Autonopedia

THE DENTAL KIT

In this page, there are lists of medicines, instruments, and other supplies recommended in this book. Keep them together in a kit. You may want to change some of them, or add others to meet your own needs.

As a dental worker, you will be able to get many of the items on the lists from your government medical stores. Some things you will have to buy yourself. That can be expensive, so we make several suggestions to help you save money.

Before you order, decide how many of each thing you need. Ask yourself: How many persons do I treat each day? For what problems? Then order enough medicines and supplies for three months. Note: as more people learn about the treatment you can give, more will come to ask for your help. Remember this when you order. Remember, also, that some persons may need more than one treatment.

We recommend how many medicines,supplies, and instruments you will need if you see 10 people a day-200 a month. You cannot be exact, of course, because you cannot predict exactly what problems will arise. However, we can say that, on the average:

In a group of 10 persons with urgent problems:

• 6 persons need you to take out 1 or more teeth (so you must inject)
• 2 persons need cement fillings
• 2 persons need medicine before you can treat them.

Many of these persons must return for another visit:

• 5 persons need you to scale their teeth and teach them how to care for them better
• 1 person will need a cement filling
• 2 persons will need treatment after taking medicine.

MEDICINES

Use	Proper Name	Amount you need in 3 months	Amount to keep in kit
For Pain	1.  aspirin, 300 mg tablets 2. acetaminophen (paracetamol) 500 mg unlets	2,000 tablets 500 tablets	100 tablets 10 tablets
For Infections	1.  penicillin, 250 mg tablets 2. erythromycin, 250 mg tablets 3.  nystatin, creme or solution	2,000 tablets 500 tablets 12small tubes or bottles	100 tablets 40 tablets 2 small tubes or bottles

Another antibiotic, tetracycline, is not recommended for any of the treatments in this book because it is a broad-spectrum antibiotic. Narrow-spectrum antibiotics (see 'antibiotics',) are usually safer and just as effective for most dental problems. If you do use tetracycline, remember, do not give tetracycline to a pregnant woman or to a young child. Tetracycline can make a young, developing tooth turn yellow.

SUGGESTIONS:

1.  Compare prices before you buy medicines. Often the same medicine has many different names. The generic name (the name we use on this page) usually is cheapest, and the medicine is just as good as the 'brand-name medicines'. Use the generic name to order and buy, not the brand name.

2. Always look for a date on the package. It is called the expiration date (or expiry date). If today is later than that date, do not buy or use that medicine.

3.  Be careful to give the correct dose. Read the next two pages carefully, as well as the Treatment section of each problem.

4. For serious infections or serious pain, see page below.

THE CORRECT DOSE

Before you give medicine, think about the sick person's weight and age. The smaller children are, the less medicine they need. For example, pain medicine like aspirin (300 mg tablets) or acetaminophen (500 mg tablets) can be broken up into smaller tablets:

Adults	Children 8-12	Children 3-7	Babies
2 tablets	1 tablet	1/2 tablet	acetaminophen only, 1/4 tablet

Notes: Do not hold aspirin on the bad tooth. Aspirin has acid that can hurt the tooth. Always swallow aspirin immediately. For severe pain, when aspirin does not help, an adult can take a 30 mg tablet of codeine.

Antibiotics To Fight Infection

Antibiotics kill bacteria that cause infections. Some antibiotics work better than others on certain bacteria. If you can, test the pus to find which antibiotic works best.

Do not give penicillin to a person who is allergic to it. Ask about the person's allergies before you give penicillin pills or injections. When you inject penicillin, always keep epinephrine (Adrenalin) ready to inject if the person shows signs of allergic shock. Stay with the person for 30 minutes. If you see these signs . . .

• cool, moist, pale, gray skin (cold sweat)
• difficulty breathing
• weak, rapid pulse (heartbeat)
• loss of consciousness

. . , immediately inject epinephrine: 1/2 ml for adults or 1/4 ml for children. For more information on allergic shock, see Where There Is No Doctor, pages 68 to 72.

Always give the full dose of penicillin or any antibiotic, even if the person feels better. See page 88 for the correct dose of penicillin or erythromycin in 250 mg tablets. Erythromycin also comes in liquid form. It has 125 mg in 5 ml, so 10 ml of liquid (about two large teaspoons) is the same as one tablet.

It is important to take a strong first dose of penicillin or erythromycin, and then smaller doses four times a day for 3 to 5 days after that. Carefully read the instructions.

THE BEST CHOICE

SECOND CHOICE (for those allergic to penicillin)

Penicillin G or V: 1 tablet = 250 mg. Give enough tablets for 3 days First Dose (take all at once) Adults 8 tablets and children over 25 kg. (2000 mg.) Children under 25 kg. 4 tablets (1000 mg.) Then every 6 hours for 3 days (12 doses) Adults 2 tablets and children over 25 kg. (500 mg.) Children under 25 kg. 1 tablet (250 mg.) IMPORTANT: to allow it to best fight infection, take penicillin before eating.

Erythromycin: 1 tablet (or capsule) = 250 mg. Give enough tablets for 3 days First Dose (take all at once) Adults 4 tablets and children over 25 kg. (1000 mg.) Children under 25 kg. 2 tablets (500 mg,) Then every 6 hours for 3 days (12 doses) Adults 2 tablets and children over 25 kg. (500 mg.) Children under 25 kg. 1 tablet (250 mg.) IMPORTANT: to avoid upset stomach, take erythromycin with meals.

For serious infections, it may be necessary to take the antibiotics for a longer time. Take the same first dose as above, then take 1/2 the first dose every 6 hours until the condition begins to improve. Then take the second, smaller dose every 6 hours until the end of five days, or seven days if it is very serious.

* Usually you can take out the tooth 1 or 2 days before the end of the antibiotic treatment, but the person must continue to take all of the tablets, even after you have taken out the tooth.

INJECTIONS: FOR SEVERE INFECTIONS

It is always safer to take medicine by mouth. Sometimes, however, an infection is so bad that you need to give medicine by injection. Learn how to give injections from an experienced health worker. The injections described on this page are not like the anesthetic injections in the mouth - you must inject these medicines into a large muscle in the buttocks or arm. For more instructions on this kind of injection, see Chapter 9 (pages 65-74) of Where There ts No Doctor.

For severe infection: There are two kinds of penicillin to inject.

You will usually use 'aqueous procaine penicillin'. Give only 1 injection per day.

For very severe infections, give 'crystalline penicillin' every 6 hours for the first day. It acts quickly and for a short time only.

INJECTABLE MEDICINES
SUPPLIES			DOSES
	Amount you need in 3 months	Amount to keep in kit	Adult (over 40 kg)	Child 6-12 years old (22-39 kg)	Child 1-6 years old ( 10-22 kg)
1. procaine penicillin. bottle with 300,000 unit per ml	200 bottles	4 bottles	4 ml once per day	2 ml once per day	1 ml once per day
2. crystalline penicillin, bottle with 1,000,000 units per ml	50 bottles	1 bottle	3 ml 4x per day	1-1/2 ml 4x per day	1/2 ml 4x per day

 

SUPPLIES

Use:	Proper Name	Amount you need in 3 months	Amount to keep in kit
Used to make dressings	1. clean cotton gauze	8 packages of 100	20 pieces
	2. clean cotton rolls	10 packages of 50	8 rolls
to fill cavities	3. oil of cloves (eugenol)	50 ml	1 small bottle
	4. zinc oxide powder	500 grams	1 small bottle
To harden sensitive teeth	5. fluoride water, concentrated	50 ml	1 small bottle
To give injections of local anesthetic	6. lidocaine 2% 1.8 ml cartridge	8 boxesof 100 cartridges	10 cartridges
	7. disposable needles, 27 gauge, long	8 boxes of 100 needles	10 needles
	8. lidocaine topical anesthetic	5 small tubes	1 tube
To make rinses	1. salt 2. hydrogen peroxide	2 kilograms 3 litres	100 grams 500 ml
To keep instruments clean *	Zephiran, concentrated solution	12 small bottles	1 small bottle
To keep instruments sharp	Arkansas sharpening stone	1 stone	1 stone
For examining	wooden tongue depressors	8 boxes of 50 per box	10

* Note: You can clean instruments with a homemade solution.

FLUORIDE WATER

You can use a solution of fluoride and water (above, number 5) in two ways:

To treat a sensitive tooth, make this concentrated mixture (see box above). Mix:

• 500 tablets sodium fluoride (1.1 mg each) in 59 ml of water or
• 1 gram of sodium fluoride powder with 50 ml of water.

Put cotton rolls between the lip and gum on each side of the bad tooth. Dry the bad tooth with cotton and look for the small groove that is causing the pain. Wet some cotton with the fluoride water and rub it on the tooth. Keep the tooth wet with fluoride water for 1 minute. One week later, give the same treatment again.

To help prevent cavities, especially in children, make a solution of fluoride and water using sodium fluoride powder. Mix 2 grams of the powder with 1 litre of water. Then, once a week, take a mouthful and rinse for 60 seconds with teeth closed together, 'washing' every surface of every tooth. Then spit it out-do not swallow the fluoride water. Also, do not eat or drink for 30 minutes.

SUGGESTIONS:

If you order your supplies in bulk long before you need them, you probably will pay lower prices. If you have a place to store supplies that is clean, dry, and free from cockroaches and rats, consider ordering enough for one year instead of only 3 months.

INSTRUMENTS

Buying instruments can be confusing, because there are so many. Only a few of them are really necessary. You can take out most teeth with the 4 basic instruments below.

When you order, use the proper name. Many companies use numbers to describe the instruments, but a different company may use a different number. If you use the proper name along with the number given here, most companies will understand what you want.*

*AII of the instruments described here are available at low cost from: ECHO, 4 West Street, Ewell Surrey KT17, 1UL, England.

When you are treating several people on the same day, you will need to clean some instruments at the same time that you are using others. Therefore, it is necessary to have several of each kind of instrument, to be sure that the instrument you need will be ready (clean or sterile) when you need it.

There are three instruments you will need for each person who comes to you, no matter which treatment is needed. They are: a mirror, probe, and cotton pliers. Keep them together. Below we recommend that you have 15 of each of these, so you can keep one in each treatment kit.

You do not need to buy all of these instruments. You can make several of them. If you like, buy only one example of each of the instruments below, and use them as models to copy when you make your own extra instruments.*

Use	Proper Name	Number to buy or make
To examine or to give any treatment	1. dental mouth mirror 2.  explorer 3.  cotton pliers	15 15 15
To inject	Aspirating dental syringe (to use with 1.8 ml cartridges)	3
To scale teeth	1.  Ivory C-1 scaler 2.  Gracey 11-12 curette	1 1
To place cement fillings	1.  spoon excavator 2.  filling instrument 3. cement spatula	1 1 1
To remove teeth	1.  spoon excavator 2.  straight elevator (no. 34) 3.  upper universal forcep (no. 150) 4.  lower universal forcep (no. 75)	3 3 3 3

The Four Basic Instruments

You can take out most teeth with these 4 instruments:

A spoon or probe

Use this to separate the gum from the tooth.

... an elevator

An elevator will loosen a tooth, or lift out a broken root.

and two forceps

upper universal forcep

lower bicuspid forcep

Use forceps to pull out the tooth. There is one for upper teeth and one for lower teeth.

Other forceps can be useful, especially for taking out a strong back tooth. They have pointed beaks that are made to fit between the roots of a back molar. As a result, you can hold onto the larger tooth better.

Curved elevators are good for taking out broken roots. You can force their pointed ends more easily between the root and the bone that is holding it.

Cryers elevators

Unfortunately, forceps and elevators are expensive. If you want to order more than the 4 basic instruments, remember the cost.

*lf you want the help of a charitable organization in buying instruments see here.

WHERE YOU WORK IS IMPORTANT

Work wherever it is light and bright. You must be able to see what needs to be done. Sunlight or light from a lamp is usually enough. Use a dental mirror to direct more light into the mouth.

Use a chair that has a back high enough to support the person's head.

Think about how you can stand and work the most easily:

To take out a lower tooth, you need to push down and then pull up.

So the person should be sitting down low.

If you stand on a box, he will be lower.

To take out an upper tooth, you need to push up and then pull down.

So the person should be sitting up high.

If he sits on cushions, he will be higher.

 

Weight (how heavy something is):

1 kilogram = 1000 grams

1 gram = 1000 mg

1 grain = 65 mg

Volume (how full something is):

1000 ml = 1 litre

236.5 ml = 1 cup

5 ml = 1 teaspoon

1 ml = 1 cubic centimeter (cc)