Post on 14-Apr-2017
Copyright © 2017 Wolters Kluwer • All Rights ReservedCopyright © 2014 Wolters Kluwer • All Rights Reserved
Module 4—Use of Dental Mouth Mirror
Section 1Fundamentals of Mirror Use
Copyright © 2017 Wolters Kluwer • All Rights Reserved
Dental Mirror
A dental mirror is used to view tooth surfaces that cannot be seen using direct vision. For example, a clinician needs to view the lingual surfaces of the maxillary anterior teeth using a dental mirror or mouth mirror.
2
Copyright © 2017 Wolters Kluwer • All Rights Reserved
The working-end of a dental mirror has a reflecting mirrored surface.
3
Copyright © 2017 Wolters Kluwer • All Rights Reserved
Types of Dental Mirrors
4
Copyright © 2017 Wolters Kluwer • All Rights Reserved
Three Common Types
1. Front surface2. Concave3. Plane (flat surface)
5
Copyright © 2017 Wolters Kluwer • All Rights Reserved
Front Surface
-Reflecting surface is on front surface of the glass-Produces a clear mirror image with no distortion -Most commonly used type because of good image quality-Reflecting surface is easily scratched
6
Copyright © 2017 Wolters Kluwer • All Rights Reserved
Concave
-Reflecting surface is on front surface of the mirror lens-Produces a magnified image-Not recommended because magnification distorts the image
7
Copyright © 2017 Wolters Kluwer • All Rights Reserved
Plane (Flat Surface)
-Produces a double image (ghost image)-Durable, resists scratching because the reflecting surface is on the back of the mirror lens-Not recommended because double image is distracting
8
Copyright © 2017 Wolters Kluwer • All Rights Reserved
Stabilization of the Dental Mirror
-During instrumentation, clinician grasps mirror in the nondominant hand-The ring and index fingers are used to stabilize the mirror in the mouth-Clinician may rest fingers on the patient’s chin, cheek, or tooth surface to stabilize the mirror
9
Copyright © 2017 Wolters Kluwer • All Rights Reserved
Fulcrums
-Extraoral fulcrum—a stabilization point outside the patient’s mouth-Intraoral fulcrum—a stabilization point for the hand on a tooth surface-Intraoral fulcrum optional with a dental mirror, but recommended when used with a periodontal instrument
10
Copyright © 2017 Wolters Kluwer • All Rights Reserved
Extraoral Fulcrum
11
Copyright © 2017 Wolters Kluwer • All Rights Reserved
Uses of the Dental Mirror
12
Copyright © 2017 Wolters Kluwer • All Rights Reserved
Functions of the Dental Mirror
1. Indirect vision2. Retraction3. Indirect illumination4. Transillumination
13
Copyright © 2017 Wolters Kluwer • All Rights Reserved
1. Indirect Vision
The use of a mirror to view a tooth surface or intraoral structure that cannot be seen directly
14
Copyright © 2017 Wolters Kluwer • All Rights Reserved
Is Direct Vision the Best?
-For most clinicians the visual sense is the most dominant-During periodontal instrumentation TOUCH is the greatest asset for detection and removal of deposits-Mastery of indirect vision is important for preventing awkward body positions when trying to view teeth “directly”
15
Copyright © 2017 Wolters Kluwer • All Rights Reserved
-Use of the mirror head to hold the patient’s cheek, lip, or tongue so that the clinician can view tooth surfaces that are otherwise hidden from view by these soft tissue structures
2. Retraction
16
Copyright © 2017 Wolters Kluwer • All Rights Reserved
Retraction of Tongue
17
Copyright © 2017 Wolters Kluwer • All Rights Reserved
Retraction of the Lip
-The index finger is used to retract the lip away from the teeth-More comfortable for patient than using a mirror for retraction of the upper or lower lip
18
Copyright © 2017 Wolters Kluwer • All Rights Reserved
Retraction of Cheek
19
Copyright © 2017 Wolters Kluwer • All Rights Reserved
-Use of the mirror to reflect light onto a tooth or soft tissue structure in a dark area of the mouth
3. Indirect Illumination
20
Copyright © 2017 Wolters Kluwer • All Rights Reserved
4. Transillumination
-The technique of directing light off of the mirror surface and through the anterior teeth
21
Copyright © 2017 Wolters Kluwer • All Rights Reserved
Functions of the Dental Mirror
The dental mirror has four important functions during periodontal instrumentation:
1. Indirect vision2. Retraction3. Indirect illumination4. Transillumination
22
Copyright © 2017 Wolters Kluwer • All Rights ReservedCopyright © 2014 Wolters Kluwer • All Rights Reserved
Chapter 4—Use of Dental Mouth Mirror
Section 2Is Achieving Direct Vision Really Best?
Copyright © 2017 Wolters Kluwer • All Rights Reserved
Definition of Transillumination
-The technique of directing light off of the mirror surface and through the anterior teeth
24
Copyright © 2017 Wolters Kluwer • All Rights Reserved
Transillumination
-Can reveal carious lesions as dark regions within enamel of interproximal surfaces of anterior teeth-The mirror is used to reflect light through the anterior teeth-Carious lesions and anterior restorations will both appear as dark shadows with transillumination
25
Copyright © 2017 Wolters Kluwer • All Rights Reserved
Use of Transillumination
-Only anterior teeth can be transilluminated because these teeth are thin enough to allow light to pass through them
-Posterior teeth are “bulky teeth” that cannot be transilluminated
26
Copyright © 2017 Wolters Kluwer • All Rights Reserved
Transillumination Indicating Caries
27
Copyright © 2017 Wolters Kluwer • All Rights Reserved
Procedure for Transillumination
28
Copyright © 2017 Wolters Kluwer • All Rights Reserved
Light Position
-Position unit light directly over the oral cavity with light beam perpendicular to the facial surfaces of the anterior teeth-Patient should be in the chin-down position
29
Copyright © 2017 Wolters Kluwer • All Rights Reserved
Position Mirror
-Position yourself at 12:00-Hold the mirror behind the mandibular anterior teeth with reflecting surface parallel to the lingual surfaces
30
Copyright © 2017 Wolters Kluwer • All Rights Reserved
View the Transilluminated Teeth
-Look DIRECTLY at the teeth, not in the mirror-Teeth should appear to “glow,” lighted by the reflected light
31
Copyright © 2017 Wolters Kluwer • All Rights Reserved
Note:
When practicing transillumination on a student partner, you probably will not see any shadows on the teeth.This is because he or she most likely does not have untreated interproximal decay on the anterior teeth.
32
Copyright © 2017 Wolters Kluwer • All Rights Reserved
Example: Interproximal Decay
Detection by Transillumination
33
Copyright © 2017 Wolters Kluwer • All Rights Reserved
Indirect Vision
As seen here, no decay is visible when the lingual surfaces of these teeth are viewed with indirect vision in a mirror. (Courtesy of Dr. Robert P. Langlais)
34
Copyright © 2017 Wolters Kluwer • All Rights Reserved
The same teeth as in the previous slide.Transillumination reveals interproximal decay—seen as shadows on the teeth. (Courtesy of Dr. Robert P. Langlais)
35
Copyright © 2017 Wolters Kluwer • All Rights Reserved
Transillumination is a useful technique for detecting “hidden” decay on anterior teeth.
36