 Hello, I'm Andrea here with Dental L Tutoring. This week in the VIP Board Exam Prep Academy, we are going over different trace setups, but I wanted to go over one with all of you guys, specifically for YouTube, just because who doesn't love a good trace setup and talking about it, it can be very confusing. When you first become a dental assistant, you have to know all of the trace setups because you're going to have to set up before the dentist. If you don't set up, the dentist isn't going to know what to do. Trust me, they rely on dental assistants, but in school, I find you learn about it in the textbook. You learn how to set up and prepare for the procedures in the textbook, but you don't really know the full trace setup. So in the video today, I'm going to go through the IRM trace setup. So this is when the dentist is placing a temporary, medicated, filling type of material. So why would we use it, all of that? So I'm going to talk about that now. So let me just share my screen here for you. So unfortunately, it's a little bit of a blurry picture, but this was the best one that I could find and it truly does show the IRM trace setup. It almost looks like they started setting up though for an amalgam as well, because they have the amalgam condenser here, which you really don't need, but I'm not so worried about the instruments that I can talk to you guys about, but I wanted to show you what things look like. So basically, why would you need the IRM for a patient? And why would a dentist ask you for one? This is when the patient comes in, they're in a lot of pain, they have a big cavity or they might not even be in pain, but they might just have a big cavity. If the dentist opens up the tooth and sees like, oh, this is a very big cavity, I have to clean it a lot more than I thought it's almost touching the nerve. You don't want the pulp to get inflamed. So instead of just simply placing a composite or instead of placing an IR, or sorry, instead of placing a composite or instead of placing an amalgam, they're going to first place the IRM. So there's actually two different ways of doing this. I'm going to focus on placing the IRM as a temporary filling, not permanent, but there's another way you can also place IRM and that would be underneath an amalgam filling, not underneath a composite that's not going to work, but underneath an amalgam filling. It doesn't work for composites because you have to bond composites and it's just a different make all together. But for IRM, you can use it as the bottom layer to really protect the tooth and add a medication if you will to the tooth and then some dentist place an amalgam over top. But of course, that's a permanent solution because you can't just take an amalgam next week. Like there's no point, it's a permanent filling. So that's an option too. So maybe that's why on this tray setup there's an amalgam condenser because they were getting ready to place an amalgam, which kind of looks like it because I see the amalgam here. I see the discoid cleoids here. I see the longer, so I see a plugger. I see a couple of different things that suggests an amalgam filling. So basically for the IRM, you want to set up for a basic filling setup. A rubber dam may or may not be needed. It's hard to say, but you want to set up the high speed handpiece. You want to set up the slow speed handpiece. You want to set up the anesthetic, a mirror explorer. Maybe you want to set up a ball burnisher because they might want to burnish the IRM a little bit. A condenser for sure. Maybe a PFI, a plastic filling instrument just to help to carve it a bit better. A spoon excavator, I'm just kind of thinking here. The articulating paper, as you can see. A Q-tip for the topical, before the anesthetic, the gauze. Here they have what looks like copolyte. They have the IRM materials here. The di-cal, so they have a couple of things here. So the di-cal would be used before the IRM as a liner, if you will, to really seal up that prepped area. And then the IRM would be placed over top. Sometimes a liner isn't used, sometimes it is. Copolyte kind of the same thing. You might use that under the IRM, under the amalgam. It's hard to say. So that's why they have that set up here. But the IRM, you guys, you would have learned this in school, you need to mix it up. It's a very difficult material to mix up because you basically put in the powder on the paper pad here. It's a little scoop sometimes too, depending on the size of the IRM that you need. And then the liquids here, you would put that in the powder, mix it up with the spatula. It takes time. You can't go too fast. You can't go too slow. And then you want it into like a sticky putty. So you would roll it into a ball and it's kind of like a sticky putty. If it's too hard and not sticky, you have to mix up another one. It means it's set too quickly. If it's too sticky, you have to add more powder. But you guys ask your instructor how to do that perfectly. That's more hands-on, okay? So basically what you do, you guys, is the dentist would use anesthetic. So the topical and then the anesthetic that is needed to freeze the tooth. They would obviously prep the tooth, clean out the cavity with the high-speed handpiece, clean out the cavity with the spoon excavator, and then say to you, okay, it's time to put in the IRM. So they might use di-cal as the bottom layer. They might use copalite. They will tell you what they want. And then it's time to mix up the IRM. Mixing the IRM takes at least one minute. So they're not going to expect it right away. They know that you have to mix it. But then you would hand the dentist, the like rolled up sticky putty into their hand. Be careful, as a dental assistant, I totally tried to do that once and it fell on the floor. So then I'm like, oh my God, let me mix up another one. So it does happen, but be careful. In my opinion, it's even better if you mix it up like on the counter and then give it to the dentist on the counter. So you're not picking it up and putting it in the dentist's hand, but it's up to you how they want you to do it. And then they're going to place the IRM, they're going to carve it to the tooth, check the occlusion, and that's it. It doesn't need to be cured with a curing light, none of that. The IRM, it doesn't look like a tooth. It doesn't look like enamel. It doesn't look like a composite filling. It's going to look like a white piece of material is stuck inside the tooth. But that's what it looks like. It is meant to add in the medication and really help that tooth heal. It's normal to leave in the IRM for at least three months and then have the patient come back, take an X-ray, how does the tooth look? Is the pulp inflamed? If it's not, then you can put in a permanent filling. Some dentists decide to leave a little bit of the IRM in there and then put a filling over top. So talk to your dentist to see what they want to do. So I hope this helps you guys. If you have any questions, please let me know. I will leave the link for you guys down below for the VIP package, the Board Exam Prep Academy. It's a full course where I teach dental assisting students how to pass the board exam. This is something you have to know. There is a separate course for dental hygienists as well, but I will leave the links for you guys down below. If this helped you guys, please click like. That does help me in my channel and make sure to two click subscribe because that just means that I can upload more videos more often. Okay, you guys, thank you so much. I do have another video on the crown and bridge prep tray setup. So definitely check for that and a composite tray setup as well. So I will talk to you guys very soon and thank you again so much for watching.