A Practical Guide to Hospital Dentistry

261 Pages·5.618 MB·English

by  Varghese George.

A Practical Guide
to
Hospital Dentistry
A Practical Guide
to
Hospital Dentistry
K George Varghese
Vice Principal
Professor and Head
Dept. of Oral and Maxillofacial Surgery
Govt.Dental College, Kottayam, Kerala
®
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A Practical Guide to Hospital Dentistry
© 2008, K George Varghese
All rights reserved. No part of this publication should be reproduced, stored in a retrieval system, or transmitted in
any form or by any means: electronic, mechanical, photocopying, recording, or otherwise, without the prior written
permission of the author and the publisher.
This book has been published in good faith that the material provided by author is original. Every effort is made
to ensure accuracy of material, but the publisher, printer and author will not be held responsible for any inadvert-
ent error(s). In case of any dispute, all legal matters are to be settled under Delhi jurisdiction only.
First Edition: 2008
ISBN 978-81-8448-243-0
Typeset at JPBMP typesetting unit
Printed at Gopsons Paper Ltd. A-14, Sector 60, Noida
Dedicated
to
the loving memory of
my beloved parents
Prof. KV Varghese
and
Mrs. Rosakutty Varghese
Contributors
K George Varghese MDS, DSS (Vienna) Selliamma Kuruvilla MSc
Professor and Head Associate Professor
Department of Oral and Maxillofacial Surgery College of Nursing, Kottayam
Govt.Dental College, Kottayam, Kerala Chapter 9
Chapters 1, 2, 3, 4, 6,10,11, 14,16,17
Susamma Andrews MD
George Philip MDS, FDSRCS, FFDRCS Professor and Head
Senior Lecturer Department of Anaesthesia
Department of Oral and Maxillofacial Surgery Govt. Medical College
Govt. Dental College, Kottayam, Kerala Kottayam, Kerala
Chapter 5 Chapter 12
TR Sreedevi MSc R Dayananda Babu MS, MNAMS
Associate Professor Former Professor and Head
College of Nursing Department of Surgery, Govt. Medical College, Thrissur,
Kottayam, Kerala Kottayam and Co-operative Medical College
Chapter 6 Pariyaram, Kerala
Chapters 13, 15
Sajeesh Kuriakose MDS, FFDRCS
Head Tomy Mappalakayil MD
Division of Oral and Maxillofacial Surgery Assistant Professor
PVS Hospital, Kochi Department of Forensic Medicine, Govt.Medical College,
Chapter 7 Kottayam, Kerala
Chapter 17
R Sajith Kumar MD
Chief George F Moolayil, DCH, PGDMLE
Infectious Diseases National Law School of India, Bangalore
Govt.Medical College, Kottayam, Kerala Pediatrician and Consultant in Medical Law
Chapter 8 Chapters 18, 19
Foreword
Dentistry in general and maxillofacial surgery in particular has seen an unprecedented advancement by leaps
and bounds during the past decade. Dental and maxillofacial surgery has become an inevitable part of the Trauma,
Head and Neck and Aesthetic Surgery teams. Dentistry is keeping pace with the fast track progress technology
is making. Dental surgeons who work in a hospital set up need to update their knowledge on in-patient management.
Dr. George Varghese, a renowned maxillofacial surgeon and a teacher with repute for the past two decades
and more, working in close quarters with Plastic, ENT, Neuro and general surgeons is the apt person to pen
this book, ‘A Practical Guide to Hospital Dentistry’.
I am sure this book will be helpful for house-surgeons, post-graduate students and general dental surgeons
who work in hospitals. This is a reference book not only to dental surgeons but to other specialists as well. One
of the first of its kind, I am sure, this will be a hotly sought after practical guide.
Varghese Mani
Oral and Maxillofacial Surgeon
Principal
Mar Baselios Dental College
Kothamangalam, Kerala, India
Preface
During the past two decades the hospital environment, needs and expectations of the society as well as the medical
profession have made a quantum leap. In the past, with minimal personnel and material support the hospital
dentist cared for patients in primitive ambulatory care facilities and operating rooms. Their work was mainly
restricted to management of acute infections and dentoalveolar trauma. The advances made in modern diagnostic
and therapeutic dentistry as well as in maxillofacial surgery has widened the scope of hospital dental practice.
And at the same time it has increased the duties and responsibilities of the dentists working in hospitals.
This book is intended mainly for postgraduate students, fresh graduates and students who are about to start
or continue their training in the hospital environment and also for the general dentists who are members of
the hospital dental department or serve as part time consultants in hospitals. This book also will be a guide to
the administrators to establish and direct the dental department in an efficient manner consistent with the needs
of the hospital, the profession and the society.
Even though certain books are available on hospital dental practice, they are published from western countries
which are written to suit to their existing needs and requirements.
K George Varghese
Acknowledgements
At the outset we thank the God Almighty, who has made our dream of writing this book a reality. Nothing
is possible without his blessings.
I acknowledge with great respect my post graduate teacher Dr. PI John, Former Professor and Head of the
Department of Oral and Maxillofacial Surgery, Government Dental College, Thiruvananthapuram for teaching
the basics of maxillofacial surgery and who inducted me into the speciality.
I am indebted to Dr. VK Kuriakose (late) whom I consider as my mentor. Under his guidance I started my
career as a maxillofacial surgeon.
My sincere thanks to Dr. Varghese Mani, Principal, Mar Baselios Dental College, Kothamangalam who blessed
me with a befitting foreword for this book.
I would like to express my deep appreciation to all contributors, whose untiring efforts have made this possible.
I am grateful to Dr. B Ekbal, former Vice-Chancellor, University of Kerala and former Professor of Neuro
Surgery, Medical College, Kottayam for necessary guidance in writing the section on “Management of Head
Injury”.
I would like to thank Dr. George Paul, Oral and Maxillofacial Surgeon, for permitting me to adapt the section
“Dental / Oral and Maxillofacial Surgeon as Expert Witness”.
My special thanks to my wife Alice for her constant support and encouragement to accomplish this endeavor.
I am also grateful to Jaypee Brothers Medical Publishers (P) Ltd. Delhi, who encouraged me to write this
book and for publishing it.
Contents
1. Organization of Dental Department ......................................................................................1
2. Admission and Medical Record............................................................................................4
3. Casualty Service ...................................................................................................................9
4. The Medically Compromised Patient ..................................................................................26
5. Management of Odontogenic Infections..............................................................................58
6. Common Medical and Nursing Procedures.........................................................................72
7. Conscious Sedation.............................................................................................................92
8. Infection Control in Dental Practice .................................................................................111
9. Preoperative Preparations .................................................................................................127
10. Operation Theater Setup and Aseptic Procedures ............................................................139
11. Postoperative Management................................................................................................148
12. Management of Shock in Trauma......................................................................................155
13. Intravenous Fluids and Postoperative Fluid Management .................................................166
14. Transfusion of Blood and Blood Products.........................................................................173
15. Surgical Site Infection......................................................................................................191
16. Prevention and Management of Oral Problems of Cancer Therapy..................................194
17. Dental Jurisprudence ........................................................................................................213
18. Medical Negligence ..........................................................................................................225
19. Consumer Protection Act and its Relevance to Dental Practice.......................................234
Appendices............................................................................................................................................241
Index.....................................................................................................................................................247