Thank you for volunteering to help Jerusalem’s socioeconomically disadvantaged children and young people. As you will see while working at the clinic, your services are greatly needed. Although some of you may come from countries where rates of dental caries are declining, many of the children referred to our clinic arrive with very poor oral health. This may result from several factors, including:

• A poor-quality diet that is high in sugar.
• 
  
• A lack of regular, ongoing oral hygiene at home.
• 
  
• Limited parental awareness of the importance of preventive care and regular dental check-ups.
• 
  

These children come from families facing serious financial hardship. Our goal is not only to treat their immediate dental needs, but also to give them the knowledge and skills necessary to maintain proper oral hygiene. We teach them to recognize potential problems and explain the wider health consequences associated with chronic oral disease and the persistent accumulation of pathogenic biofilm.

We treat children, adolescents, and young adults between the ages of 4 and 26, providing comprehensive chairside dental care. The children are generally very cooperative. Those requiring specialized care are treated by pediatric dentistry specialists and local pediatric dentistry residents.

Clinic working hours are from 8:00 a.m. to 1:00 p.m. (08:00–13:00).

As our volunteer dentists come from many different countries, we make every effort to standardize treatment. The Clinic Dental Director establishes an individual treatment plan for each patient.

To reduce the number of visits required, we aim to complete as much treatment as reasonably possible during each appointment, including quadrant dentistry when appropriate.

Local anesthesia is used in almost all relevant procedures. Our policy is to provide pain-free dental care and to help children and their parents understand that dental treatment does not need to be a traumatic experience. We use computerized local-anesthetic delivery systems, including Dentapen and STA.

Once a treatment plan has been prepared, each patient visits the Donald Berman Preventive Oral Health Care Unit, where they receive guidance on oral hygiene, proper nutrition, and dental care. Treatment begins once the patient demonstrates an ability to maintain an appropriate level of oral hygiene.

Each family is invited to return for regular six-month recall appointments. Every recall visit begins with a dental examination and a follow-up session in the Preventive Oral Health Care Unit.

In children: Composite or Compomer are the materials of choice for interproximal posterior restorations. Composites or Glass Ionomers may be used for Preventative Resin Restoration (PRR) or for temporary fillings.

In case of pulp exposures in vital deciduous teeth, we perform a pulpotomy with Formocresol or Biodentin, followed by IRM dressing. A stainless steel crown or composite restoration 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.

In non-vital deciduous teeth we perform a pulpectomy, using Metapex or choose to extract and place a space maintainer.

In pulp exposures in young permanent teeth, direct pulp-capping is only recommended if all caries have been removed, 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 only.

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.

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 you enjoy the experience!

Dr. Roy Petel, Director