In today's market, dentists need to be open to using different approaches for increasing patient awareness of how dentistry can benefit them. The five key areas of practice management addressed here are just a few of the many ways to keep your practice healthy in our changing profession. Dentists who are committed to improving patient communication and accommodating the needs of their patients will be the ones for whom the future is bright.
Leukoplakia is the most common premalignant lesion of the oral mucosa. The term should be used only for white lesions that cannot be characterised as any other definable lesion. The chance of malignant transformation can to some extent be predicted on the basis of the clinical appearance, the oral subsite, and the histopathological findings in the biopsy. The management of patients with oral leukoplakia is primarily directed towards elimination of possible causative factors. If the lesion persists, treatment is recommended in most cases. Of the various available treatment modalities no one is superior to the others. Both treated and untreated patients should be scheduled for long term follow-up, probably life long, with 6-12 month intervals in order to he able to detect possible recurrences in an early stage. Erythroplakia is less common than leukoplakia, but carries a considerably higher risk of malignant transformation. Therefore, erythroplakias should always be removed and subsequently, followed up.
While it is arguable that the operative procedures depicted in this article could have been done equally well with alternative forms of isolation, it is indisputable that rubber dam provides for the most thorough 'isolation' in the comprehensive sense of the term. It allows for the finite control over peripheral variables such as access and controlled gingival retraction. This in turn permits meticulous execution of restorative procedures within the luxury of 'true four-handed dentistry'. Most operative procedures are done within the limitations of single handed dentistry as the other 'three hands' are involved with retraction, fluid evacuation and access control. The rubber dam is indeed indispensable and with the increased awareness of infection control it is conceivable that rubber dam isolation will continue to be associated with quality patient care. Part 2 of this article will detail the application of the 'Modified Gingival Retractor' in the isolation of cervical lesions.
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