Hepatitis B-Part 2: Treatment and Prevention

Hepatitis B is a potentially life-threatening liver infection caused by the hepatitis B virus (HBV). It can cause chronic infection and puts people at high risk of death from cirrhosis and liver cancer.

In the first part of the article, you have read the epidemiology, mode of transmission of Hepatitis B virus, its sign and symptoms, groups at risk, the relationship of HBV and HIV infection, and how the diagnosis is confirmed. In this part of the article, we shall discuss about its treatment and prevention.

You can also take a free mock test on Hepatitis B.

Hepatitis B: Part 1 - Epidemiology and Clinical Features

Overview 

Hepatitis is an inflammation of the liver that's caused by a variety of contagious viruses and non-infectious agents leading to a range of health problems, some of which can be fatal. There are five main strains of the hepatitis virus, known as types A, B, C, D and E. While their infection results in liver disease, they differ in important ways including modes of transmission, severity of the illness, geographical distribution and prevention methods. 

Particularly types B and C lead to chronic disease in hundreds of millions of people and together are the most common cause of liver cirrhosis, liver cancer and viral hepatitis related deaths. 

An estimated 354 million people worldwide having no access to testing and treatment live with hepatitis B or C. 

Some types of hepatitis are preventable through vaccination. A WHO study found that an estimated 4.5 million premature deaths could be averted in low-and middle- income countries by 2030 through vaccination, individual tests, drugs and education campaigns. WHO’s global hepatitis strategy, championed by all WHO Member States, aims to reduce new hepatitis infections by 90 and deaths by 65 between 2016 and 2030.

Hepatitis B is a potentially life-threatening liver infection caused by the hepatitis B virus (HBV). It can cause chronic infection and puts people at high risk of death from cirrhosis and liver cancer.

In this first part of the article, we shall discuss the following aspects of hepatitis:

1. Epidemiology, 
2. Mode of transmission
3. Sign and symptoms 
4. Groups at risk
5. Relationship of HBV and HIV infection H
6. How to confirm the diagnosis
7. Sample MCQs

Design of a Custom Tray for Final Impression for Complete Denture

The 'custom trays' also known as 'special trays' are fabricated so that the final impression of the patient’s edentulous mouth can be made accurately using selective pressure technique with proper border extensions. The selective pressure technique helps in making the impression in such a way that when the newly fabricated dentures are in function in the mouth of the patient, they exert pressure only on those areas of the mouth that can withstand the masticatory load. The selective pressure technique of impression making spares the non-pressure bearing areas of the edentulous jaw and thus eliminates the possibility of trauma resulting in ulceration and pain in the oral mucosa. 

The special tray is made on the primary cast that has been prepared of plaster of Paris by pouring the primary impression made in alginate or impression compound. The impression taken in impression compound records the mucosa in a compressed state whereas the impression taken with alginate records the mucosa in a non-compressed state. From these two opposite states of mucosal records, a dentist proceeds to prepare a special tray that is used to make an impression with pressure on the mucosa in selected areas. We will learn here as to how to make a special tray on a cast that has been made from impression compound.

Oral Ulcers: Clinical features, Causes & Treatment

Traumatic ulcers in healing stage caused by sharp teeth

An ulcer is a tissue defect which has penetrated the epithelial-connective tissue border, with its base at a deep level in the submucosa, or even within muscle or periosteum. An ulcer is a deeper breach of the epithelium than an erosion or an excoriation, and involves damage to both epithelium and lamina propria.

Books for ADC Examination

The following books have been recommended by Australian Dental Council.

General Dentistry

1. Australian Dental Association Inc. Policy Statement 6.5.1, Code of ethics for dentists.
2. Australian Dental Association, Victorian Branch. By-law 2, Ethics.
3. Fan KFM, Jones J. MCQs in dentistry, 2nd edn. Knutsford, UK: PasTest Ltd, 2010
4. Ireland R, ed. A dictionary of dentistry. Oxford: Oxford University Press, 2010
5. Mitchell DA, Mitchell L. Oxford handbook of clinical dentistry, 7th ed. Oxford: Oxford University Press, 2014

Five reasons you should take an implant supported prosthesis

Schematic diagram showing implant components and how a crown is placed on implant which in turn placed in a bony socket in the jaw bone

People often ask me; can I get a fixed artificial teeth? While most of the time, they can get it, but in few unfortunate one, it remained impossible to provide a fixed partial denture due to their unfavourable oral conditions. In those cases, we suggest them, “you should take an implant supported prosthesis”.

Nine reason you should not go for implant supported prosthesis

Schematic diagram showing implant components and how a crown is placed on implant which in turn placed in a bony socket in the jaw bone

Implant supported prostheses that include over-dentures, crowns and bridges are the treatment of choice in modern dentistry. They are very predictable in nature and have a track record of very successful life span serving their purpose. But, there are certain conditions where the dental implants cannot be provided due to the inherent nature of the disease. The implant supported prostheses are contraindicated in the following conditions:

1. Immune disorders (leukemia)
2. Cancer
3. Disorders of coagulation (anticoagulants, liver cirrhosis, thrombocytopenia, tendency to hemorrhage)
4. Rheumatoid disease (steroid medication)
5. Unstable endocrine disorders
6. Chemotherapy (i.e. bisphosphonates) and radiotherapy within the last 5 years
7. Patients under 16 years old (incomplete development of bones)
8. Psychosis
9. Pregnancy

 

 

 

Domains of Practice in Australian Dentistry

To read about new blueprint of ADC exam click HERE. 

Domain 6. Patient Care 

 6.1 Clinical Information Gathering  

It covers the collection and recording of information that is necessary and relevant. 

As an Australian dentist you must be able to:   

 

1. obtain and record a relevant history of the patient’s medical, social and oral health status  

2. perform an examination for health, disease and abnormalities of the dentition, mouth and associated structures  

3. select necessary clinical, pathology and other diagnostic procedures and interpret results  

4. take radiographs relevant to dental practice  

5. evaluate individual patient risk factors for oral disease 

6. maintain accurate, consistent, legible and contemporaneous records of patient management and protect patient privacy  

 

6.2 Diagnosis and Management Planning  

• It covers the identification of disease or abnormalities that require treatment or investigation As an Australian dentist you must be able to:   

• 1. recognise health as it relates to the individual  

• 2. diagnose disease or abnormalities of the dentition, mouth and associated structures and identify conditions which require management  

• 3. determine the impact of risk factors, systemic disease and medications on oral health and treatment planning   

• 4. formulate and record a comprehensive, patient-centred, evidence-based oral health treatment plan  

• 5. determine when and how to refer patients to the appropriate health professional  

• 6. obtain and record patient informed consent and financial consent for treatment  

 

6.3 Clinical Treatment and Evaluation  

It covers the provision of evidence-based patient-centred care. 

As an Australian dentist you must be able to:    

1. apply the principles of disease and trauma prevention and early intervention in the management of the dentition, mouth and associated structures  

2. apply the principles of behaviour management  

3. manage a patient’s anxiety and pain related to the dentition, mouth and associated structures  

4. manage surgical and non-surgical treatment of diseases and conditions of the periodontium and supporting tissues of the teeth or their replacements  

5. manage surgical and non-surgical treatment of pulp and periapical diseases and conditions with endodontic treatment  

6. manage the loss of tooth structure by restoring the dentition with direct and indirect restorations  

7. utilise patient removable prostheses to rehabilitate, restore appearance and function, prevent injury and stabilise the occlusion 

8. utilise fixed prostheses to rehabilitate, restore appearance and function and stabilise the occlusion  

9. manage oral conditions, pathology and medically related disorders and diseases associated with the dentition, mouth and associated structures  

10. manage skeletal and dental occlusal discrepancies  

11. manage the removal of teeth and oral surgical procedures  

12. administer, apply and/or prescribe pharmaceutical agents  

13. evaluate and monitor the progress of treatment and oral health outcomes  

14. manage dental emergencies. 

15. manage medical emergencies. 

Radiography: Effects of Radiation on Oral Tissues

Dentists often encounter cancer patients, who are to undergo radiotherapy or have received it in the recent past. Besides cancer therapy, these patients need dental treatment for different ailments. Therefore, it becomes paramount important for a dentist to know the effects of large doses of ionizing radiation on oral mucosa.

In this section, we shall talk about the effects of radiation on oral tissues.

Journey of Dentist to Australia: Part 2

Saudi Arabia Riyadh landscape at Morning – Riyadh Tower Kingdom Centre, Kingdom Tower, Riyadh Skyline – Burj Al-Mamlaka, AlMamlakah – Riyadh at Daylight – Tower View-Getty Images

Click to read part 1 of the story at the link given below 

Journey of Dentist to Australia: Part 1 

 

....... Continues 

 

With the passage of time, Ganesh became aware of the situation of his family. He started to understand the pain of his wife and the thought process of his father. He, who always cared for him, was worried about his future; the future ahead of his family life as well as financials, as it has to have a long-lasting effect on his Son too. 

Both Ganesh and his wife dropped the idea of ADC as it was clear, no matter how hard they try it, it was not meant for them. Moreover, they were out of funds, rather, better word was, in negative funds. So, to regain their lost finances, they modified their plan.  

The plan was to try for a gulf job and regain the lost finance. They consulted with their friend who had experience of the gulf job. Ganesh and his wife got a decent job in Saudi Arabia. It was a job in a remote area of the Kingdom, but since they had their own circumstances, they adjusted themselves in a few months. 

In this world there is no end to issues, no matter where a person lives. This soon started being applied to them too. A recently came new dentist in their workplace had Arab origin and the staff started giving him preferential treatment. The distribution of work started skewing, putting Ganesh in a difficult situation. His wife was cool as being a female, she was spared, or the person involved had no guts to disturb her and be caught in a situation that might have backfired. 

Ganesh contacted his friend for solace. He understood his situation and the options available. He decided, as long as I am getting my salary, I have to stay here and refill my coffer. There was no second choice. 

His wife and he stayed for five years in Saudi Arabia and then started thinking of coming back to India. They have earned sufficient, filled their coffer and most importantly regained lost self-esteem and self-worth. Their family life has again come back on a smooth track. 

Before coming back to India, Ganesh refurbished his old clinic when he had visited India last time. It was ready to start the work. Ganesh started working in his own clinical practice the next day of arrival to India. His wife got her old tutoring job back in the same college she was teaching in. Within a year, they decided to open a second clinic. Soon it was booming by the hard-working ethics of his wife, who decided to go take the clinical practice as full-time work. 

The couple decided to buy a house near their old home and were happy ever after. Ganesh remained obliged to his friends who supported him during his bad time.