Dry Socket

Introduction

Like with root canal, the thought of dry socket probably sends chills down your spine. Even if you've never had this condition, you may wince in sympathetic pain as a relative or co-worker recounts his or her tale of dry socket. Although dry socket can indeed be painful, the condition has taken on frightening proportions that may not match reality.

Dry socket (alveolar osteitis) is a dental condition that occurs when the blood clot at the site of a tooth extraction is dislodged, exposing underlying bone and nerves and causing increasing pain. It's the most common complication following tooth extractions, such as the removal of impacted wisdom teeth. But with proper postoperative dental care and avoidance of risk factors, dry socket often can be prevented. When it does occur, treatment usually provides immediate relief.

Signs and symptoms

Dry socket is a condition that sometimes occurs after a tooth extraction. It has several tell-tale signs and symptoms, including:

* Partial or total loss of the blood clot at the extraction site, which you may notice as an empty-looking (dry) socket
* Visible bone in the socket
* Pain that increases between one and three days after tooth extraction and that typically becomes severe and unrelenting
* Pain that radiates from the socket to your ear or eye on the same side of your face
* Bad breath or a foul odor coming from your mouth
* Unpleasant taste in your mouth
* Swollen lymph nodes around your jaw or neck

Causes

Normally, a blood clot forms at the site of a tooth extraction. This blood clot serves as a protective layer over the underlying bone and nerve endings in the empty tooth socket. The clot provides the foundation for the growth of new tissue and bone.

In some cases, though, the clot doesn't form properly or is physically dislodged before complete healing. With the clot gone, bone and nerves in the socket are exposed to air, fluids and food. This can cause intense pain, not only in the socket but also along the nerves radiating to the ear and eye on the same side of your face.

But the precise cause of dry socket remains the subject of study. Some researchers believe that several issues may be at play, including:

* Bacterial contamination of the socket
* Difficult or traumatic tooth extraction surgery
* Roots or bone fragments remaining in the wound after surgery

Dry socket occurs in about 3 percent to 5 percent of all tooth extractions, but it's much more common after extraction of wisdom teeth and impacted wisdom teeth in particular.

Risk factors

Certain factors can increase your risk of developing dry socket after a tooth extraction. These include:

* Smoking and tobacco use. Chemicals in cigarettes or other forms of tobacco may contaminate the wound site. In addition, the act of sucking on a cigarette may physically dislodge the blood clot prematurely.
* Taking oral contraceptives. High levels of estrogen can greatly increase the risk of dry socket by dissolving the blood clot.
* Not following post-extraction guidelines. If after oral surgery you don't follow instructions, such as avoiding certain foods or caring for your wound properly, your risk of dry socket increases.
* You've had dry socket in the past. Having dry socket once means you're more likely to develop it again.
* Tooth or gum infection. Current or previous infections around the tooth to be extracted increase the risk of dry socket.
* Less experience. Although dry socket can occur with even the most experienced dentists and oral surgeons, having a less experienced dentist or oral surgeon may increase your risk.

When to seek medical advice

When you've had a tooth extracted, any discomfort you experience normally gets better with each passing day. If you develop new or worsening pain in the days after your tooth extraction, don't try to tough it out. Contact your dentist or oral surgeon right away so that you can get properly assessed and treated.

Screening and diagnosis

In order to determine if you have dry socket, or another condition, your dentist or oral surgeon will ask about your symptoms and examine your mouth. He or she will check to see if you have a blood clot in your tooth socket and whether you have exposed bone. You may also need to have X-rays taken of your mouth and teeth to rule out other conditions.

Complications

Dry socket can cause a variety of complications. Pain, of course, is the major complication. Because of the pain and repeat trips to your dentist or oral surgeon for treatment, you may miss time at work or school.

Dry socket also delays the healing process after a tooth extraction. Gum tissue normally takes three to four weeks to heal, while bone can take up to six months to heal, and dry socket can delay this process.

Dry socket can also interfere with the placement of dental implants or with other dental procedures, and these may need to be rescheduled until you've healed completely. In addition, infection sometimes develops after dry socket, but that's uncommon.

Treatment

Treatment of dry socket is mainly geared toward reducing its symptoms, particularly pain. Treatment includes:

* Medicated dressings. This is the main way to treat dry socket. Your dentist or oral surgeon generally packs the socket with medicated dressings. You may need to have the dressings changed several times in the following days. The severity of your pain and other symptoms determines how often you need to return for dressing changes or other treatment.
* Flushing out the socket. Your dentist or oral surgeon will flush the socket to remove any food particles or other debris that has collected in the socket and that contributes to pain or infection.
* Pain medication. Talk to your doctor about which pain medications are best for your situation. If over-the-counter pain relievers aren't effective, you may need a stronger prescription pain medication.
* Self-care. You may be instructed how to flush your socket at home to promote healing and eliminate debris. To do this, you'll be given a plastic syringe with a curved tip to squirt water, salt water, mouthwash or a prescription rinse into the socket. You may need to continue to do this daily for three or four weeks.

Once treatment is started, you may begin to feel some relief in just a few hours. Pain and other symptoms should continue to improve over the next few days. Complete healing typically goes smoothly and generally takes about 10 to 14 days.

Prevention

Steps that both you and your dentist or oral surgeon take may go a long way in helping prevent dry socket or to reduce your risk.

What your dentist or oral surgeon can do
Although dry socket has been recognized since the late 1800s, medical science has yet to develop a surefire way to prevent it. Some research suggests that treatment with certain medications such as antibiotics before or after oral surgery may reduce your risk of dry socket. However, this practice remains controversial, and some believe that preventive treatment with antibiotics isn't appropriate because it may contribute to problems such as antibiotic-resistant bacteria. Talk to your dentist and oral surgeon about using these medications or precautions when you have tooth extraction surgery:

* Antibacterial mouthwashes immediately before and after surgery
* Oral antibiotics
* Antiseptic solutions applied to the wound
* Medicated dressings applied after surgery

What you can do before tooth extraction surgery

* Seek out a dentist or oral surgeon with experience in tooth extractions.
* If you take oral contraceptives, try to time your extraction to days 23 to 28 of your menstrual cycle, when estrogen levels are lower.
* Stop smoking and the use of other tobacco products at least 24 hours before tooth extraction surgery.
* Talk to your dentist or oral surgeon about any prescription or over-the-counter medications or supplements you're taking, as they may interfere with blood clotting.

What you can do after tooth extraction surgery

* Avoid spitting for the first few days.
* Don't drink with a straw for the first few days.
* Don't drink carbonated beverages for two to three days after your tooth extraction.
* Gently brush teeth adjacent to the extraction site.
* Don't rinse your mouth vigorously or excessively.
* Resist the desire to touch the extraction site with your fingers or tongue.
* Eat soft foods and foods that don't have residuals, which are particles that may lodge in your socket. Avoid pasta, popcorn and peanuts, for example. Instead, eat mashed potatoes, pudding, or clear or cream soups.


Self-care

Dry socket rarely results in infection or serious complications. But getting the pain under control is a top priority. You can help promote healing and reduce symptoms during treatment of dry socket by:

* Holding cold packs to the outside of your face to help decrease pain and swelling
* Taking pain medications as prescribed
* Not smoking or using tobacco products
* Drinking plenty of clear liquids to remain hydrated and to prevent nausea that may be associated with some pain medications
* Rinsing your mouth gently with warm salt water several times a day
* Brushing your teeth gently around the dry socket area
* Keeping scheduled appointments with your dentist or oral surgeon for dressing changes and other care
* Calling for a sooner appointment if your pain returns or worsens before your next scheduled appointment

Dry Sockets (Alveolar Osteitis): Dry socket symptoms and treatments.

What are dry sockets?

A dry socket, more formally referred to as alveolar osteitis by dentists, is a fairly common complication associated with tooth extractions. The formation of a dry socket involves a scenario where the blood clot which forms in the tooth socket's after the extraction isn't properly retained (either it disintegrates by way of fibrinolysis or becomes dislodged). Since this blood clot is an important factor in protecting the boney socket and initiating the healing process, the healing of the extraction site is interrupted and becomes delayed.

What are the symptoms of a dry socket?

Dry sockets can have a throbbing pain. With most tooth extractions a dental patient will experience some level of discomfort at the extraction site (no matter how minor) on the day the tooth has been removed and then, with each day that passes, less and less pain as the healing process progresses. In those cases where a dry socket forms, the patient typically notices that their level of discomfort does progressively diminish for the first few days but then, between three and five days after the extraction, pain from the extraction site begins to intensify.

Dry socket signs and symptoms ...

The pain associated with a dry socket can be moderate to severe in intensity and often has a throbbing component. The pain can be just localized to the extraction site or it may radiate from the extraction site to the patient's ear or eye (on the same side of their face). Additionally, the dental patient may notice a foul odor or taste emanating from the tooth socket. Upon visual inspection (when possible) the tooth socket will appear to be empty (minimal or no blood clot or granulation tissue present) and when looking down into the socket exposed bone is visible. The term "dry socket" is derived from this empty socket appearance. The lymph nodes in the patient's jaw or neck may become enlarged.

How often do dry sockets occur?
Dry socket formation is often associated with lower wisdom tooth removal.

The frequency of occurrence for dry sockets, when considering for all tooth extractions collectively, is roughly on the order of 1 to 3%. Extractions involving lower teeth, especially molars, are statistically more likely to result in dry socket formation. Dry sockets may occur in as many as 20% of the cases involving the extraction of mandibular (lower) impacted wisdom teeth.


Risk factors: What causes dry sockets?

Dental research has yet to definitively determine the exact pathogenesis associated with dry socket formation. However, as we discussed previously, dry sockets result from a situation where the blood clot that normally forms in the tooth's socket after an extraction has not been properly retained.

Dental researchers have identified a number of factors that appear to be associated with an increase incidence of experiencing a dry socket and we have listed many of these factors below. We should bring to your attention however that the results of many studies are conflicting and therefore not all of the (potential) risk factors we list here are necessarily accepted by the dental community as a whole. Your dentist should be able to shed light on those factors that their experience has demonstrated to them are significant.

Dental patients who don't follow their dentist's postoperative instructions have a greater incidence of dry sockets.

Place the gauze directly over the socket, then apply firm pressure. We've listed this factor first because this is absolutely something you have control over. People who follow their dentist's instructions after having a tooth extracted, especially those regarding allowing a blood clot to form and then protecting it, will have fewer postoperative complications.

Typically a dentist will advise their patients that after a tooth extraction they should, at minimum, place firm biting pressure on the gauze packing that the dentist has placed over their extraction site for the next 30, and probably preferably, 60 minutes. Under normal circumstances this will provide opportunity for a blood clot to form in the tooth socket. Once a blood clot has formed, the patient must be diligent in their efforts not to disrupt it. This means that for the first 24 hours after the extraction the dental patient should avoid vigorous rinsing, refrain from actions like sucking on a straw or cigarette, avoid alcohol and tobacco use in general, minimize physical stress and exercise, and avoid hot liquids such as coffee or soup. Of course these instructions are generalized. Your dentist should provide you with those postoperative instructions that they feel are important for your specific situation. If they don't, just ask.

Dental patients who have experienced dry sockets with past tooth extractions are at greater risk for developing a dry socket with future tooth extractions.

If you have had a dry socket in association with a previous tooth extraction, you should consider yourself to be at somewhat greater risk for experiencing a dry socket again. Of course it's certainly possible that your previous dry socket experience might have been related to not having followed your dentist's postoperative instructions as closely as you should have. If so, your previous experience might be the motivation you need to follow your dentist's instructions more diligently this time.

Traumatic tooth extractions are more likely to result in dry socket formation.

All dentists know that there seems to be a correlation between the amount of tissue trauma created during the tooth extraction process and the potential for a dental patient to experience a dry socket. The general hypothesis is that the traumatized bone in the area of the extraction site releases compounds (tissue activators) that then diffuse into the blood clot that has formed in the tooth socket. These tissue activators cause the blood clot to disintegrate, thus leading to the delayed healing of the socket. It is also thought that some of the compounds released as a result of this blood clot disintegration are kinins, a type of compound known to stimulate pain receptors (hence causing much of the pain associated with dry sockets).

The amount of trauma associated with a tooth extraction might be planned or unplanned. With some wisdom tooth extractions the dentist will know beforehand that a fair amount of tissue trauma will be created. As an example, if an impacted wisdom tooth is entirely encased in the jaw's bone the dentist will need to both make an incision through gum tissue and remove that bone that lies over the impacted tooth before they can access the tooth itself. In comparison, when a dentist extracts a wisdom tooth that has already erupted into normal position in the mouth then the dentist already has direct access to the tooth and therefore no gum incision or bone removal is likely to be needed.

A dentist may approach an extraction hoping that its removal will be straight forward and simple but instead finds that the extraction is much more difficult than expected. (This is why having a less experienced dentist perform your tooth extraction may place you at greater potential for experiencing a dry socket.) With a difficult extraction the tissues surrounding the tooth will be manipulated to a greater degree. The amount of time over which the tissues are manipulated will be increased also. Both of these factors will result in relatively more collective trauma to the area where the extraction has taken place. Subsequently the patient will be at greater risk for developing a dry socket than if the tooth had come out more easily.

Patients who smoke tend to have a greater incidence of dry socket formation.

People who smoke are at greater risk for dry sockets. Some studies have suggested that people who smoke are more than four times more likely to experience a dry socket than a nonsmoker. A number of theories have been postulated as to what the association between tobacco smoking and dry sockets might be. Some relate it at the cellular level and the cytotoxicity of the smoke itself while others to the overall systemic effects of nicotine. The carbon monoxide that is introduced into the bloodstream by smoking does reduce the amount of oxygen that can be carried, thus producing a reduced oxygenation of the healing tissues. Additionally, it has been theorized that tobacco smoke might contaminate the wound site or may alter its bacterial population. One other factor to consider, the sucking action associated with smoking may draw out or otherwise dislodge the blood clot that has formed in the tooth socket.

Women who take oral contraceptives are at greater risk for dry sockets.

Women taking birth control pills are at greater risk for dry sockets. Women who take oral contraceptives (birth control pills) seem to be at greater risk for developing dry sockets than those who don't. It is thought that estrogen can play a role in disintegration of the socket's blood clot. It has been suggested that by coinciding their tooth extractions with those days in their oral contraceptive dosing cycle when their medication contains its lowest estrogen levels may help to minimize the occurence of dry sockets. The association between estrogen and dry sockets in general may also explain why women as a group are 20% more likely to experience dry sockets than men.

The presence of bacteria may play a role in dry socket formation.

Your dentist may write you a prescription for an antibiotic. There is some research that supports a view that bacteria might play a role in the development of dry sockets. Some studies have reported that dental patients who have a high pre or postoperative bacterial count in the region of the extraction site are at greater risk for dry socket formation. People who have poor oral hygiene seem to have a greater incidence experiencing dry sockets. People who have active infection in the gum tissue surrounding a tooth (pericoronitis) are also at greater risk.

This is one reason why a dentist might feel that they need to place a patient on a regimen of antibiotics for some days before an extraction is performed. This is also the reason why some studies have suggested that rinsing with an antibacterial mouthwash (chlorhexidine) before a tooth extraction or placing an antibiotic-impregnated packing into the tooth socket at the time of the extraction can be ways of minimizing the occurrence of dry sockets. These findings are not universally accepted by the dental community however and therefore are not universally practiced. While it would always be left up to the discretion of the treating dentist, most protocols for treating dry sockets do not include placing the dental patient on an antibiotic regimen.

The age of the dental patient may be related to the risk for experiencing dry sockets.

Some studies have suggested that there is an association between the age of the dental patient and the incidence of dry socket formation. While not supported by the findings of all studies, the general rule of thumb is that comparatively younger patients are at less risk for dry sockets than comparative older patients. As an example, one study found that dental patients in the age group 15 to 19 years developed dry sockets at a rate of about 3% whereas patients in the age group 30 to 34 experienced them at three times this rate. This is one of the reasons why a dentist might suggest wisdom tooth removal in the age window: late teens to early 20's.

Dry socket formation is often associated with lower wisdom tooth removal.
Dry socket risk: Location, location, location.

The location of the tooth needing extraction seems to correlate with the risk of dry socket formation. In general there is a greater incidence of dry sockets with the extraction of lower teeth as opposed to upper teeth. A greater incidence of dry sockets with molars as opposed to front teeth. The greatest risk of dry socket formation seems to be associated with lower wisdom teeth, especially impacted lower wisdom teeth.

How do dentists treat dry sockets?

The focus of the protocol that a dentist follows when providing treatment for a patient who has a dry socket is usually only supportive and palliative. A dry socket is a situation where the extraction site's healing has been delayed. With time the extraction site will still go ahead and heal on its own, it will just take longer than it would otherwise. Dry socket treatments do not speed up the healing of the wound, they simply help to mitigate the discomfort the patient experiences while the (now prolonged) healing process takes place. A medicated dressing will sooth a dry socket.

It's typical that the discomfort associated with a dry socket is difficult to control with analgesics (pain pills) alone (either non-prescription or prescription). Usually the best treatment solution involves returning to your dentist's office so they can wash out the extraction site and then place a medicated dressing into the socket.

The dressing that is selected for placement into the tooth socket will vary from dentist to dentist depending upon their previous experiences with different products. Some of the more common ingredients incorporated into dry socket dressings are eugenol (an extract of clove oil) and benzocaine (an anesthetic). Usually the dressing is changed (depending on the patient's comfort requirements) every 24 to 48 hours for 3 to 6 days. A patient can experience dramatic relief, even within an hour, once a dry socket dressing has been placed.

Don't be hesitant to seek treatment from your dentist for your dry socket.

All dentists know that the potential for dry socket formation always exists. And although there may be factors that can influence the incidence rate, a patient actually experiencing a dry socket is, to some degree, simply bad luck. A dentist also knows that cleansing and then placing a treatment dressing into the tooth socket can be an important factor in helping the patient manage the pain associated with their dry socket.

For both of these reasons, you'll probably find that your dentist is sympathetic to your cause and accommodating in providing you with assistance. They know that dry sockets, while certainly a disappointing complication associated with tooth extractions, always can and will occur and therefore they fully anticipate that some patients will be contacting them and require assistance with their dry sockets.

Penelitian Kebutuhan Perawatan karies Gigi Pada Anak-Anak Usia 12 Dan 15 Tahun Di SD Negeri 060924 Dan SLTP Negeri 36 Kecamatan Medan Johor

Kategori/Subjek: Dentistry/Pendidikan Dokter Gigi
Keyword: Karies gigi
Bahasa: Indonesia
Penulis: Hargo Basuki
Penerbit: ( 2008-05-09 )

Abstrak:
Tujuan penelitian ini adalah untuk mengetahui persentase dan rata-rata kebutuhan perawatan karies gigi. Populasi pada penelitian ini adalah anak-anak usia 12 dan 15 tahun pada murid SD dan SLTP. Secara purposif diambil sampel pada SDN 060924 dan SLTPN 36 Kecamatan Medan Johor. Secara random diambil 100 orang usia 12 tahun dan 100 orang usia 15 tahun di sekolah tersebut, dengan demikian jumlah sampel adalah 200 orang. Indeks untuk mengukur kebutuhan perawatan karies gig; dipakai Treatment Need Index (TNI). Diperoleh hasil bahwa persentase kebutuhan perawatan fisur silen 77%, kebutuhan restorasi konservasi permulaan (initial) 65%, kebutuhan restorasi konservasi sedang (moderate) 47%, kebutuhan restorasi tingkat lanjut (advance) 25,5% dan kebutuhan perawatan radikal 32,5%. Rata-rata kebutuhan perawatan karies gigi pada kelompok usia 12 tahun 4,89 gigi tiap anak dan meningkat pada kelompok usia 15 tahun yaitu 7,09 gigi tiap anak. Kebutuhan fisur silen, restorasi konservasi permulaan, restorasi konservasi sedang, restorasi konservasi tingkat lanjut dan kebutuhan perawatan radikal leblh rendah pada kelompok usia 12 tahun dibandingkan kelompok usia 15 tahun. Diharapkan hasil penelitian ini akan dapat memberikan masukan bagi tenaga kesehatan gigi untuk merencanakan kebutuhan perawatan gigi khususnya Usaha Kesehatan Gigi Sekolah (UKGS) dan sebagai bahan penyuluhan kepada masyarakat.

Abstract:

Lisensi:
USU e-Repository © 2008

Apologize - Timbaland Feat. One Repulic

I'm holding on your rope
Got me ten feet off the ground
And I'm hearing what you say
But I just can't make a sound
You tell me that you need me
Then you go and cut me down
But wait
You tell me that you're sorry
Didn't think I'd turn around and say...

That it's too late to apologize, it's too late
It's too late to apologize, it's too late

I'd take another chance, take a fall, take a shot for you
And I need you like a heart needs a beat
(But that's nothing new)

Yeah yeah
I loved you with a fire red, now it's turning blue
And you say
Sorry like an angel, heaven let me think was you.
But I'm afraid

It's too late to apologize, it's too late
I said it's too late to apologize, it's too late
Woahooo woah

It's too late to apologize, it's too late
I said it's too late to apologize, it's too late
I said it's too late to apologize, yeah
I said it's too late to apologize, yeah

I'm holding on your rope
Got me ten feet of the ground

Orofacial Pain and Temporomandibular problems

IDENTIFY YOUR PROBLEM:
The following questionnaire may help you know if your pain and discomfort could be due to your masticatory muscles and the TMJ.

1.	Do you have pain in your jaw when you chew or open wide?
2.	Does your jaw feel tired after chewing or a dental visit?
3.	Do you suffer form headaches on the side of your head?
4.	Do you have difficulty in opening your mouth wide?
5.	Does your jaw make noises like clicking or grinding when you chew or open wide?
6.	Do you suffer from ear pain or dental pain that does not respond to normal medical or dental treatment?

We offer a comprehensive program to control chronic orofacial, head, and neck pain. The most common symptoms that patients have are: headaches, jaw pain, jaw clicking and popping, painful opening and chewing, neck pain, ear aches, and toothaches.

Pain patterns may look like this:

Headache that originates in the temporalis muscle is very common among headache sufferers.

Ear aches and tooth aches that don’t respond to normal treatments may be due to referred pain from the muscles of mastication. Also the jaw joint (TMJ) is right in front of the ear canal, so pain in this joint may be felt as ear pain.

treatment program is tailored to each patient’s needs which will include from 3 to 6 visits, and can be programmed in 1 to 2 weeks. After this the patient will be taught a maintenance program which will be followed at home, to continue managing the problem. In many occasions a mandibular intra oral appliance will be made to help control habits and bruxism. The rate of success after 1 year is very high if the patient continues to follow a simple maintenance program at home.

NO MEDICATIONS
In most cases the treatment will not involve medications. We can also combine this treatment with other dental needs such as dental restorations and Periodontics. Many patients have visited us from the United States, Canada, and Spain, and sinsce the treatment, have been able to feel free of pain.

Dental Restorative Treatment

Fig.1. Before Amalgams

Fig.2. After composites

One of the most important objectives in our clinic is to give the patient the highest possible balance between esthetics, restorative dentistry, occlusion, and oral health. Some dental treatments are guided almost only by esthetics, leaving the health of the periodontal tissues, the oral mucosa, and the masticatory system in a second level. Also there has to be good balance with masticatoy function which must include efficacy in mastication with healthy masticatory muscles and temporomandibular joints.

We use the best dental restorative materials and dental technicians. The restorative treatment goes hand in hand with the periodontal and functional needs of the patient. We offer all the new techniques and procedures with the latest materials. Porcelain crowns, fixed bridges, bonded composite fillings, removable partial dentures, tooth whitening. In a few hours we can change your old amalgam fillings to white composite fillings.

Penyuluhan Tentang Pengawasan Minum Obat

Sehubungan tentang tingginya angka penemuan kasus TB Paru dan Kusta di wilayah kerja Puskesmas Tapian Dolok, maka Plan of Action Puskesmas Tapian Dolok perlu Pengawasan ketat kepada penderita. Kegiatan Penyuluhan Pengawasan Minum Obat diberikan kepada keluarga penderita TB Paru dan Kusta. Diharapkan keluarga dapat mengawasi keluarganya untuk teratur minum obat karena pengobatan TB Paru dan Kusta memerlukan minum obat dalam waktu 6 sampai 1 tahun. Pelaksanaan ini pada hari Senin, 12 November 2007 di Nagori Purbasari. Sebagai Pembicara : Surio Retno Sari (Surveilen TB Paru dan Kusta).

Penyuluhan Kesehatan Reproduksi dan IMS/HIV/AIDS

Permasalahan remaja kerapkali dikaitkan dengan permasalahan perilaku sosial. Secara fisik, remaja itu sehat. Namun, apa yang menjadi permasalahan terhadap remaja?Pada umumnya remaja menghadapi permasalahan Gizi misalkan obesitas atau terlalu kurus, perilaku hidup bersih dan sehat dan juga dalam menghadapi masa-masa pubertas.
Masa pubertas sangat rentan dihadapi remaja. Perlunya pengetahuan tentang kesehatan reproduksi kepada remaja yang kurang didapat dari sekolah maupun di rumah. Maka Plan of Action Puskesmas Tapian Dolok bertanggung jawab terhadap kondisi yang dihadapi remaja dengan Program PELAYANAN KESEHATAN PEDULI REMAJA. Dan untuk menghindari perilaku seks bebas, maka dipandang perlu pengetahuan kesehatan reproduksi, penyakit infeksi menular seksual dan HIV/AIDS yang dikaitkan juga dengan Narkoba.

Staf baru Puskesmas Tapian Dolok

Beberapa staf baru yang masuk ke Puskesmas Tapian Dolok, berikut penempatannya :
1. Ika Sari Dewi Br. Sinuhaji, Bidan Desa Sinaksak.
2. Rima Melati Damanik, Bidan Desa Sinaksak.
3. Windariani, Bidan Desa Dolok Maraja.
4. Hapsah Ritonga, Bidan Desa Dolok Maraja.
5. Maria, Bidan Desa Purbasari.
6. Mawaddah, Bidan Desa Dolok Ulu.
7. Titin Romaito Pakpahan, Bidan Desa batu Silangit.
8. Tri Budi Utami, Bidan Desa Pematang Dolok Kahean.
9. Reni, Bidan Desa Naga Dolok.
10. Rofiqoh Nasution, Bidan Desa Negeri Bayu Muslimin.
11. Posma Panjaitan, Puskesmas Tapian Dolok.
12. Elbani Br. Ginting, Puskesmas Tapian Dolok.
13. Rosna Hasibuan, Bidan Desa Nagur Usang.

Beberapa staf Puskesmas Tapian Dolok yang pindah/mutasi

Beberapa Staf Puskesmas Tapian Dolok yang pindah tugas dari Pemerintah Kabupaten Simalungun :
1. Rompita Sihotang, pindah ke Pemerintah Kabupaten Serdang Bedagai.
2. Sukesih, pindah ke Pemerintah Kabupaten Serdang Bedagai.
3. Marlince Silalahi, pindah ke Pemerintah Kota Tebing Tinggi.
4. Dayang S.A. Saragih, pindah ke Pemerintah Kabupaten Aceh Tenggara.

Adapun staf Puskesmas Tapian Dolok yang mutasi di lingkungan Pemerintah Kabupaten Simalungun (Luar Puskesmas Tapian Dolok) :
1. Lorenna malau, ke Puskesmas Penombean Pane.
2. Perniati Purba, ke Puskesmas Penombean Pane.
3. Juniar Manurung, ke Puskesmas Pembantu Rambung Merah.

Adapun Staf Puskesmas Tapian Dolok yang mengalami mutasi di lingukungan Puskesmas Tapian Dolok.
1. Risde Saragih, ke Puskesmas Tapian Dolok.
2. Junita Sijabat, ke Puskesmas Tapian Dolok.
3. Paulina Papuas, ke Puskesmas Tapian Dolok.
4. Kamisah, ke Puskesmas Tapian Dolok.
5. T. Lisbet Pasaribu, ke Puskesmas Pembantu Naga Dolok.
6. Anita Situmorang, ke Puskesmas Pembantu Bah Sulung.
7. Utari, ke Puskesmas Pembantu Bah Sulung.

Staf PTT Puskesmas Tapian Dolok yang telah diangkat menjadi CPNS

Beberapa Staf Puskesmas Tapian Dolok yang telah diangkat menjadi CPNS Pemerintah Kabupaten Simalungun :
1. Dr. Togi Jerry L. Aruan, Staf Medis Fungsional.
2. Kamisah, Bidan Desa Purbasari.
3. Junita Sijabat, Bidan Desa Sinaksak.
4. Risde Saragih, Bidan Desa Sinaksak.
5. Paulina Papuas, Bidan Desa Nagur Usang.
6. Lorenna malau, Bidan Desa Batu Silangit.
7. T.Lisbet Pasaribu, Bidan Desa Naga Dolok.
8. Juniar Manurung, Bidan Desa Dolok Ulu.

Beberapa staf Puskesmas Tapian Dolok yang melanjutkan pendidikan

Sehubungan dengan pentingnya peningkatan Sumber Daya Manusia di Puskesmas Tapian Dolok, maka beberapa staf melanjutkan pendidikan setingkat lebih tinggi. Adapun staf yang sedang melanjutkan pendidikan :
1. Dr. Marlina Lubis, melanjutkan S2 Magister Kesehatan di Universitas Sumatera Utara.
2. Drg. Erika Natalia Girsang, melanjutkan S2 Magister Administrasi dan Kebijakan Rumah Sakit di Universitas Sumatera Utara.
3. Dalan Sorbina Siburian, melanjutkan D3 Kebidanan di Politeknik Kesehatan Departemen Kesehatan RI.
4. Surio Retno Sari, melanjutkan D3 Kebidanan di Politeknik Kesehatan Departemen Kesehatan RI.
5. Susantri Roberta Saragih, melanjutkan D3 Kebidanan di Politeknik Kesehatan Departemen Kesehatan RI.
6. Ratna Damanik, melanjutkan D3 Perawat Gigi di Politeknik Kesehatan Departemen Kesehatan RI.

Sedangkan staf yang telah selesai pendidikan :
1. Ruhlina Damanik. D3 Kebidanan Politeknik Kesehatan Departemen Kesehatan RI.
2. Puji Sembiring. D3 Gizi Politeknik Kesehatan Departemen Kesehatan RI.

Seminar Dental Pain

Seminar sehari “Dental Pain” dilakukan di International Convention Hall Pematangsiantar tanggal 2 September 2006, merupakan pertemuan ilmiah dan penyegaran pengetahuan doktergigi di Kota Pematangsiantar dan Kabupaten Simalungun.
Pertemuan disponsori oleh Novartis, dengan mengundang pembicara tunggal dari Fakultas Kedokteran Gigi USU Medan , drg Tulus Pasaribu SpBM.
Dalam seminar drg.Tulus Pasaribu SpBm mengungkapkan dan memberikan penjelasan ilmiah tentang hal yang dapat menimbulkan rasa sakit dental pain origin dan contoh kasus.
Pada kesempatan ini beliau memberikan penjelasan tentang paper ilmiah yang disampaikan oleh teman sejawat drg.Johnson Siahaan dan drg.Hargo Basuki (yang diedit dari situs e-medicine).

Sumber : www.drgsubur.wordpress.com

Fasilitas Puskesmas Tapian Dolok

Gambar 1. Puskesmas keliling / Ambulance

Gambar 2. Laboratorium dilengkapi pemeriksaan gula darah, urin rutin,
pemeriksaan BTA, golongan darah, HB Sahli



Gambar 3. Klinik Gigi


Gambar 4. Poliklinik dan UGD

Gambar 5. Ruang data dan internet speedy

Gambar 6. Kantin yang higenis

Puskesmas Tapian Dolok

Gambar 1. Gedung Administrasi Puskesmas Tapian Dolok

Gambar 2. Gedung Pelayanan Puskesmas Tapian Dolok

Puskesmas Tapian Dolok berada di bawah Instansi Pemerintah Kabupaten Simalungun. Terletak di Nagori Purbasari, Kecamatan Tapian Dolok, Kabupaten Simalungun, Propinsi Sumatera Utara. Jarak dari Ibukota Propinsi Sumatera Utara lebih kurang 120 Km dari Kota Medan.Wilayah kerja Puskesmas Tapian Dolok mencapai 1 Kelurahan dan 9 Nagori/Desa. Dengan jumlah penduduk mencapai 39.846 jiwa (Sensus BPS 2000).

Adapun Satelit-satelit Puskesmas Tapian Dolok :
1. Puskesmas Pembantu Bah Sulung.

2. Puskesmas Pembantu Dolok Kahean.

3. Puskesmas Pembantu Naga Dolok.

4. Puskesmas Pembantu Nagur Usang.

5. Puskesmas Pembantu Kampung Muslimin.

6. Polindes Sinaksak.

7. Polindes Dolok Maraja.

8. Pos Kesehatan Desa Naga Dolok.

9. Polindes Batu Silangit.
10. Polindes Purbasari.
11. Polindes Dolok Ulu.
12. Polindes Negeri Bayu Muslimin.
13. Polindes Nagur Usang.
14. Polindes Dolok Kahean.
15. Polindes Pematang Dolok Kahean.

VISI dan MISI Puskesmas Tapian Dolok

Visi : Terwujudnya Kecamatan Tapian Dolok yang sehat menuju terwujudnya Indonesia Sehat 2010.

Misi :

1. Menggerakkan pembangunan berwawasan kesehatan di Kecamatan Tapian Dolok.

2. Mendorong kemandirian hidup sehat bagi keluarga dan masyarakat di Kecamatan Tapian Dolok.

3. Memelihara dan meningkatkan mutu, pemerataan dan keterjangkauan pelayanan kesehatan yang diselenggarakan Puskesmas Tapian Dolok kepada masyarakat Kecamatan Tapian Dolok.

4. Memelihara dan meningkatkan kesehatan perseorangan, keluarga dan masyarakat beserta lingkungannya di Kecamatan Tapian Dolok.

Puskesmas Tapian Dolok terdiri dari 6 (enam) bagian program, yaitu :

1. Promosi Kesehatan.

2. Kesehatan Ibu dan Anak serta Keluarga Berencana.

3. Kesehatan Lingkungan.

4. Gizi.

5. Pencegahan dan Pemberantasan Penyakit Menular.

6. Pelayanan Kesehatan Peduli Remaja.

Struktur Organisasi

Kepala Puskesmas

drg. Hargo Basuki

Urusan Tata Usaha

Tata Usaha :

1. Supomo

2. Karto Pasaribu

SP2TP : Alsion Purba

Bendahara : Sukesih

I. Bagian Promosi Kesehatan

1. dr. Novi Silva Vera

2. Roslina Purba

3. Ramnesty Saragih

4. Ratna Damanik

II. Bagian Kesehatan Ibu dan Anak serta Keluarga Berencana

1. dr. Marliana Lubis

2. Dalan Sorbina Siburian

3. Rotua Simanjuntak

4. Firmayani Sinaga

5. Utari

6. Paulina Papuas

III. Bagian Gizi

1. dr. Togy Jerry Loan Aruan

2. Supiaty Tanjung

3. Puji Sembiring

IV. Bagian Pemberantasan Penyakit Menular

1. dr. Ratna Kusuma Silalahi

2. Nurlela Saragih

3. Rayani Damanik

4. Malina Saragih.

V. Bagian Kesehatan Lingkungan

1. drg. Hargo Basuki

2. Riris Tambunan

3. Supomo

4. Risma Sitanggang

VI. Pelayanan Kesehatan Peduli Remaja

1. drg. Hargo Basuki

2. Rahmat Syahputra Harahap

3. Rayani Damanik

4. Rotua Hasibuan

5. Dayang Suhanna Aisyah Saragih

Surveilen

1. Jiwa : Mariani Saragih

2. Mata : Sri Suryaningsih

3. TB Paru / Kusta : Surio Retno Sari

4. Campak / ISPA / AFP : Susantri Roberta Saragih

5. Diare : Ruhlina Damanik

6. Rabies / DBD / Malaria / HIV-Aids : Lenny Sidauruk

7. Avian Influenza : Ennyda Simanjuntak

Puskesmas Pembantu Bah Sulung

1. Alina Sitompul

2. Ramianta Saragih

Puskesmas Pembantu Dolok Kahean

1. Edward Togatorop

2. Linnaria Girsang

3. Sri Nomi

Puskesmas Pembantu Naga Dolok

1. Mawarni Sinaga

2. Martha Siahaan

Puskesmas Pembantu Nagur Usang

1. Laster Damanik

2. Rompita Sihotang

Puskesmas Pembantu Kampung Muslimin

1. Eliasari Br. Kaban

Bidan Desa / Polindes

1. Sinaksak : Risde Saragih, Junita Sijabat

2. Dolok Maraja : Anita Situmorang

3. Purbasari : Kamisah

4. Dolok Ulu : Juniar Manurung

5. Batu Silangit : Lorenna Malau

6. Dolok Kahean : Kelly Rosari Siahaan

7. Pematang Dolok Kahean : Junita Sirait

8. Naga Dolok : Tionar Lisbet Pasaribu