My comprehensive treatment plan for Rangi will include restorative treatments, along with a caries management plan to avoid secondary caries and enhance enamel remineralisation. Furthermore, adequate preventive periodontal measures may halt the progression of Rangi’s gingivitis. I will plan Rangi’s treatment according to his caries risk status. According to the protocols for the clinical management of caries by risk factor level (CAMBRA), this is a positive measure of successful caries management (Jenson, et al., 2007). My initial focus will include pain management related to the 75 and 61 respectively. Due to irreversible pulpitis I will extract both teeth to relieve Rangi’s pain. However, I will consider Rangi’s anxiety and inform his mother of the alternative treatment of referral to a dentist to receive a pulpectomy.
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In addition, the extraction of primary anterior incisors have minimal effect on the developing permanent teeth (Welbury, 2001). Due to Rangi’s asthma, I will select Mepivicaine as my choice of local anaesthesic. Wilkins (2005) emphasises that local anaesthetic with epinephrine contain sulphite properties that produce asthma symptoms. As a consequence, Rangi’s asthma is a contraindication to Mepivicaine. Mepivicaine seem to be the safest option of local anaesthetic for patients with contraindications to vasoconstrictors (Daubländer, Müller, & Lipp, 1997). Therefore, the moderate duration of action related to Mepivicaine (3%) without a vasoconstriction seems to be the ultimate option for the extend of Rangi’s treatment plan. I will ensure thorough communication with Rangi to prepare him for the local anaesthesia and the restorative treaments. According to Welbury (2001) the level of a patient’s anxiety may increase perception of pain. Simultaneously, increased awereness of pain may incur anxiety. Therefore I will ensure enduring comfort for
In addition, the extraction of primary anterior incisors have minimal effect on the developing permanent teeth (Welbury, 2001). Due to Rangi’s asthma, I will select Mepivicaine as my choice of local anaesthesic. Wilkins (2005) emphasises that local anaesthetic with epinephrine contain sulphite properties that produce asthma symptoms. As a consequence, Rangi’s asthma is a contraindication to Mepivicaine. Mepivicaine seem to be the safest option of local anaesthetic for patients with contraindications to vasoconstrictors (Daubländer, Müller, & Lipp, 1997). Therefore, the moderate duration of action related to Mepivicaine (3%) without a vasoconstriction seems to be the ultimate option for the extend of Rangi’s treatment plan. I will ensure thorough communication with Rangi to prepare him for the local anaesthesia and the restorative treaments. According to Welbury (2001) the level of a patient’s anxiety may increase perception of pain. Simultaneously, increased awereness of pain may incur anxiety. Therefore I will ensure enduring comfort for