WATCHMAN : IVORY
FIELD DENTISTRY  ·  GRID DOWN READY  ·  MODULE 10
COMMAND SUITE
MODULE 01  ·  IVORY
Examination & Diagnosis
Systematic protocol for identifying which tooth is the problem and whether it is salvageable.

In a grid-down scenario, correct diagnosis is everything. Treating the wrong tooth wastes supplies and patient tolerance. This module walks through the examination sequence — chief complaint, visual inspection, percussion, thermal testing, and charting — so you identify the problem tooth before you touch an instrument. Primary references: Murray Dickson's Where There Is No Dentist and the Special Operations Forces Medical Handbook dental protocols.

01
Chief Complaint
Ask the patient to describe the pain in their own words. Location — which side, upper or lower? Character — sharp, dull, throbbing, constant, or only with pressure or temperature? Duration — when did it start, is it getting worse? Triggers — does hot, cold, biting, or lying down make it worse? Previous episodes — has this tooth been treated before?
02
Visual Inspection
Use a headlamp and dental mirror. Look for: visible cavities (dark spots on biting surfaces or between teeth), cracked or fractured teeth, broken fillings, gum swelling or redness localized to one area, sinus tract (a small pimple on the gum — indicates chronic abscess draining), and discoloration (grey or dark tooth suggests pulp death).
03
Percussion Test
Tap lightly on the biting surface of each tooth in the suspect area using the handle of an instrument or a tongue depressor. A normal tooth produces a dull thud. A tooth with periodontal involvement or abscess produces sharp pain on percussion. This is your single most reliable indicator of which tooth is the source. Tap multiple teeth and compare — the patient's reaction is your guide.
04
Thermal Testing
A healthy tooth responds to cold with brief, immediate pain that resolves within seconds. A tooth with irreversible pulpitis responds to cold with pain that lingers 15–30 seconds after the stimulus is removed — this tooth needs extraction or will abscess. A tooth that does not respond to cold at all may have a dead pulp (necrotic) — already gone or abscessing at the root. Use a small ice chip wrapped in gauze as your cold stimulus.
05
Chart and Record
Record the tooth number (use standard dental numbering 1–32), the diagnosis, and your planned treatment before you begin. Document in the Treatment Log (Module 08). This creates a record for follow-up, tracks outcomes, and ensures you do not confuse teeth if the patient returns.
Brief cold sensitivity, no spontaneous pain, responds to percussion slightly or not at all. Cause is usually a cavity or cracked enamel that has not yet reached the pulp. Treatment: temporary or permanent restoration. Tooth is salvageable.
Spontaneous throbbing pain, lingering cold sensitivity (15+ seconds), moderate percussion response. Pulp is inflamed beyond recovery. Treatment: extraction is the field-realistic option. Will abscess without treatment.
No cold response (pulp dead), severe percussion pain, possible swelling, possible sinus tract on gum. Infection present at root tip. Treatment: extraction + antibiotics. Monitor for spreading infection.
Pain on biting, localized gum swelling alongside the tooth (not at the apex), tooth may be mobile. Infection is in the gum pocket, not the pulp. Treatment: drainage, irrigation, antibiotics. Tooth may or may not be salvageable.
MODULE 02  ·  IVORY
Local Anesthesia
Nerve block techniques for the upper and lower jaw — so procedures can be performed without unnecessary suffering.

ALLERGY CHECK REQUIRED: Always ask about allergy to local anesthetics before injection. Ask specifically about reaction to dental injections in the past — not just general drug allergies. If allergy is present or suspected, do not inject. Proceed with maximum non-injectable pain control and consider whether the procedure can be delayed.

Two nerve blocks cover the vast majority of field dental procedures. The inferior alveolar nerve block anesthetizes all lower teeth on one side plus the lower lip and chin. The posterior superior alveolar block anesthetizes upper molars. Infiltration injections handle upper front teeth. Lidocaine 2% with 1:100,000 epinephrine is the standard agent — the epinephrine prolongs effect and reduces bleeding. Without epinephrine, duration is significantly shorter.

01
Landmark Identification
Have the patient open wide. Place your thumb on the coronoid notch — the deepest concavity on the anterior border of the ramus felt from inside the mouth. Your thumb nail should bisect the occlusal plane (the biting surfaces of the lower teeth). The injection site is at the height of your thumbnail, 1cm medial (toward the middle) from the anterior border of the ramus.
02
Needle Approach
Approach from the opposite side of the mouth — if blocking the right side, the syringe barrel crosses over the lower left premolars. Insert the needle at the injection point at the height of the thumbnail. Advance slowly, parallel to the occlusal plane, until you contact bone (approximately 20–25mm). If you hit bone before 20mm, you are too far anterior — withdraw slightly and redirect slightly posterior.
03
Aspiration and Injection
Before injecting, aspirate (pull back slightly on the plunger). If blood appears in the cartridge, you are in a blood vessel — withdraw, reposition, and re-aspirate before injecting. If aspiration is negative, deposit 1.5–1.8mL slowly over 60 seconds. Slow injection reduces patient discomfort significantly. Onset is 3–5 minutes. Success is confirmed when the patient reports tingling or numbness of the lower lip and chin on that side.
04
Lingual Nerve Block (concurrent)
As you withdraw from the inferior alveolar injection, deposit a small amount (0.5mL) approximately halfway out. This blocks the lingual nerve, anesthetizing the tongue and floor of mouth on that side — important for lower extractions where lingual tissue may be involved.
01
Supraperiosteal Infiltration (Upper Front Teeth)
Upper incisors and canines are easily blocked with a simple infiltration injection. Insert the needle at the height of the mucobuccal fold (where the cheek meets the gum) above the tooth root apex. Angle at 45 degrees toward the bone. Deposit 1–1.5mL slowly. Onset is 2–3 minutes. This works well for upper front teeth because the bone is thin and the anesthetic diffuses through easily.
02
Posterior Superior Alveolar Block (Upper Molars)
Retract the cheek. Insert needle at the mucobuccal fold at the level of the upper second molar. Angle 45 degrees upward and 45 degrees toward the midline, advancing 16mm. Aspirate — this area is highly vascular. Deposit 1.5–1.8mL slowly. Blocks upper second and third molars reliably. Upper first molar often requires supplemental infiltration at the mesiobuccal root.
Lidocaine 2% with 1:100,000 epinephrine. Duration: 60–90 min pulpal anesthesia, 3–5 hours soft tissue. Maximum dose: 4.4mg/kg body weight (7 cartridges for average adult).
Plain lidocaine 2%. Duration drops to 30–45 minutes pulpal. Use when epinephrine is contraindicated (uncontrolled hypertension, severe cardiac disease). Extraction procedures will likely require re-injection.
Wait 10 full minutes before concluding failure. If still inadequate, a second injection slightly more posterior usually succeeds. Intraligamentary injection (needle into the periodontal ligament) provides immediate supplemental anesthesia when block is incomplete.
Metallic taste, perioral numbness, ringing in ears, confusion, seizure. Lay patient flat, establish airway, monitor. Due to intravascular injection — aspiration before every injection is essential.
MODULE 03  ·  IVORY
Temporary Restorations
Cement filling technique to seal cavities and fractured teeth and buy time.

A temporary restoration does two things: relieves sensitivity by sealing exposed dentin, and prevents progression by blocking bacteria from reaching or advancing toward the pulp. In a grid-down scenario, a well-placed temporary restoration can keep a tooth functional for months. The most field-practical material is zinc oxide eugenol (ZOE) cement — it is soothing to the pulp, antibacterial, and easy to mix and place without electricity.

01
Anesthetize if Needed
For shallow cavities, the tooth may not need anesthesia — the patient will tell you. For deeper cavities approaching the pulp, anesthetize first. Attempting cavity preparation on a sensitive tooth without anesthesia is unnecessary suffering and produces poor results because the patient cannot keep still.
02
Remove Loose Decay
Use a spoon excavator (a small hand instrument with a curved blade) to remove soft, loose decay. You do not need a drill. Remove all soft, discolored material until you reach firm tooth structure. Do not excavate aggressively near the pulp — leaving a thin layer of firm, stained dentin over the pulp is acceptable and safer than perforating into it.
03
Dry the Cavity
Cotton pellets or gauze to absorb moisture. The cavity must be reasonably dry for the cement to bond and set properly. Do not use air to dry if the tooth is sensitive — it will be painful and may drive bacteria deeper.
01
Mix the Cement
Dispense equal amounts of ZOE powder and liquid on a mixing pad. Incorporate the powder into the liquid in small increments, mixing in a figure-8 motion. Correct consistency for a temporary filling is a stiff putty — it holds its shape when rolled into a ball and does not stick to a dry gloved finger. For a base under a deeper restoration, a slightly thinner consistency (toothpaste-like) is appropriate.
02
Place the Cement
Use a plastic instrument or the flat end of a spoon excavator to carry the mixed cement to the cavity and pack it in. Overfill slightly — the excess will be removed. Adapt the cement into the cavity walls and corners. Work before the cement begins to set (typically 2–3 minutes working time).
03
Shape and Carve
Before the cement hardens fully, remove the excess from the biting surface and carve the restoration to approximate the natural tooth anatomy. The most critical point: the patient must be able to close their teeth together comfortably. A high bite (restoration too tall) causes significant post-operative pain and can damage the opposing tooth. Have the patient close carefully and mark any high spots by the feel of uneven pressure, then reduce.
04
Post-Op Instructions
Do not eat on that side for one hour while the cement fully hardens. Soft foods only for 24 hours. If the bite feels high when the anesthetic wears off, return to have it adjusted — do not leave a high bite. ZOE restorations are not permanent and will need replacement or definitive treatment when available. Duration in function: weeks to months depending on cavity size and occlusal forces.

For fractured teeth with exposed dentin (sensitivity to air and cold but no spontaneous pain), the treatment is the same — dry the exposed area and seal with ZOE cement. For fractured teeth with exposed pulp (a tiny pink dot visible in the fracture — the patient has severe pain to any stimulus), seal with ZOE immediately as a palliative measure and plan for extraction. A pulp exposure in a grid-down setting has no field-viable treatment other than extraction.

MODULE 04  ·  IVORY
Abscess & Infection
Recognition, drainage, antibiotic selection, and when spreading infection has become an airway emergency.

AIRWAY THREAT — KNOW THESE SIGNS: Difficulty swallowing, difficulty opening the mouth (trismus), swelling extending to the floor of the mouth or the neck, fever above 101°F, the patient appears systemically ill (chills, rapid pulse, sweating). These indicate spreading infection — Ludwig's angina or deep space infection. This is a life-threatening emergency. Immediate extraction of the source tooth, high-dose IV antibiotics if available, and evacuation to surgical care if possible.

Severe throbbing pain, tooth extremely tender to percussion, possible swelling of the face or jaw on the affected side. The abscess is at the root apex. Tooth has irreversible pulpitis or necrotic pulp. Requires extraction + antibiotics.
Small pimple-like bump on the gum, may have minimal or no pain because the infection is draining. The sinus tract is the body's pressure relief valve. Still requires extraction — infection is ongoing even without severe pain. Closes after extraction.
Localized swelling that feels soft and fluid-filled when pressed. Pus has collected and is ready to drain. This can and should be drained — it will provide immediate pain relief. Then extract the source tooth.
Diffuse firm swelling — no soft spot. Infection is spreading through tissue but has not yet localized into a collectable abscess. Antibiotics first to localize the infection. Extraction of source tooth. Do not incise cellulitis — there is nothing to drain and it spreads bacteria.
01
Anesthetize Around (Not Through) the Abscess
Never inject directly into infected tissue — it is ineffective (acidic pH of infected tissue neutralizes the anesthetic) and spreads bacteria. Instead, block the nerve supplying the area. For mandibular teeth, inferior alveolar block. For maxillary teeth, regional infiltration away from the swollen area. Topical anesthetic on the mucosa before injecting also helps.
02
Incise and Drain
Using a #15 scalpel blade or the tip of an 18-gauge needle, make a 1cm incision at the most dependent point of the fluctuant swelling — where gravity would cause pus to collect. The incision should be through the mucosa into the abscess cavity. Pus will evacuate. Do not squeeze or express — allow it to drain passively. Large quantities of pus indicate a well-established abscess.
03
Irrigate the Cavity
Irrigate the abscess cavity with saline or dilute chlorhexidine solution using a blunt-tipped syringe. This flushes debris and bacteria from the space. Continue until the return is clear.
04
Place Drain If Needed
For large abscesses, place a small piece of penrose drain or a strip of rubber dam through the incision and suture one end loosely to the mucosal edge. This keeps the incision from closing prematurely while the cavity continues to drain. Remove after 24–48 hours. Extract the source tooth as soon as the patient's condition allows — typically 24–48 hours after drainage.
Amoxicillin 500mg — 3x daily for 5–7 days. Covers oral streptococci and most dental pathogens. First choice unless allergy present.
Clindamycin 300mg — 3x daily for 5–7 days. Excellent coverage of dental anaerobes. Note: C. difficile risk with prolonged use.
Amoxicillin-clavulanate (Augmentin) 875mg — 2x daily. Broader coverage including beta-lactamase producing anaerobes. Use when initial antibiotic is failing or infection is aggressive.
Antibiotics treat the systemic component of infection. They do not resolve the source. The tooth must be extracted. A patient who improves on antibiotics and refuses extraction will relapse when the course ends.
MODULE 05  ·  IVORY
Extraction Protocol
Full step-by-step extraction protocol — instrument technique, socket management, and post-extraction care.

Extraction is the definitive field treatment for irreversible pulpitis, necrotic teeth, and unresolvable abscesses. Done correctly, it is a safe and effective procedure. Done incorrectly — inadequate anesthesia, wrong instrument technique, or failure to manage the socket — it creates complications that are far worse than the original tooth. Take your time. Adequate anesthesia is not optional.

☐  Correct tooth confirmed by percussion and patient agreement
☐  Anesthesia administered and confirmed (lip/tongue numb, no pain to instrument pressure)
☐  Minimum 10 minutes wait after injection before beginning
☐  Patient seated upright or semi-reclined — not fully supine
☐  Adequate lighting confirmed
☐  All instruments laid out before starting
☐  Gauze and post-extraction care instructions ready
☐  Bleeding history checked — anticoagulants or clotting disorders noted
01
Luxate with the Elevator
Before applying forceps, use a straight elevator placed in the periodontal ligament space between the tooth and bone to luxate (loosen) the tooth. Insert the elevator with the concave side facing the tooth and apply controlled rotational pressure, using the adjacent alveolar bone — never the adjacent tooth — as a fulcrum. Work the elevator around the tooth, increasing mobility. A well-luxated tooth requires significantly less force to remove with forceps and dramatically reduces the risk of fracture.
02
Apply Forceps Correctly
Forceps beaks must engage the root, not the crown — push them apically as far as possible before applying pressure. The beaks should be parallel to the long axis of the tooth. Incorrect placement at the crown level causes crown fracture and a retained root, which is a significantly worse problem. Confirm seating before applying extraction force.
03
Controlled Extraction Movement
Apply firm, controlled pressure in the direction that expands the socket. For lower single-rooted teeth (incisors, canines): labial and lingual figure-8 motion. For lower molars: primarily buccal pressure — the lingual bone is dense and resistant. For upper teeth: buccal-palatal motion. Move slowly and deliberately. Jerking or twisting before the socket is adequately expanded fractures roots. You should feel progressive mobility with each movement.
04
Delivery
When the tooth is sufficiently mobile, deliver it in the direction of least resistance — usually buccal for most teeth. Examine the extracted tooth: are both roots present on a multi-rooted tooth? Is the root complete? A fractured root tip left in the socket requires retrieval if accessible — a retained infected root tip will not heal and will abscess.
05
Socket Management
Irrigate the socket with saline. Compress the buccal and lingual plates gently with your fingers to reduce the expanded bone. Place a gauze pack over the socket and have the patient bite firmly for 30–45 minutes. Do not remove the gauze to check — every removal disturbs clot formation. If bleeding continues after 45 minutes, replace gauze and maintain pressure. A properly formed blood clot in the socket is the foundation of healing — protect it.
TELL THE PATIENT:
— Bite on gauze for 45 minutes. Do not remove it early.
— No spitting, rinsing, or drinking through a straw for 24 hours — displaces clot.
— No smoking for 48 hours minimum — dramatically increases dry socket risk.
— Soft foods only for 48 hours. No food on the extraction side.
— Some bleeding for 12–24 hours is normal. Dark red seeping is normal. Bright red free-flowing is not.
— Begin gentle warm salt water rinses after 24 hours — 3x daily for one week.
— Pain peaks at 6–12 hours, then progressively improves. If pain is increasing after day 3, suspect dry socket or infection.
— Return immediately if: difficulty breathing, difficulty swallowing, swelling spreading to neck, fever, or uncontrolled bleeding.

Dry socket occurs when the blood clot dislodges or fails to form, exposing bare bone. It presents 3–5 days post-extraction with severe, throbbing pain that radiates to the ear or temple — distinctly worse than expected post-extraction soreness. Visual inspection shows an empty socket with exposed whitish bone rather than a dark blood clot. Treatment: gently irrigate the socket with saline, then pack with iodoform gauze soaked in ZOE or clove oil. Replace packing every 24–48 hours until pain resolves. Dry socket is painful but not dangerous — it resolves with time and local dressing.

MODULE 06  ·  IVORY
Supply Planning
Tiered dental cache from personal carry kit through community clinic level — what to stock at each tier.

Dental supply planning follows the same tiered logic as medical supply planning. Tier 1 is what every individual carries. Tier 2 is the group first aid kit. Tier 3 is the community clinic cache — positioned for extended operations when resupply is unavailable. Document your current inventory in each tier below and note gaps.

TIER 1
Personal Carry — Every Individual
Pocket-sized. Fits in a IFAK or cargo pocket. Covers the most common field dental emergencies for self-care or buddy care.
Dentemp or equivalent pre-mixed temporary cement (2 applications)  ·  Dental mirror (small)  ·  Cotton pellets (10)  ·  Oil of cloves / eugenol for pain relief  ·  2x2 gauze (6 pieces)  ·  Ibuprofen (dental pain management)  ·  Small dental pick or explorer
TIER 2
Group Kit — Designated Dental Responder
Carried by or accessible to the group's designated dental responder. Covers examination, restorations, and basic extractions for the group.
Dental mirror x3  ·  Explorer/probe x2  ·  College pliers  ·  Spoon excavators (small & medium)  ·  Plastic instrument for cement placement  ·  ZOE powder and liquid (full kit)  ·  Mixing pad and spatula  ·  Lidocaine 2% with epi carpules x20  ·  Dental syringes x2  ·  Assorted needles (short and long) x20  ·  Cotton rolls x50  ·  Gauze 2x2 x50  ·  Dental forceps #150 (upper universal) and #151 (lower universal)  ·  Straight elevator #301  ·  Curved elevator  ·  Periosteal elevator  ·  Topical anesthetic gel  ·  Amoxicillin 500mg x42 (one full course x2)  ·  Clindamycin 300mg x21 (one full course)  ·  Ibuprofen 200mg x100  ·  Iodoform gauze packing strips  ·  Tongue depressors x10  ·  Penrose drain strips x4  ·  Small headlamp (dedicated)
TIER 3
Community Clinic Cache — Extended Operations
Positioned for long-term grid-down scenarios. Supports multiple group members over months of operation. Requires a dedicated dental supply cache and trained personnel.
Full instrument kit (duplicates of all Tier 2 instruments)  ·  Surgical forceps (upper and lower molar-specific)  ·  Root tip picks and elevators  ·  Bone file  ·  Surgical curette  ·  Needle drivers x2  ·  Tissue scissors  ·  Resorbable suture 3-0 chromic gut x10  ·  Non-resorbable suture 3-0 silk x10  ·  #15 scalpel blades x20  ·  Scalpel handle  ·  ZOE cement x6 kits  ·  Glass ionomer cement (GC Fuji IX or equivalent) x4 kits  ·  Calcium hydroxide liner (Dycal)  ·  Lidocaine carpules x100  ·  Epinephrine 1mg/mL x6 (anaphylaxis)  ·  Broad-spectrum antibiotics x12 courses  ·  Chlorhexidine 0.12% oral rinse x4 liters  ·  Saline irrigation x2 liters  ·  Dental reference texts (Dickson, SOFMH dental protocols)  ·  Autoclave bags or cold sterilization solution for instrument reprocessing
Where There Is No Dentist — Murray Dickson. The primary field reference. Written for community health workers with no dental training. Practical, clear, and directly applicable. Stock a physical copy in your Tier 3 cache.

Special Operations Forces Medical Handbook — Chapter on dental. Military field dental protocols. Extraction technique, abscess management, anesthesia. Available as a physical reference.

Where There Is No Doctor — Werner. Covers systemic signs of dental infection and when dental disease has become a medical emergency.
MODULE 07  ·  IVORY
Training Log
Track which group members have dental first aid skills and what training they have completed.

More than one person in your group should have basic dental first aid skills. If your primary dental responder is incapacitated, someone else needs to know how to pack a socket, place a temporary restoration, and recognize a spreading infection. Document training by member so you know who can do what.

+ ADD GROUP MEMBER
MODULE 08  ·  IVORY
Patient Records — Encrypted
One record per patient, organized by name or callsign. Open a record to see every visit, allergy, and medication inside it.
🔒 LOCKED
OUTPUTS  ·  IVORY
Print Outputs
Field reference cards and supply lists for printing and laminating.

Print and laminate the reference cards for your dental kit, or print the Full Field Reference for a 3-ring binder. A reference in your hands is worth more than a perfect module on a dead device. Each button opens your print dialog — choose a printer or Save as PDF to keep a digital copy.

OUTPUT 1
Extraction Protocol Card

Step-by-step extraction checklist, post-op instructions, and dry socket management. Single laminated card for the dental kit.

OUTPUT 2
Infection Alert Card

Abscess recognition guide, airway threat warning signs, antibiotic dosing quick reference. For group members to recognize when a dental problem has become an emergency.

OUTPUT 3
Supply List

Complete tiered supply list for Tier 1, 2, and 3 caches with your inventory notes. Use for restocking and procurement planning.

OUTPUT 4  ·  BINDER
Full Field Reference

Everything in one document for your 3-ring binder — examination, anesthesia, restorations, abscess management, extraction, the tiered supply list (with your notes), and the group training log. Patient records are deliberately excluded and print individually from the Treatment Log.

Patient Records Print Individually

Treatment Log case records are not part of the binder reference and never print in bulk. Open Module 08 · Treatment Log and use the 🖶 PRINT button on a case to print that single patient record for filing in that patient's medical folder.

Data stored locally in browser. Key: ao_ivory_v1  ·  Export JSON before clearing or reinstalling.
HELP  ·  IVORY
User Manual
Full illustrated guide to every screen. Hover any underlined term for its meaning.
WATCHMAN:IVORY
FIELD DENTISTRY  ·  GRID DOWN READY  ·  MODULE 10

User Manual

Plain-language guide. No dental background needed to read it.
IVORY is a reference and record-keeping tool, not a dentist. Read this once, then keep the printed Field Reference in your binder.

This manual assumes you have never opened IVORY before. It explains every screen in order. Work through it the first time, then use the table of contents to jump to what you need. Hover any underlined term on screen for its meaning.

READ FIRSTIVORY contains procedures — anesthesia, drainage, extraction — intended only for prolonged grid-down situations when no dentist is reachable. If professional dental care is available, use it. Nothing here replaces training or a licensed provider.
CONTENTS

What's in here

SECTION 1

What IVORY is for

IVORY does two jobs. First, it is a field reference: step-by-step protocols for the dental emergencies most likely to take a group member out of action when no dentist is available — a raging toothache, a broken tooth, an abscess, a tooth that has to come out. Second, it is a record keeper: it tracks your dental supplies, who in your group has been trained, and a log of every procedure performed.

The program covers, in order:

  • Diagnosis — figuring out which tooth is the problem and whether it can be saved.
  • Pain control — the two nerve blocks that cover most field procedures.
  • Treatment — temporary fillings, draining infection, and extraction when there is no other option.
  • Logistics — what to stock, who to train, and a record of what you have done.
PLAIN VERSIONIVORY turns "someone has a horrible toothache and there is no dentist" into a clear sequence: identify the tooth, control the pain, treat or remove, and write it down.
SECTION 2

The one rule that matters

Everything in IVORY is for austere conditions only — a long grid-down event where a dentist and a real clinic are simply not reachable. The first time you open the module, a notice appears. Type your name or callsign, check the box, and acknowledge it. That acknowledgment is stamped with the date and time and shown in the footer.

WHY THE NOTICEIt is not legal theater. It is a reminder that these are last-resort procedures. A wrong extraction is far worse than the toothache you started with. If care is available, get it.

You can re-show or reset the notice later. See Saving, backups & settings.

SECTION 3

What's on your screen

The screen has three fixed parts and one big working area. The left sidebar is your menu. The top bar shows the module name and the way back to the Command Suite. The main area in the middle is whatever module you have open. The footer shows your acknowledgment.

WATCHMAN : IVORY COMMAND SUITE MODULES 01 EXAMINATION 02 ANESTHESIA 03 RESTORATIONS 04 ABSCESS 05 EXTRACTION 06 SUPPLY 07 TRAINING RECORDS 08 TREATMENT LOG OUTPUTS / HELP ■ PRINT OUTPUTS ? USER MANUAL MODULE 01 · IVORY EXAMINATION & DIAGNOSIS The middle area shows whatever module is selected on the left. STEP / CARD STEP / CARD
The IVORY screen: top bar, left menu, main work area

To move around, click an item in the left menu. The open module is highlighted in green. Most reference modules (01–05) are read-only protocols. The records modules (06–08) and the outputs have buttons that save your data or print.

SECTION 4

Your first 15 minutes

You do not have to set anything up to use IVORY as a reference — the protocols are ready immediately. But fifteen minutes now makes it far more useful in a crisis.

  1. Read Module 01 (Examination) once, start to finish. It is the foundation — treating the wrong tooth wastes supplies and patient tolerance.
  2. Open Module 06 (Supply Planning) and write down what you actually have in each tier. Note expiration dates. This is the single most valuable thing you can do today.
  3. Open Module 07 (Training Log) and add the people in your group. Check off any dental skills they already have.
  4. Go to Print Outputs and print the Full Field Reference for your binder, plus the laminate cards for your kit.
  5. That is it. When a real problem appears, you open the matching module and follow the steps.
DO IT NOWPrint the cards while you have power and a printer. A laminated card in the kit works when the device is dead.
MODULE 01

Examination & Diagnosis

This module is the examination sequence: chief complaint, visual inspection, percussion, thermal testing, and charting. The goal is to identify the one problem tooth and decide whether it can be saved before you touch an instrument.

The bottom of the module has a Diagnosis Decision Guide that sorts the common findings into four buckets — reversible pulpitis (save it), irreversible pulpitis (extract), necrotic/abscess (extract + antibiotics), and periodontal abscess (drain). Match what you see to the closest bucket.

KEY TESTThe percussion test is your most reliable single indicator. Tap several teeth and compare the patient's reaction — the one that jumps is usually the source.
MODULE 02

Local Anesthesia

Two nerve blocks cover most field dental work. The IAN block numbs the lower jaw on one side. The PSA block plus simple infiltration handles the upper teeth. The module walks each one through landmark, needle approach, aspiration, and injection.

ALWAYSAsk about anesthetic allergies before injecting, and aspirate (pull back on the plunger) before every injection. Blood in the cartridge means reposition before injecting. The module lists the toxic-reaction signs to watch for.

Standard agent is lidocaine 2% with epinephrine. The reference notes at the bottom cover dose limits, the plain-lidocaine option, what to do when a block fails, and toxic-reaction signs.

MODULE 03

Temporary Restorations

A temporary filling relieves sensitivity and stops a cavity from getting worse. The field-practical material is ZOE cement. The module covers cavity preparation (no drill needed — a spoon excavator removes soft decay), mixing the cement to the right consistency, placing and carving it, and post-op instructions.

THE BITEThe most common mistake is leaving the filling too tall. The patient must be able to close comfortably. Reduce any high spot — a high bite causes real pain.

The module also covers fractured teeth, including the difference between exposed dentin (seal it) and an exposed pulp (seal as a stopgap, plan for extraction).

MODULE 04

Abscess & Infection

This module covers recognizing an abscess, draining it, choosing an antibiotic, and — most important — spotting when an infection has become a life threat.

AIRWAY EMERGENCYDifficulty swallowing or opening the mouth, swelling spreading to the floor of the mouth or neck, or fever with a sick-looking patient means deep-space infection (Ludwig's angina). This is life-threatening. Source-tooth removal, aggressive antibiotics, and evacuation if at all possible.

For a soft, fluid-filled (fluctuant) abscess, the module gives the drainage technique: anesthetize around the infection, incise at the lowest point, irrigate, and place a drain if needed. Antibiotic selection lists amoxicillin first, clindamycin for penicillin allergy, and Augmentin for severe spread. The standing rule: antibiotics buy time; the tooth still has to come out.

MODULE 05

Extraction

Extraction is the definitive field treatment for a tooth that cannot be saved. The module opens with a pre-extraction checklist — right tooth confirmed, anesthesia confirmed, ten-minute wait, instruments laid out — then walks the procedure: luxate with the elevator, seat the forceps on the root, controlled socket-expanding movement, delivery, and socket management.

TAKE YOUR TIMEA well-loosened tooth comes out with far less force and far less risk of a broken root. Adequate anesthesia is not optional.

Post-extraction instructions for the patient and a section on dry socket round out the module. Record every extraction in the Treatment Log.

MODULE 06

Supply Planning

Dental supplies follow the same tiered logic as medical supplies. Tier 1 is personal carry (fits in an IFAK). Tier 2 is the group responder's kit. Tier 3 is the community clinic cache for extended operations. Each tier lists standard contents; below each is a notes box where you record what you actually have, gaps, and expiration dates.

Type into the notes boxes and click SAVE INVENTORY NOTES. Your notes are included when you print the Supply List or the Full Field Reference.

START HEREIf you do nothing else in IVORY, fill in your Tier 1 and Tier 2 inventory. Knowing exactly what you have — and what you are missing — is worth more than any protocol.
MODULE 07

Training Log

More than one person in your group should have basic dental skills. If the primary responder is hurt or away, someone else needs to be able to pack a socket or recognize spreading infection. Click ADD MEMBER, enter a callsign and role, and check off the skills that member has completed. Notes can record dates and source material.

The training log is group-readiness data, not patient data — it is included in the Full Field Reference binder print.

MODULE 08

Patient Records — encrypted

Module 08 keeps one record per patient, organized by name. A record holds the person's demographics, allergies, current medications, medical alerts, and a list of every visit. Open a record and all of that history is inside it.

ENCRYPTED AT RESTRecords are encrypted with AES-256-GCM and stay locked until someone enters a password. Nothing leaves this device. When you are done, press 🔒 LOCK to seal them again.

First-time setup

The first time you open Module 08 it asks the boss to create the vault: set a suite-wide Master password (8+ characters) and record the one-time recovery key it shows you — use 🔶 PRINT KEY CARD or write it down. Store that key offline; it is the only way back in if every password is lost, and it is shown only once.

You are then offered the optional JWBuild rescue choice. NO (the default) means only you can ever unlock the records. YES saves a locked rescue file on this computer only — it cannot open anything by itself, but if you ever lose both passwords and the key card, you can send it to JWBuild, verify you are the license owner, and receive a one-time unlock code. Either way, nothing is ever transmitted. Change your choice later with the 🛡 RESCUE button while the records are open.

Three ways to unlock

  • Master — the boss's suite-wide password (skeleton key).
  • Operator (Primary) — a daily password for the medic, set from inside the records with 🔑 OPERATOR PW. Optional, added after setup.
  • Recovery key — the one-time key from setup, used if the passwords are lost.

All three open the same records; setting an operator password does not re-encrypt anything, and the Master always still works.

If every password and the key card are lost

If rescue was enabled at setup, the lock screen shows 🛡 JWBUILD RESCUE (last resort). Download the rescue file, email it to JWBuild support with your WATCHMAN license key, and after identity verification you receive a one-time unlock code. Entering it opens the records once and immediately forces a new Master password and a new recovery key card — the emailed code can never open anything again, and the operator password must be set again afterward. If rescue was declined and both passwords and the key card are gone, the records are unrecoverable by design.

Name or callsign

OPSECThe identity field accepts a real name or a callsign — whichever your operational security posture calls for. The list and search work on whatever you enter.

Adding a visit

Open a patient and press + NEW VISIT. Pick the visit type first — routine exam, problem visit, follow-up, or trauma — and the form walks you through what that visit needs: structured exam findings (pain triggers, lingering pain, percussion, mobility, swelling, sinus tract), a gums and soft-tissue assessment (calculus, gum disease extent and severity, an oral-cancer soft-tissue check), diagnosis and procedure, an anesthetic safety block with pre-op vitals and a weight-based maximum-dose warning, medications, outcome, and a follow-up date that flags the patient for recall on the roster. Every patient record also carries a tap-to-chart tooth diagram (SF 603 style) that tracks the status of all 32 teeth over time. Allergies and medications are tracked at the patient level, and the app warns you if you prescribe something the patient is allergic to.

MIGRATIONAny treatment-log cases from an earlier version are folded into encrypted records automatically the first time you set up or unlock the vault — grouped by patient name, each old case becoming a visit.

Printing a record: each patient has a ⏎ PRINT button. It prints only that one patient, with allergies, medications, medical alerts, and the full visit history, formatted for that person's folder. Patient records never print in bulk and are deliberately excluded from the binder reference — one patient, one printout.

OUTPUTS

Printing — binder vs. patient files

The Print Outputs screen has four reference outputs. Click any button and your print dialog opens — pick a printer or choose Save as PDF.

  • Extraction Protocol Card — a laminate card: checklist, post-op instructions, dry-socket management.
  • Infection Alert Card — a laminate card: abscess recognition, airway warning signs, antibiotic dosing.
  • Supply List — the full tiered cache list with your inventory notes.
  • Full Field Reference (Binder) — everything in one document for your 3-ring binder.
PATIENT FILES ARE SEPARATEThe Full Field Reference and the bulk outputs never contain patient records. Patient records print one at a time, from the ⏎ PRINT button on each record in Module 08. This keeps each patient's file as its own document and avoids dumping everyone's medical history into one print job.

The Full Field Reference compiles the clinical protocols (examination, anesthesia, restorations, abscess, extraction), the tiered supply list with your notes, and the group training log — the reference material a binder should hold.

SECTION 14

Saving, backups & settings

IVORY saves your data automatically to this device's browser storage (key ao_ivory_v1). Nothing leaves the machine. There is no cloud and no account.

  • Export — on the Print Outputs screen, EXPORT ALL DATA downloads a backup file. Do this before reinstalling or clearing.
  • ImportIMPORT DATA restores from a backup file (it overwrites current data).
  • ClearCLEAR ALL DATA wipes everything on this device. It cannot be undone.
  • Theme & disclaimer — the gear (⚙) in the top bar opens suite settings, where the dark/light theme is shared across all WATCHMAN modules and the dental notice can be reset.
BACKUP HABITExport a backup after any major update to your supply notes or training log. The export file is small and easy to store with your other documents.
REFERENCE

Tooth numbering (Universal System, 1–32)

IVORY uses the standard US Universal Numbering System. Teeth are numbered 1–32 starting at the upper-right last molar, across the top to the upper-left, then down and back across the bottom. Record the number in the Treatment Log so you never confuse teeth on a return visit.

UPPER (PATIENT'S RIGHT → LEFT): 1–16 1 2 3 4 5 6 7 8  |  9 10 11 12 13 14 15 16 LOWER (PATIENT'S LEFT → RIGHT): 17–32 17 18 19 20 21 22 23 24  |  25 26 27 28 29 30 31 32 Common: #19 = lower-left first molar · #30 = lower-right first molar · #8/#9 = upper front center
Universal tooth numbering, 1–32
SECTION 16

Glossary

IAN blockInferior Alveolar Nerve block — numbs the entire lower jaw on one side plus lip and chin.
PSA blockPosterior Superior Alveolar block — numbs the upper molars.
ZOEZinc Oxide Eugenol — soothing, antibacterial dental cement used for temporary fillings; mixes and sets without power.
PulpitisInflammation of the tooth's nerve. Reversible = savable. Irreversible = the nerve is dying; the tooth will abscess.
NecroticDead pulp. The tooth no longer responds to cold and is heading toward (or already has) an abscess.
AbscessA pocket of infection at the root or in the gum. May drain through a small gum pimple (sinus tract).
FluctuantSoft and fluid-filled when pressed — pus has collected and can be drained.
CellulitisFirm, diffuse swelling with no soft spot — infection spreading through tissue. Do not incise; antibiotics first.
LuxateTo loosen a tooth in its socket with an elevator before applying forceps.
Dry socketLoss of the protective clot after extraction, exposing bone. Severe pain 3–5 days out; treated with medicated packing.
IFAKIndividual First Aid Kit — the small personal kit each person carries (your Tier 1 dental items live here).
OPSECOperational Security — keeping sensitive details (like patient identities) protected. Use callsigns in records.
SECTION 17

Common questions

Do I need a dental background to use this?

No — IVORY is written for prepared laypeople, drawing on field references like Where There Is No Dentist. But reading a protocol is not the same as practicing it. Train on the skills in calm times (Module 07 tracks who has).

Why won't all the patient records print at once?

By design. Patient records are individual files. Printing them in bulk would put everyone's medical history into one document — bad for both filing and OPSEC. Print each case from its own 🖶 PRINT button.

Where is my data stored? Is it private?

Everything is stored locally in this device's browser storage and nothing is uploaded. Patient records (Module 08) go a step further: they are encrypted with AES-256-GCM and stay locked behind a password. Export a backup file to move the rest of your data or keep a copy.

The print dialog opened a blank or blocked window.

Allow pop-ups for this page. The print outputs open in a new window that triggers your print dialog. If it is blocked, your browser will show a pop-up notice you can approve.

Can I change the theme or colors?

The dark/light theme is shared suite-wide: change it once in the gear (⚙) settings and every WATCHMAN module follows. The dental protocols themselves are fixed reference content and do not change with the theme.

REMEMBERIVORY is a reference and a record. It is not a dentist, and it does not replace training or professional care. Use it when there is no other option.
SECTION 18

Demo sandbox

IVORY ships with a demo sandbox — a separate copy pre-loaded with a worked example: a stocked three-tier supply inventory with noted gaps, two trainees at different skill levels, and a treatment log with three cases (an extraction, a temporary restoration, and an abscess drainage still marked ongoing).

Opening and leaving. In the live module, click DEMO in the sidebar under this manual. Inside the demo, that same slot reads RETURN TO LIVE and takes you back. The amber DEMO BUILD badge in the top bar tells you which copy you are in.

Your real data is safe. The demo keeps everything in separate storage slots, including its own encrypted patient records vault, its own rescue file, and its own auto-lock timer. Nothing you do in the demo — adding patients, setting passwords, enabling rescue, clearing data — can touch your real records.

Practice the encryption ceremony. The demo is the safe place to walk through the full Module 08 setup: master password, the recovery key card, and the optional JWBuild rescue choice. Do it once in the demo before doing it for real. A rescue file downloaded from the demo is named with DEMO so it can never be mistaken for a real rescue request.

Resetting. The ⟲ RESET DEMO button in the top bar wipes all demo data — including any password you set in the demo — and restores the clean sample sandbox.

WATCHMAN:IVORY
FIELD DENTISTRY  ·  GRID DOWN READY  ·  MODULE 10

User Manual

Plain-language guide. No dental background needed to read it.
IVORY is a reference and record-keeping tool, not a dentist. Read this once, then keep the printed Field Reference in your binder.

This manual assumes you have never opened IVORY before. It explains every screen in order. Work through it the first time, then use the table of contents to jump to what you need. Hover any underlined term on screen for its meaning.

READ FIRSTIVORY contains procedures — anesthesia, drainage, extraction — intended only for prolonged grid-down situations when no dentist is reachable. If professional dental care is available, use it. Nothing here replaces training or a licensed provider.
CONTENTS

What's in here

SECTION 1

What IVORY is for

IVORY does two jobs. First, it is a field reference: step-by-step protocols for the dental emergencies most likely to take a group member out of action when no dentist is available — a raging toothache, a broken tooth, an abscess, a tooth that has to come out. Second, it is a record keeper: it tracks your dental supplies, who in your group has been trained, and a log of every procedure performed.

The program covers, in order:

  • Diagnosis — figuring out which tooth is the problem and whether it can be saved.
  • Pain control — the two nerve blocks that cover most field procedures.
  • Treatment — temporary fillings, draining infection, and extraction when there is no other option.
  • Logistics — what to stock, who to train, and a record of what you have done.
PLAIN VERSIONIVORY turns "someone has a horrible toothache and there is no dentist" into a clear sequence: identify the tooth, control the pain, treat or remove, and write it down.
SECTION 2

The one rule that matters

Everything in IVORY is for austere conditions only — a long grid-down event where a dentist and a real clinic are simply not reachable. The first time you open the module, a notice appears. Type your name or callsign, check the box, and acknowledge it. That acknowledgment is stamped with the date and time and shown in the footer.

WHY THE NOTICEIt is not legal theater. It is a reminder that these are last-resort procedures. A wrong extraction is far worse than the toothache you started with. If care is available, get it.

You can re-show or reset the notice later. See Saving, backups & settings.

SECTION 3

What's on your screen

The screen has three fixed parts and one big working area. The left sidebar is your menu. The top bar shows the module name and the way back to the Command Suite. The main area in the middle is whatever module you have open. The footer shows your acknowledgment.

WATCHMAN : IVORY COMMAND SUITE MODULES 01 EXAMINATION 02 ANESTHESIA 03 RESTORATIONS 04 ABSCESS 05 EXTRACTION 06 SUPPLY 07 TRAINING RECORDS 08 TREATMENT LOG OUTPUTS / HELP ■ PRINT OUTPUTS ? USER MANUAL MODULE 01 · IVORY EXAMINATION & DIAGNOSIS The middle area shows whatever module is selected on the left. STEP / CARD STEP / CARD
The IVORY screen: top bar, left menu, main work area

To move around, click an item in the left menu. The open module is highlighted in green. Most reference modules (01–05) are read-only protocols. The records modules (06–08) and the outputs have buttons that save your data or print.

SECTION 4

Your first 15 minutes

You do not have to set anything up to use IVORY as a reference — the protocols are ready immediately. But fifteen minutes now makes it far more useful in a crisis.

  1. Read Module 01 (Examination) once, start to finish. It is the foundation — treating the wrong tooth wastes supplies and patient tolerance.
  2. Open Module 06 (Supply Planning) and write down what you actually have in each tier. Note expiration dates. This is the single most valuable thing you can do today.
  3. Open Module 07 (Training Log) and add the people in your group. Check off any dental skills they already have.
  4. Go to Print Outputs and print the Full Field Reference for your binder, plus the laminate cards for your kit.
  5. That is it. When a real problem appears, you open the matching module and follow the steps.
DO IT NOWPrint the cards while you have power and a printer. A laminated card in the kit works when the device is dead.
MODULE 01

Examination & Diagnosis

This module is the examination sequence: chief complaint, visual inspection, percussion, thermal testing, and charting. The goal is to identify the one problem tooth and decide whether it can be saved before you touch an instrument.

The bottom of the module has a Diagnosis Decision Guide that sorts the common findings into four buckets — reversible pulpitis (save it), irreversible pulpitis (extract), necrotic/abscess (extract + antibiotics), and periodontal abscess (drain). Match what you see to the closest bucket.

KEY TESTThe percussion test is your most reliable single indicator. Tap several teeth and compare the patient's reaction — the one that jumps is usually the source.
MODULE 02

Local Anesthesia

Two nerve blocks cover most field dental work. The IAN block numbs the lower jaw on one side. The PSA block plus simple infiltration handles the upper teeth. The module walks each one through landmark, needle approach, aspiration, and injection.

ALWAYSAsk about anesthetic allergies before injecting, and aspirate (pull back on the plunger) before every injection. Blood in the cartridge means reposition before injecting. The module lists the toxic-reaction signs to watch for.

Standard agent is lidocaine 2% with epinephrine. The reference notes at the bottom cover dose limits, the plain-lidocaine option, what to do when a block fails, and toxic-reaction signs.

MODULE 03

Temporary Restorations

A temporary filling relieves sensitivity and stops a cavity from getting worse. The field-practical material is ZOE cement. The module covers cavity preparation (no drill needed — a spoon excavator removes soft decay), mixing the cement to the right consistency, placing and carving it, and post-op instructions.

THE BITEThe most common mistake is leaving the filling too tall. The patient must be able to close comfortably. Reduce any high spot — a high bite causes real pain.

The module also covers fractured teeth, including the difference between exposed dentin (seal it) and an exposed pulp (seal as a stopgap, plan for extraction).

MODULE 04

Abscess & Infection

This module covers recognizing an abscess, draining it, choosing an antibiotic, and — most important — spotting when an infection has become a life threat.

AIRWAY EMERGENCYDifficulty swallowing or opening the mouth, swelling spreading to the floor of the mouth or neck, or fever with a sick-looking patient means deep-space infection (Ludwig's angina). This is life-threatening. Source-tooth removal, aggressive antibiotics, and evacuation if at all possible.

For a soft, fluid-filled (fluctuant) abscess, the module gives the drainage technique: anesthetize around the infection, incise at the lowest point, irrigate, and place a drain if needed. Antibiotic selection lists amoxicillin first, clindamycin for penicillin allergy, and Augmentin for severe spread. The standing rule: antibiotics buy time; the tooth still has to come out.

MODULE 05

Extraction

Extraction is the definitive field treatment for a tooth that cannot be saved. The module opens with a pre-extraction checklist — right tooth confirmed, anesthesia confirmed, ten-minute wait, instruments laid out — then walks the procedure: luxate with the elevator, seat the forceps on the root, controlled socket-expanding movement, delivery, and socket management.

TAKE YOUR TIMEA well-loosened tooth comes out with far less force and far less risk of a broken root. Adequate anesthesia is not optional.

Post-extraction instructions for the patient and a section on dry socket round out the module. Record every extraction in the Treatment Log.

MODULE 06

Supply Planning

Dental supplies follow the same tiered logic as medical supplies. Tier 1 is personal carry (fits in an IFAK). Tier 2 is the group responder's kit. Tier 3 is the community clinic cache for extended operations. Each tier lists standard contents; below each is a notes box where you record what you actually have, gaps, and expiration dates.

Type into the notes boxes and click SAVE INVENTORY NOTES. Your notes are included when you print the Supply List or the Full Field Reference.

START HEREIf you do nothing else in IVORY, fill in your Tier 1 and Tier 2 inventory. Knowing exactly what you have — and what you are missing — is worth more than any protocol.
MODULE 07

Training Log

More than one person in your group should have basic dental skills. If the primary responder is hurt or away, someone else needs to be able to pack a socket or recognize spreading infection. Click ADD MEMBER, enter a callsign and role, and check off the skills that member has completed. Notes can record dates and source material.

The training log is group-readiness data, not patient data — it is included in the Full Field Reference binder print.

MODULE 08

Patient Records — encrypted

Module 08 keeps one record per patient, organized by name. A record holds the person's demographics, allergies, current medications, medical alerts, and a list of every visit. Open a record and all of that history is inside it.

ENCRYPTED AT RESTRecords are encrypted with AES-256-GCM and stay locked until someone enters a password. Nothing leaves this device. When you are done, press 🔒 LOCK to seal them again.

First-time setup

The first time you open Module 08 it asks the boss to create the vault: set a suite-wide Master password (8+ characters) and record the one-time recovery key it shows you — use 🔶 PRINT KEY CARD or write it down. Store that key offline; it is the only way back in if every password is lost, and it is shown only once.

You are then offered the optional JWBuild rescue choice. NO (the default) means only you can ever unlock the records. YES saves a locked rescue file on this computer only — it cannot open anything by itself, but if you ever lose both passwords and the key card, you can send it to JWBuild, verify you are the license owner, and receive a one-time unlock code. Either way, nothing is ever transmitted. Change your choice later with the 🛡 RESCUE button while the records are open.

Three ways to unlock

  • Master — the boss's suite-wide password (skeleton key).
  • Operator (Primary) — a daily password for the medic, set from inside the records with 🔑 OPERATOR PW. Optional, added after setup.
  • Recovery key — the one-time key from setup, used if the passwords are lost.

All three open the same records; setting an operator password does not re-encrypt anything, and the Master always still works.

If every password and the key card are lost

If rescue was enabled at setup, the lock screen shows 🛡 JWBUILD RESCUE (last resort). Download the rescue file, email it to JWBuild support with your WATCHMAN license key, and after identity verification you receive a one-time unlock code. Entering it opens the records once and immediately forces a new Master password and a new recovery key card — the emailed code can never open anything again, and the operator password must be set again afterward. If rescue was declined and both passwords and the key card are gone, the records are unrecoverable by design.

Name or callsign

OPSECThe identity field accepts a real name or a callsign — whichever your operational security posture calls for. The list and search work on whatever you enter.

Adding a visit

Open a patient and press + NEW VISIT. Pick the visit type first — routine exam, problem visit, follow-up, or trauma — and the form walks you through what that visit needs: structured exam findings (pain triggers, lingering pain, percussion, mobility, swelling, sinus tract), a gums and soft-tissue assessment (calculus, gum disease extent and severity, an oral-cancer soft-tissue check), diagnosis and procedure, an anesthetic safety block with pre-op vitals and a weight-based maximum-dose warning, medications, outcome, and a follow-up date that flags the patient for recall on the roster. Every patient record also carries a tap-to-chart tooth diagram (SF 603 style) that tracks the status of all 32 teeth over time. Allergies and medications are tracked at the patient level, and the app warns you if you prescribe something the patient is allergic to.

MIGRATIONAny treatment-log cases from an earlier version are folded into encrypted records automatically the first time you set up or unlock the vault — grouped by patient name, each old case becoming a visit.

Printing a record: each patient has a ⏎ PRINT button. It prints only that one patient, with allergies, medications, medical alerts, and the full visit history, formatted for that person's folder. Patient records never print in bulk and are deliberately excluded from the binder reference — one patient, one printout.

OUTPUTS

Printing — binder vs. patient files

The Print Outputs screen has four reference outputs. Click any button and your print dialog opens — pick a printer or choose Save as PDF.

  • Extraction Protocol Card — a laminate card: checklist, post-op instructions, dry-socket management.
  • Infection Alert Card — a laminate card: abscess recognition, airway warning signs, antibiotic dosing.
  • Supply List — the full tiered cache list with your inventory notes.
  • Full Field Reference (Binder) — everything in one document for your 3-ring binder.
PATIENT FILES ARE SEPARATEThe Full Field Reference and the bulk outputs never contain patient records. Patient records print one at a time, from the ⏎ PRINT button on each record in Module 08. This keeps each patient's file as its own document and avoids dumping everyone's medical history into one print job.

The Full Field Reference compiles the clinical protocols (examination, anesthesia, restorations, abscess, extraction), the tiered supply list with your notes, and the group training log — the reference material a binder should hold.

SECTION 14

Saving, backups & settings

IVORY saves your data automatically to this device's browser storage (key ao_ivory_v1). Nothing leaves the machine. There is no cloud and no account.

  • Export — on the Print Outputs screen, EXPORT ALL DATA downloads a backup file. Do this before reinstalling or clearing.
  • ImportIMPORT DATA restores from a backup file (it overwrites current data).
  • ClearCLEAR ALL DATA wipes everything on this device. It cannot be undone.
  • Theme & disclaimer — the gear (⚙) in the top bar opens suite settings, where the dark/light theme is shared across all WATCHMAN modules and the dental notice can be reset.
BACKUP HABITExport a backup after any major update to your supply notes or training log. The export file is small and easy to store with your other documents.
REFERENCE

Tooth numbering (Universal System, 1–32)

IVORY uses the standard US Universal Numbering System. Teeth are numbered 1–32 starting at the upper-right last molar, across the top to the upper-left, then down and back across the bottom. Record the number in the Treatment Log so you never confuse teeth on a return visit.

UPPER (PATIENT'S RIGHT → LEFT): 1–16 1 2 3 4 5 6 7 8  |  9 10 11 12 13 14 15 16 LOWER (PATIENT'S LEFT → RIGHT): 17–32 17 18 19 20 21 22 23 24  |  25 26 27 28 29 30 31 32 Common: #19 = lower-left first molar · #30 = lower-right first molar · #8/#9 = upper front center
Universal tooth numbering, 1–32
SECTION 16

Glossary

IAN blockInferior Alveolar Nerve block — numbs the entire lower jaw on one side plus lip and chin.
PSA blockPosterior Superior Alveolar block — numbs the upper molars.
ZOEZinc Oxide Eugenol — soothing, antibacterial dental cement used for temporary fillings; mixes and sets without power.
PulpitisInflammation of the tooth's nerve. Reversible = savable. Irreversible = the nerve is dying; the tooth will abscess.
NecroticDead pulp. The tooth no longer responds to cold and is heading toward (or already has) an abscess.
AbscessA pocket of infection at the root or in the gum. May drain through a small gum pimple (sinus tract).
FluctuantSoft and fluid-filled when pressed — pus has collected and can be drained.
CellulitisFirm, diffuse swelling with no soft spot — infection spreading through tissue. Do not incise; antibiotics first.
LuxateTo loosen a tooth in its socket with an elevator before applying forceps.
Dry socketLoss of the protective clot after extraction, exposing bone. Severe pain 3–5 days out; treated with medicated packing.
IFAKIndividual First Aid Kit — the small personal kit each person carries (your Tier 1 dental items live here).
OPSECOperational Security — keeping sensitive details (like patient identities) protected. Use callsigns in records.
SECTION 17

Common questions

Do I need a dental background to use this?

No — IVORY is written for prepared laypeople, drawing on field references like Where There Is No Dentist. But reading a protocol is not the same as practicing it. Train on the skills in calm times (Module 07 tracks who has).

Why won't all the patient records print at once?

By design. Patient records are individual files. Printing them in bulk would put everyone's medical history into one document — bad for both filing and OPSEC. Print each case from its own 🖶 PRINT button.

Where is my data stored? Is it private?

Everything is stored locally in this device's browser storage and nothing is uploaded. Patient records (Module 08) go a step further: they are encrypted with AES-256-GCM and stay locked behind a password. Export a backup file to move the rest of your data or keep a copy.

The print dialog opened a blank or blocked window.

Allow pop-ups for this page. The print outputs open in a new window that triggers your print dialog. If it is blocked, your browser will show a pop-up notice you can approve.

Can I change the theme or colors?

The dark/light theme is shared suite-wide: change it once in the gear (⚙) settings and every WATCHMAN module follows. The dental protocols themselves are fixed reference content and do not change with the theme.

REMEMBERIVORY is a reference and a record. It is not a dentist, and it does not replace training or professional care. Use it when there is no other option.
SECTION 18

Demo sandbox

IVORY ships with a demo sandbox — a separate copy pre-loaded with a worked example: a stocked three-tier supply inventory with noted gaps, two trainees at different skill levels, and a treatment log with three cases (an extraction, a temporary restoration, and an abscess drainage still marked ongoing).

Opening and leaving. In the live module, click DEMO in the sidebar under this manual. Inside the demo, that same slot reads RETURN TO LIVE and takes you back. The amber DEMO BUILD badge in the top bar tells you which copy you are in.

Your real data is safe. The demo keeps everything in separate storage slots, including its own encrypted patient records vault, its own rescue file, and its own auto-lock timer. Nothing you do in the demo — adding patients, setting passwords, enabling rescue, clearing data — can touch your real records.

Practice the encryption ceremony. The demo is the safe place to walk through the full Module 08 setup: master password, the recovery key card, and the optional JWBuild rescue choice. Do it once in the demo before doing it for real. A rescue file downloaded from the demo is named with DEMO so it can never be mistaken for a real rescue request.

Resetting. The ⟲ RESET DEMO button in the top bar wipes all demo data — including any password you set in the demo — and restores the clean sample sandbox.

🦷
IVORY — DENTAL NOTICE
Read before using this module
For Austere Environments Only

IVORY contains protocols for field dental care including tooth extraction, abscess drainage, local anesthesia, and temporary restorations. This information is intended exclusively for use in prolonged grid-down or austere emergency scenarios where a licensed dentist and modern dental facilities are unavailable. It is not a substitute for professional dental training or licensed dental care.

No Professional Relationship

This module does not constitute dental or medical advice, diagnosis, or treatment. No provider-patient relationship is created by its use. The information presented is drawn from field medicine references and is intended for prepared laypeople — not as a substitute for licensed professional care. If professional care is available, seek it.

You Are Responsible

The decisions you make and the actions you take are entirely your own. WATCHMAN, its authors, and its developers accept no liability for outcomes resulting from the application of any information contained in this module.

Operator Acknowledgment
Enter your name or callsign. Your acknowledgment will be recorded with the current date and time.