Thank you for volunteering to help the underprivileged children of Jerusalem. As you will see while working in the clinic, your services are greatly needed. While some of you may come from countries where the caries rate is in decline, the dental condition of many of the children who attend our clinic is very poor. Children’s teeth suffer for many reasons, such as:

• Poor quality diet that is high in sugars.

• No regular oral hygiene at home.

• Parents who are unaware of the need for regular dental treatment or preventative care.

These children come from families with financial problems. Our policy is not only to treat them, but also to educate them. We treat children from 4 to 26 years old, giving them all the chair side dentistry available. The children are generally very well behaved. (Those who need special care are treated by Specialists in Pediatric Dentistry and Local interns in Pediatric Dentistry).

Clinic working hours are: Sunday – Tuesday from 8:00 a.m. to 1:30 p.m. (13:30) and Thursday from 8:00 a.m. to 12:30pm.

As our volunteers come from so many different countries, an attempt is made to standardize the treatment. The Dental Director establishes a treatment plan for each child. (Should there be any problem, please discuss it with the on-duty dental director – Dr. Roy Petel, Prof. Eliezer Eidelman or Dr. Ziva Luria-Har Zion).

In consideration for the children, we try to do as much treatment as possible per visit, i.e. quadrant dentistry when applicable, thereby reducing the number of treatment visits.

Local anesthetic is used almost always. Our policy is to provide painless dentistry and, hopefully, to convince the children and their parents that dentistry is not a traumatic experience.

After the treatment plan has been made, the children attend the Donald Berman Preventative Oral Health Care Unit where they receive oral hygiene education – including proper diet & teeth care. Only once the children show that they can maintain oral hygiene does the treatment start.

Each family is invited for regular 6-month recall visits, which all begin with a check-up and a visit to the Preventative Oral Health Care Unit.

The children routinely visit our hygienist for detartrage, application of fissure sealants and topical fluoride varnish.

Amalgam is still the material of choice for interproximal posterior fillings in our clinic. Composites or Glass Ionomers may be used for Preventative Resin Restorative (PRR) or for anterior teeth.

In case of pulp exposures in vital deciduous teeth, we perform a pulpotomy with Formocresol, followed by IRM dressing. A stainless steel crown or amalgam filling is then placed, preferably all in one visit.

MTA (Mineral Trioxide Aggregate) has been shown to be biologically superior to Formocresol, and has produced better results, in pulpotomy procedures in deciduous teeth. It is also used for pulp caps or perforations in permanent teeth. We use MTA when the material is available.

In non-vital primary teeth we perform a root canal filling, using Endoflas or choose to extract and place a space maintainer.

In pulp exposures in permanent teeth, direct pulp-capping is only recommended if all the caries have been removed, and the exposure is very small and the tooth is asymptomatic (i.e. less than 1mm). In cases where the exposure is more extensive, we prefer either:

• Partial Pulpotomy, using MTA or calcium hydroxide

• Cervical pulpotomy (apexogenesis)

• Extirpation, followed by calcium hydroxide in the canals. Obviously, we will carry out regular follow-up and a full root canal treatment as soon as possible.

When a root canal treatment is required, it is performed by a board certified Endodontist.

Surgical Extractions of molars are performed only by board certified oral surgeons and periodontists.

Use of rubber dam is recommended for all treatments when administering local anesthesia and a must for all root canal treatments.

Because we emphasize oral health education, we recommend that if a child in your chair has a lot of plaque or gingivitis, s/he should be sent to the hygienist instead of being treated by you.

Our clinic uses the FDI nomenolative system for the numbering of teeth:

Upper right – Upper left

55 54 53 52 51 – 61 62 63 64 65

18 17 16 15 14 13 12 11 – 21 22 23 24 25 26 27 28

Lower right – Lower left

48 47 46 45 44 43 42 41 – 31 32 33 34 35 36 37 38

85 84 83 82 81 – 71 72 73 74 75

We hope that you enjoy your stay.

Dr. Roy Petel
Director