Oxford Handbook of Clinical Dentistry

813 Pages·2014·16.4 MB·English

by  David Mitchell

OXFORD MEDICAL PUBLICATIONS
Oxford Handbook of
Clinical Dentistry
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Oxford Handbook of
Clinical
Dentistry
Sixth edition
David A. Mitchell
and
Laura Mitchell
with contributions from
Lorna McCaul
1
3

Great Clarendon Street, Oxford, OX2 6DP,
United Kingdom
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© David A. and Laura Mitchell, 99, 995, 999, 2005, 2009, 204
The moral rights of the authors have been asserted
First published 99
Second edition published 995
Third edition published 999
Fourth edition published 2005
Fifth edition published 2009
Sixth edition published 204
Impression: 
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v
Preface to the
first edition
Dental students are introduced to real live patients at an early stage of
their undergraduate course in order to fulfil the requirements for clinical
training, with the result that they are expected to absorb a large quantity of
information in a relatively short time. This is often compounded by clinical
allocations to different specialities on different days, or even the same day.
Given the obvious success of the Oxford handbooks of clinical medicine
and clinical specialities, evidenced by their position in the white coat pockets
of the nation’s medical students, the extension of the same format to den-
tistry seems logical. However, it is hoped that the usefulness of this idea will
not cease on graduation, particularly with the introduction of Vocational
Training. While providing a handy reference for the recently qualified gradu-
ate, it is envisaged that trainers will also welcome an aide mémoire to help
cope with the enthusiastic young trainee who may be more familiar with
recent innovations and obscure facts. We also hope that there will be much
of value for the hospital trainee struggling towards FDS.
The Oxford Handbook of Clinical Dentistry contains those useful facts and
practical tips that were stored in our white coat pockets as students and
then postgraduates; initially on scraps of paper, but as the collection grew,
transferred into notebooks to give a readily available reference source.
The dental literature already contains a great number of erudite books
which, for the most part deal exclusively, in some depth, with a particular
branch or aspect of dentistry. The aim of this handbook is not to replace
these specialist dental texts, but rather to complement them by distilling
together theory and practical information into a more accessible format.
In fact, reference is made to sources of further reading where necessary.
Although the authors of this handbook are not the specialized authorities
usually associated with dental textbooks, we are still near enough to the
coal-face to provide, we hope, some useful practical tips based on sound
theory. We were fortunate whilst compiling this handbook in being able to
draw on the expertise of many colleagues; the contents, however, remain
our sole responsibility. The format of a blank page opposite each page of
text has been plagiarized from the other Oxford handbooks. This gives
space for the reader to add his own comments and updates. Please let us
know of any that should be made available to a wider audience.
We hope that the reader will find this book to be a useful addition to their
white coat pocket or a companion to the BNF in the surgery.
vi
Preface to the
second edition
It would appear that our ‘baby’ is now a toddler and rapidly outgrowing
his previous milieu. Caring for such a precocious child is hard work and
therefore we have again relied on the help of understanding friends and col-
leagues who have contributed their knowledge and expertise.
The pace of change in dentistry, both scientifically and politically, is so
fast that although the first edition was only published in 99, this second
edition has involved extensive revision of all chapters. Advances in dental
materials and restorative techniques have necessitated major revision of
these sections and we are indebted to Mr Andrew Hall, who has helped
update the chapter on restorative dentistry.
Since the first edition was published, political changes in the UK have
resulted in a shift towards private dentistry. This changing emphasis is
reflected in the practice management chapter, which now includes a new
page on independent and private practice. In addition recent developments
in cross-infection control and UK health and safety law have been included.
That old favourite, temporomandibular pain dysfunction syndrome,
has also been given the treatment and is now situated on a newly devised
page in the chapter on oral medicine. Non-accidental injury, guided tissue
regeneration, AIDS, ATLS, and numerous other topical issues have been
expanded in this edition.
One aspect of this developing infant remains, however, unchanged. The
sole purpose of this book is to enable you, the reader, to gain easy access
to the sometimes confusing conglomerate of facts, ideas, opinions, dogma,
anecdote, and truth that constitutes clinical dentistry. To this framework
you should add, on the blank pages provided, the additional information
which will help you treat the next patient or pass the next exam, or more
importantly the practical hints and tips which you will glean with experience.
It is the potential for that interaction which makes this book distinctive in
clinical dentistry. It is participating in that interaction which makes your book
unique.
vii
Preface to the
third edition
Like any proud parents we are surprised and delighted with the contin-
ued development of our ‘baby’, and we are grateful to all those who have
helped or provided positive feedback. We are also grateful to our col-
leagues who have helped with the ‘baby-care’.
Of course, now being of school age, peer group rivalry has arrived, but
ours is a robust child and despite being the first kid on the block welcomes
both competition and change.
Some of this change is reflected by bringing in a new contributor who
has overseen a complete overhaul of the restorative dentistry chapters and
a large number of new contributions to reflect dentistry in the late 990s.
Our own areas of (increasingly erudite) specialist expertise have grown
apace but we think we have curbed the temptation to dwell on these in
what is, after all, a generalist text for the earlier years; we trust the odd
excursion will be forgiven.
We hope that the new sections, which include: evidence-based medi-
cine/dentistry; the new NHS complaints procedure, objective structured
clinical examinations, the 997 Advanced Life Support Guidelines, and the
completely revised restorative chapters will prove helpful and informative.
We would, however, like to remind you that the blank pages are there for
your additional notes—and it is this that makes your copy of this Handbook
unique. Please do not hesitate to share these annotations with us, we would
be happy to include the best we receive in the next edition and to acknowl-
edge the contributor.
As always while we are grateful for the contributions of our colleagues
the contents and the brickbats remain our sole responsibility.
viii
Preface to the
fourth edition
A new millennium means new technology and new challenges.
So the time has come to update the Oxford Handbook of Clinical Dentistry.
In fact the pace of change is such that all chapters in this new edition have
been completely revised. To continue the analogy of earlier prefaces: our
teenager is keen on exploring new avenues, so we are going to indulge this
by expanding our horizons into new attitudes and technology with a section
on Dentistry and the World Wide Web, and also a section on web-based
learning. This new, twenty-first century edition has the added bonus of col-
our plates and more diagrams to aid understanding.
We are, as ever, indebted to contributors past and present. The new
recruits bring both knowledge and enthusiasm to their areas of expertise as
well as to the book as a whole, and build on the work of previous contribu-
tors. To all we are greatly indebted. The ultimate responsibility for errors or
oversights remains, as always, ours.
Please keep sending us feedback—this is the best way for us to improve
future editions.
Let’s just hope the teenager doesn’t rebel!!
Preface to the
fifth edition
The first draft of this book was started in 989, the year the Berlin wall
came down and the first edition appeared in 99 making our ‘child’ legal
by this, the fifth, edition.
As an eighteenth birthday present this edition includes, as well as the
usual extensive rewrite and update of the text, a substantial improvement in
the quality of the illustrations, which are now in colour and integrated into
the text. This will mean less space for making your own notes in the blank
pages but we suspect you will be willing to make the trade-off.
In keeping with previous practice new contributors have been included
in order to ensure the material is as up to date as possible and we have
tried to avoid overemphasizing our current areas of sub-specialization. As
before, this book is the sum of its previous incarnations helped by feedback
from readers from all parts of the world and the input of contributors. As
always, responsibility for any errors or omissions lies with us.
ix
Preface to the
sixth edition
By the time this, the sixth edition of the Oxford Handbook of Clinical
Dentistry reaches the shelves or the app on your smartphone it will have
celebrated its 2st birthday. Now a mature adult it has, for the moment,
declined to leave home and despite its experience and worldly wise nature
has certain hankerings towards younger, simpler days. For this reason along
with the usual extensive updates and rewrites we want to re-emphasize the
interactive nature of this book by encouraging you to personalize your copy
using the blank ‘noteboxes’ where you create your version by augmenting
or perhaps even correcting the content in light of your reading (and if you
do, let us know the details for future editions, please don’t just make vague
comments on an Internet review site) or more importantly your personal
clinical experience.