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G.V. Black's Classification of Tooth Preparations / Cavity Preparations

Based on anatomical location of carious lesion, Greene Vardiman Black (G.V. Black) classified tooth preparations into five different classes. Later an additional class, class VI was also added. Class I refers to pit and fissure lesions, whereas all other classes are smooth surface lesions.


G.V. Black's Classification of Tooth Preparations
Class I
All pit and fissure preparations. It Includes:
➤ occlusal surfaces of premolars and molars,
➤ occlusal two-thirds of the facial and lingual surfaces of molars, and ➤lingual surfaces of maxillary incisors
Class II
Preparations involving the proximal surfaces of posterior teeth  (i.e. Premolars and Molars)

Dentist

Who is a Dentist / Dental Surgeon ?
A dentist is a person who is licensed by the nation or state's licensing body to practice dentistry independently. He can either run a private practice or work as a government employee or an employee in other's clinic. A dentist can examine and diagnose the disease of your oral cavity, perform restorations, rectify maloccluded teeth by the use of removable and fixed orthodontic appliances, extract your tooth, provide partial or complete / removable dental prostheses, etc. The dentist deals not only with the teeth, the rest of the soft tissues like tongue, palate, buccal and labial mucosa are also dealt by the dentist. Extra-oral lesions, swellings, and tumors of the head and neck region too come to the attention of the dentist first. Some facial reconstruction surgeries, surgical correction of cleft lips and palates, implants,etc. all come under the duties of a dentist or dental surgeon.

MCQs on Oral Histology - Salivary Glands Part 2


# Myoepithelial cells are present in:
A. Striated duct
B. Intercalated duct and terminal duct
C. Serous cells
D. Mucous cells

# Carmalt's glands are:
A. Major salivary glands
B. Minor salivary glands(Retromolar)
C. Minor salivary glands (lingual)
D. Taste buds

MCQs on Oral Histology - Salivary Glands Part 1


# The normal pH of saliva is about:
A. 5.5
B. 9.5
C. 7.5
D. 8.5

# Of the total amount of saliva secreted by all the salivary glands, about 60% is secreted by :
A. Parotid glands
B. Sublingual glands
C. Submandibular glands
D. None of the above

What is Depression? How can we help?

The theme for this year's world health day is depression, with a slogan- Depression: Let's Talk. Depression is aptly chosen as this year's theme because it is taking pandemic proportions in today's competitive world. More and more young generations are diagnosed as having depressions every day attributing to failures in relationships, academics, careers, finances and many other seemingly inconsequential reasons. As per the WHO's definition of health, health is a state of complete physical, mental and social well-being but not merely the absence of disease or infirmity. Yes, a person may seem well from others' perspective but he may be having troublesome issues within himself. He may not feel healthy mentally. Some unknown fear, apathy, anxiety may be lurking in his psyche and he may not know to whom he should consult. It is a global necessity that every one of us understands the fact that nobody is immune to mental illness and we should not attach a stigma to those having mental disorders.

What is depression?
Normally we all feel sad, lethargic, heartbroken and uninterested in any activities during stressful situations or after we face some major losses in life. These mild depressive symptoms are normal as we acknowledge the fact that it's not our day every day. The saying "Everyday is not Sunday" also reminds us that ups and downs in life are inevitable. Depression becomes a disorder when the symptoms become so severe that they interfere with normal functioning, and when they continue for weeks at a time. The sadness of depression is differently both quantitatively as well as qualitatively as compared to normal sadness. The most important feature is the sadness of mood or loss of interest and/or pleasure in almost all activities (pervasive sadness), present throughout the day (persistent sadness). 


Depression is so common that the life-time risk of depression in males is 8-12% and in females is 20-26%. Sadness is usually associated with pessimism and the person suffers from three common types of depressive ideas :
hopelessness (nothing is going to be good in future) ,
helplessness (nobody can help me to become better) and
worthlessness (I cannot do anything in my life, better if I end my life!! )

The person doesn't like to get involved in social interactions and is not excited about things he used to enjoy before. His appetite is decreased and keeps on thinking about some particular events repeatedly and becomes pessimistic. Some other physical manifestations (somatic syndrome) can also be seen as listed in the table below.

The suicidal tendency is seen increased in some of the risk groups. Suicidal risk is much more in the presence of following factors:
a. Presence of marked hopelessness
b. Males over 40 years age; unmarried, divorced/widowed
c. Written/verbal communication of suicidal intent and/or plan
d. Early stages of depression
e. Recovering from depression (At the peak of depression, the patient is usually either too depressed or too retarded to commit suicide)
f. Period of 3 months from recovery.

So, extra attention should be given to those persons. We should give them company, keep them engaged and occupied. We should never give them a chance to be overcomed by their depressive emotions.

How can we help ?
Depression is a disease and as every other disease it can be treated. The depressed person feels better even if we listen to his problems and show some sympathy. We should not mock or ridicule them saying things like, " You are talking nonsense, You're out of your wits, You crazy moron, What makes you so retarded? , Grow up man don't talk sissy, You got to be strong, etc.". That's not going to help.
We need to assure them that they can have their previous happy life back once again if they become aware of their condition. Regular psychiatric consultations should be made and medications should be taken as per the psychiatrist's pescription.

Let's talk about Depression..!!!

MCQs on Oral Histology - Salivary Glands


# The normal pH of saliva is about:
A. 5.5
B. 9.5
C. 7.5
D. 8.5

# Of the total amount of saliva secreted by all the salivary glands, about 60% is secreted by :
A. Parotid glands
B. Sublingual glands
C. Submandibular glands
D. None of the above

# The basket cells are also known as :
A. Myoepithelial cells
B. Endothelial cells
C. Parenchymal cells
D. None of the above

# The three bilaterally paired major salivary glands are located :
A. Extraorally
B. Intraorally
C. In tongue
D. In neck

# The parotid glands open through the :
A. Stensen's duct
B. Wharton's duct
C. Bartholin's duct
D. Blandin's duct

# The saliva is neutralised due to:
A. Mucin
B. Ammonia
C. Amino acids
D. Bicarbonates

# Among various glands, salivary gland secretion is unique in that, its secretions are controlled by:
A. Hormones
B. Nerves
C. Chemicals
D. All of the above

# The content of saliva include all except:
A. Amylase
B. Urea
C. Lysoenzyme
D. Lipase

# The ducts of glands opening into the floor of the mouth are :
A. Submandibular and sublingual
B. Submandibular and parotid
C. Sublingual and parotid
D. Von Ebner


# Sublingual gland is a :
A. Mixed gland
B. Serous gland
C. Mucous gland
D. Present in root of tongue

# Bartholin's duct is the name of:
A. Parotid duct
B. Submandibular duct
C. Sublingual duct
D. Lacrimal duct

# The glands of Blandin and Nuhn are:
A. the posterior lingual glands
B. the anterior lingual glands located near the apex of the tongue
C. the glossopalatine glands
D. the palatine glands

# A purine which is found in saliva is :
A. Uric acid
B. Thymine
C. Adenosine
D. Hypolithinium

# Which of the folowing is not found in saliva?
A. Lysozyme
B. Phosphate
C. Bicarbonate
D. Trypsin

# Mucin in mucous cells are usually demonstrated by:
A. PAP stain
B. H and E stain
C. Mucicarmine stain
D. Mallory stain

# The functions of myoepithelial cells may be:
A. Initiating contraction
B. Support for the end piece during active secretion of saliva
C. Provide signals to the acinar secretory cells for structural reorganization
D. All of the above

# Myoepithelial cells are present in:
A. Striated duct
B. Intercalated duct and terminal duct
C. Serous cells
D. Mucous cells

# Carmalt's glands are:
A. Major salivary glands
B. Minor salivary glands(Retromolar)
C. Minor salivary glands (lingual)
D. Taste buds


# On passing from acini to ductal orifices after ductal modifications, saliva becomes _________ as compared to plasma.
A. Hypertonic sometimes
B. Hypotonic
C. Isotonic
D. Hypertonic always

# Tuft cells are receptors seen on:
A. Cell rich zone
B. Lining of maxillary sinus
C. Salivary duct
D. TMJ capsule

# The parotid gland opens:
A. on the floor of the mouth
B. at the side of the lingual frenum
C. at the caruncula
D. on the buccal mucosa opposite the maxillary second molar

# Which of the following is purely serous in nature?
A. parotid and Von ebner's glands
B. Palatine glands only
C. Glossopalatine glands
D. Lingual glands

# The total volume of saliva secreted daily is :
A. 750 ml
B. 1.5 liters
C. 2 liters
D. 3 liters

# Largest amount of saliva is produced by :
A. Submandibular glands
B. Sublingual Glands
C. Parotid glands
D. Von ebner Glands

# The immunoglobulin present in saliva is:
A. IgG
B. IgA
C. IgM
D. IgE

# Salivary glands are not found in:
A. Anterior part of the hard palate
B. Posterior part of the hard palate
C. In mandible posterior to the 3rd molar
D. Nasopalatine canal

# Which of the following is purely mucous?
A. Palatine glands
B. Glossopalatine glands
C. Posterior lingual mucous glands
D. All of the above

# The minor salivary glands begin their development in fetal life during :
A. 1st month
B. 2nd month
C. 3rd month
D. 4th month

# Salivary flow is reduced in:
A. Sjogren's syndrome
B. Xerostomia
C. Inflammation of glands
D. All of the above

# The severance of duct of minor salivary glands and pooling of saliva in the tissues is called as:
A. Ranula
B. Congenital Epulis
C. Mucocele
D. Sialadenitis

# The pH of whole saliva is :
A. 1.2 - 2.4
B. 3.0 - 5.6
C. 6.7 - 7.4
D. 7.0 - 8.2


Management of Hospital waste in BPKIHS


B.P. Koirala Institute of Health Sciences (BPKIHS) is a tertiary health care center and referral center in eastern development region. Thousands of patients come here every day seeking outpatient medical care. It also has got a 700-bedded inpatient ward and the largest (in terms of manpower) emergency unit in the nation. There is also a separate College of Dental Surgery(CODS) for dental facilities which consist of nine different departments. So, a large amount of general waste and biomedical waste is produced from the hospital every day.  General waste includes paper and plastic packages of medicine, wrappers of junk foods, kitchen waste from hospital kitchen, etc. and biomedical waste includes used gloves, cotton dressings and gauges, used syringes and medicine bottles, excised body parts, etc. These waste materials must be suitably disposed of immediately lest they putrefy, emit foul smells, act as a source of infection and disease, and become a public health hazard. It is the responsibility of the healthcare institute producing those wastes for the proper management of health care waste, not the government or local governing unit.

In BPKIHS too, there is a provision of proper waste disposal, which, however, is not the best protocol to follow. Juniormost staffs are responsible for the collection and disposal of the waste. For the workers’ health and safety, Health welfare scheme/Treatment facility is provided by the institution. The workers are vaccinated and Personal protective equipment (PPE) viz. Long boots, gloves, face mask, Cap and plastic apron are also provided for the employees. The materials used for the collection of the wastes are:
-Plastic bags (Black)
-Cartons (Red/Orange/Green colored)
- Plastic buckets
-Wheel big plastic bins (Red/Orange/Green)
Trolley

The wastes are segregated by using different color coded containers for different types of wastes.
The Nepal Health Research Council (NHRC) guidelines are followed as listed below:
Green Box (Non- Infectious): Non-infected stuffs/General waste
Orange box / Red box (Infectious): Infected Stuffs – Gauze/ bandage/cannula/urobag/blood/bodyfluid contaminated stuffs
Sharp Box: Needle/syringe/surgical blade/infected sharp materials

The collection and transportation of infectious wastes from wards to the incinerator is done in two shifts per day. And the residual sterile waste is disposed of to the dumping site. This is done by the attendants posted at the incinerator.

Similarly, the non-infectious waste is collected in two shifts from the wards to the bay/Collection container by ward attendants. Then, it is transported to the dumping site by sanitary workers in three shifts. 

Though the waste segregation system has been applied, it’s not properly followed due to unawareness. Also, The spread of infection from the open dumping site and direct contact transmission of disease to those poverty struck rag-pickers from the dumping site is always a risk which may cause a serious health hazard. Besides, A clean hospital and good housekeeping have a direct effect on the health, comfort and morale of patients, visitors and hospital personnel alike. Cleanliness radiates cheer and a well-kept hospital would give the public a feeling of confidence. So, due care has to be given in proper management of wastes and adequate budget should be allocated for that purpose.