Hesperian Health Guides

The Dental Kit

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HealthWiki > Where There Is No Dentist > Appendices > The Dental Kit


a box labeled "Mouth problems: keep clean and sterile.


In this section, 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.


In the following table we give an example. 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 local name
(write in here)
Amount you
need in 3 months
Amount to
keep in kit
For
Pain
1. aspirin,
300 mg tablets
_______________ 2,000
tablets
100
tablets
2. acetaminophen,
(paracetamol)
500 mg tablets
_______________ 500
tablets
10
tablets
For
infections
1. penicillin,
250 mg tablets
_______________ 2,000
tablets
100
tablets
2. erythromycin,
250 mg tablets
_______________ 500
tablets
40
tablets
3. nystatin,
drops or
gentian violet
_______________ 12 small
bottles
2 small
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 are usually safer and just as effective for most dental problems. If you do use tetracycline, read page 355 of Where There ls No Doctor and remember, do not give tetracycline to a pregnant woman or to a young child. Tetracycline can make young, developing teeth 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 here) 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 section carefully, as well as the ‘Treatment’ section of each problem in Chapter 7. If the next section is not clear to you, read Chapter 8 (pages 59 to 64) of Where There ls No Doctor.
  4. See more information on serious infections.

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 such as aspirin (300 mg tablets) or acetaminophen (500 mg tablets) can be broken up into smaller tablets:

Four times a day:
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Adults take 2 tablets Childen 8–12 take 1 tablet Children 3–7 take ½ tablet Babies take acetaminophen only, ¼ tablet


NOTE: 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 30 mg of codeine 4 to 6 times a day, as needed.

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)
  • weak, rapid pulse (heartbeat)
  • difficulty breathing
  • loss of consciousness

… immediately inject epinephrine: .5 ml for adults or .25 ml for children. If necessary, inject the same dose again after 20 or 30 minutes. For more information on allergic shock, see Where There Is No Doctor, pages 70 to 71.

Always give the full dose of penicillin or any antibiotic, even if the person feels better. Check the correct dose of penicillin or erythromycin. Erythromycin also comes in liquid form. It has 125 mg in 5 ml, so 10 ml of liquid (about 2 large teaspoons) is the same as one 250 mg tablet.

It is important to take a strong first dose of penicillin or erythromycin, and then smaller doses 4 times a day for 3 to 5 days after that. Carefully read the instructions.

Injections: For severe infections

a syringe with marks showing volume in millimeters.
3 ml syringe
.5
1
1.5
2
2.5
3

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 Chapter 9 of this book — 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 Is No Doctor.

For severe infection: There are 2 kinds of penicillin to inject.

Procaine
Penicillin
DENT Appendix Page 210-3.png
Crystalline
Penicillin
DENT Appendix Page 210-2.png
DENT Appendix Page 210-4.png
300,000 units
in 1 ml
1,000,000 units
in 1 ml
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 DOSE
Proper Name 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
Units per ml
200
bottles
4 bottles 4 ml
2 times/
day
2 ml
2 times/day
1 ml
2 times/day
2. crystalline
penicillin,
bottle with
1,000,000
Units per ml
50
bottles
1 bottle 3 ml
4 times/
day
1.5ml
4 times/
day
1 ml
4 times/
day


SUPPLIES
Use Proper Name Local name
(write in here)
Amount you need in
3 months
Amount to
keep in kit
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 treat
sensitive
teeth
5. fluoride
toothpaste
___________________________ 1 tube 1 tube
To give
injections
of local
anesthetic
6. lidocaine
2% 1.8 ml
cartridge
___________________________ 8 boxes of 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

Fluoride

You can use a special solution of fluoride (if available) or any fluoride toothpaste, which is much cheaper and more common (see above, number 5), in 2 ways:

To treat a sensitive tooth: 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. Cover the groove with a smear of fluoride toothpaste and tell the patient not to spit or rinse it out for several minutes. One week later, give the same treatment again, or have the patient do it himself.


To help prevent cavities, in children who do not clean their teeth with fluoride toothpaste, once a week have children bring their toothbrushes or toothsticks to school. Put some fluoride toothpaste on each child’s brush or stick and have them brush and coat their teeth, leaving the paste in their mouths for at least one minute. Then they can spit it out. Do not eat or drink for 30 minutes.


In Chapter 3, children are shown using a twice‑yearly application of a special paste, a ‘topical fluoride gel’. This is good, but the weekly treatment with fluoride paste is even better for the teeth.

Weight (how heavy something is) Volume (how full something is)
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DENT Appendix Page 212-4.png
1
kilogram
(kg)
=
(equals)
10 x 100
grams
(g)
1 liter 1 cup 1 teaspoon
1 kilogram = 1000 grams 1000 ml = 1 liter
236.5 ml = 1cup
1 gram = 1000 mg 5 ml = 1 teaspoon
1 ml = 1 cubic centimeter (cc)


Use Proper Name local name
(write in here)
Amount you need in
3 months
Amount to
keep in kit
To make
rinses
1. salt ___________________________ 2 kilograms 100 grams
2. Hydrogen
peroxide
___________________________ 3 liters 500 ml
To
keep
instruments
clean
1. 95% alcohol
disinfectant solution
___________________________ 18 liters 1.5 liters
2. bleach for
disinfectant solution
___________________________ 2.5 liters 125 ml(1/2 cup)
To keep
instruments
sharp
Arkansas
sharpening stone
___________________________ 1 stone 1 stone
For
examing
wooden tongue
depressors
___________________________ 8 boxes of
50 per box
10

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.



This page was updated:30 Aug 2018