasal mucosa are NOT seen in Oral Medicine (Recall that oral medicine specialists
are the physicians of the mouth)
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Oral manifestations of systemic diseases:

34. Patients who have systemic diseases such as hypertension and diabetes with oral
problems
35. either caused by the diseases themselves or to their medications are seen in oral
medicine
36. We can't diagnose a disease from a picture
37. Many diseases look alike, and many diseases appear in different ways (They don't
have a
38. specific appearance to present with in each time)
39. Oral side effects of drugs (e.g. antihypertensive, anti diabetics..)
40. Oral cancer
41. Oral manifestations of radiotherapy
42. Oral manifestations of chemotherapy
43. Oral manifestations of immunosuppression
44. The management of oral disease in patients with AIDS
45. ** Oral Medicine specialists diagnose and identify oral cancerous lesions BUT don't
treat them.
46. ** Oral manifestations of immunosuppression
- Immunosuppression means reduction of activation or efficiency of the
immune system
- Immunosuppression is not only related to AIDS or HIV, it can be caused by:
corticosteroids
47. (Cortisone), chemotherapy, white blood cells disorders or anemia
48. ** The management of oral disease in patients with AIDS
- AIDS (HIV infected patients) cause many problems that affect the oral cavity
- You shouldn't deny or refuse to treat a patient with AIDS just because he has
AIDS

49. ** Lichen Planus is a side effect of antihypertensive and anti diabetic medications.
Many drugs can cause similar lesion so we should investigate the causes, because a
similar lesion is caused by antibiotics or Ibuprofen (an anti-inflammatory agent) as
well
50. ** The possible causes of a white lesion affecting the tongue include a list of
conditions:
- Hairy leukoplakia that indicates immunosuppression (due to AIDS)
- Frictional keratosis due to a sharp tooth or restoration that is rubbing
against the tongue
- Potentially malignant (premalignant) white lesion
- Cancer
51. ** In Oral Medicine different diseases can give similar appearance of lesions
(manifest in the sameway)
52. ** If you have a patient with a white lesion, you have to investigate, examine the
whole mouth, take a biopsy to obtain a proper diagnosis .
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Procedures Performed in Oral Medicine:
53. Biopsies: removal of tissue to obtain histopathological diagnosis
54. Incisional biopsy is done by taking a small specimen and submitting it to Oral
Pathology for examination
55. Excisional biopsy is done by excising the whole lesion and submitting it to Oral
pathology for examination
56. Medical management: prescribing topical and systemic medications to treat
conditions
57. Ordering and interpretation of tests: imaging studies (x-rays, CT scans MRI),
salivary and blood tests, microbiological investigations
58. Fabrication of mouth guards
- Sports such as karate & wrestling need mouth guards
- There are mouth guards especially designed for treating TMJ disorders
59. Specialized injections (e.g. corticosteroid injection to manage and treat some
conditions)
60. Screening for oral cancer
61. Dental treatments
62. Follow up of patients with potentially malignant conditions
63. Needle aspiration
64. Dental treatment of medically complex patients (e.g. organ transplant, renal
failure)
65. ** Oral Medicine delivers treatments for infections and prescribes medications such
as cortisone (corticosteroids), antiviral for patients with herpes simplex lesions, and
antifungal for patients with oral candidosis
66. Tegretol, (carbamazepine), is an anticonvulsant and specific analgesic for trigeminal
neuralgia







Pediatric Lecture




(1) Pediatric dentistry = an age-defined specialty that provides
both primary
and comprehensive preventive and therapeutic oral health
care for infants
and children through adolescence, including those with
special health
care needs
(2) Who are the objects of Pediatric dentistry?
-Infants
-Children
-Adolescence
-Special health care needs.

(3)What does the Pediatric dentistry provide?
- preventive oral health care
- therapeutic oral health care

(4) Its preferable that pediatric patients are seen starting from the
age of
6 months-1year, in order to establish whats called a dental home
at an early age

(5) Pediatric dentists have the training and experience to evaluate
and treat
patients, that are medically compromised.


(1) Objectives of Pediatric Dentistry:
- Giving comfort, relieving pain, removing infection, and
restoring functions
-Allaying fear and anxiety and modifying the child behavior
Promoting
optimal oral health by prevention and education
-To develop a positive attitude and behavior towards oral
health
-Implement the principles of preventive dentistry from birth

(2) Pediatric dentists try to implement:
o Good oral habits
o Good diet
o Preventive measures:

(3) A pediatric dentist should monitor the child's occlusion during
development
so that
the child won't need an orthodontic treatment in the future or
to make the malocclusion less severe

(9) Pediatric dentists manage dental trauma due to accidents
from sports and
other activities affecting primary teeth