Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

BS VI, Module III > 5. Oral Dental Considerations > Flashcards

5. Oral Dental Considerations Flashcards

1
Q

Growth hormone deficiency – Oral Manifestations

  • Overall ____ stature
  • Body proportions normal
  • Smaller maxilla and mandible
  • ____ tooth eruption
  • Delayed shedding of deciduous teeth
  • Delayed development of permanent teeth ____
  • General lack of ____ molar development
  • Reduced ____ of teeth (proportional)
A 
short
delayed
roots
third
size
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Growth hormone excess – Oral Manifestations

Gigantism (childhood)
• Abnormally \_\_\_\_
• Enlargement of facial soft tissues
• Enlargement of \_\_\_\_ bones 
• \_\_\_\_
Acromegaly (Adult)
• Enlargement of \_\_\_\_ tissues • Coarsening of soft tissues
• Mandibular \_\_\_\_
• Increased dental spacing
• \_\_\_\_
• Macroglossia
A

tall
maxillofacial
macrodontia

bony
prognathism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Hypothyroidism – Oral Manifestations

  • Cretinism (childhood); Myxedema (adult)
  • ____ swelling
  • Lip thickening
  • Association with ____
  • Macroglossia
  • ____
  • Tooth eruption delay / failure
  • Tooth ____ not impaired
  • Association with oral l____
A 
facial
lingual thyroid
dysgeusia
development
lichen planus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Hyperthyroidism – Oral Manifestations

  • Increased risk of ____
  • Rapid development of periodontal disease
  • Increased risk of ____
  • Accelerated development of jaws and teeth
  • Premature loss of ____
A

osteoporosis
dental caries
deciduous teeth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Hyperparathyroidism – Oral Manifestations

  • Osseous changes
  • Loss of ____
  • ____ pattern alterations
  • “____” appearance
  • Unilocular or multilocular radiolucencies of mandible
  • ____ tumor
  • Alteration of maxillofacial bones
  • Associated with ____
A

dental lamina dura
trabecular
ground glass

brown
CRD/ESRD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Thyroid disorders – Dental Management

  • Thorough baseline ____ history
  • Diagnosis / management of condition to date
  • Review of systems
  • ____ of diagnosed disease
  • Recognition of undiagnosed disease
  • Need for medical consultation / referral

• Update ____ history at each visit

A

medical
stability
medical

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

ypothyroidism – Dental Management

• No ____ to dental treatment in patients with stable disease

  • CNS depressants, sedatives or narcotic analgesics
  • Exaggerated ____ in hypothyroid patients
  • ____ dose in mild disease
  • ____ in patients with severe disease
A

contraindications
response
reduced
contraindicated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Hyperthyroidism – Dental Management

• No ____ to dental treatment in patients with stable disease

  • Anti-thyroid medication may cause ____ suppression
  • Consider laboratory assessment
  • Poorly-controlled or undiagnosed disease
  • Defer ____ dental treatment until stable (preferred)
  • Dental treatment / oral infection can precipitate ____ crisis
  • Avoid use of ____
  • ____-reduction protocols
A 
contraindications
bone marrow
elective
thyrotoxic
epinephrine
stress
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Stress – Reduction Protocol

  • Recognition of ____ risk and anxiety
  • Medical ____
  • Consider ____
  • ____ scheduling
  • Minimize ____ time
  • ____ signs
  • ____ of dental treatment
  • ____ control
A

medical
consultation
premedication
appointment

waiting
vital
duration
pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Thyroid cancer – Dental Management

  • Management
  • Surgery
  • Ablative ____ iodine therapy (I131)
  • External radiation / chemotherapy – rare
  • Establish optimal oral ____ prior to treatment
  • Frequent recalls
  • Radioactive iodine therapy
  • ____ gland complications
  • Oral pain
  • ____
A

radioactive
hygiene
salivary
dysgeusia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Diabetes mellitus – Oral Manifestations

  • ____
  • Increased incidence / severity of caries
  • ____
  • Oral burning / Glossodynia
  • ____
  • Oral mucosal lesions
  • ____ complications • Altered wound healing
A

xerostomia
candidiasis
lichen planus
salivary gland

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Periodontal Health and DM

• DM considered a risk factor for prevalence and severity of ____ disease

  • Degree of glycemic control
  • Increased levels of ____
  • Attachment loss
  • Progressive destructive ____
  • Alteration in wound healing
  • ↑ risk of periodontal ____ formation
A

periodontal

gingivitis
periodontitis
abscess

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Periodontal Health and DM

  • Periodontal infection may adversely affect ____ control
  • Periodontitis may be associated with increased risk of developing ____ and macrovascular disease
  • Aggressive periodontal treatment may positively affects glycemic control
A

glycemic

nephropathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

DM – Dental Management

  • Thorough baseline medical history
  • Diagnosis / management of condition to date
  • Review of systems
  • Stability of ____ disease
  • Recognition of ____ disease
  • Need for ____ consultation / referral

• Update medical history at each visit

A

diagnosed
undiagnosed
medical

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Physician consultation / referral
• Patient presents with signs / symptoms of undiagnosed disease

  • Patient with known DM
  • Patient exhibits poor ____ control
  • BG values > ____ mg/dl
  • Extensive dental treatment and/or acute infection which may limit ____ intake necessitating altering ____ dose
A

diabetic
400
caloric
insulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Before Dental Treatment

• Determine ____ control (HbA1c)

  • Antibiotic prophylaxis?
  • Lack of evidence-based ____
  • ____ AM appointments
  • 1.5 - 3 hours after breakfast / insulin

• Avoid elective dental treatment with BG > ____ mg/dl • Have glucose source available

A

glycemic
recommendations

short
400

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

During Dental Treatment

  • Limit ____ in poorly-controlled diabetics to minimize ↑ in blood glucose levels
  • Keep glucose ____ available
  • Recognize ____ and symptoms of hyper- and hypoglycemia
A

epinephrine
source
signs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

After Dental Treatment
• Adjust insulin dose according to ability to maintain ____ intake
• Avoid ____
• Post-____ antibiotics when appropriate

A

caloric
glucocorticosteroids
operative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Adrenal disorders – Oral Manifestations

• ____ disease

  • Oral hypermelanosis
  • ____ pigmentation
  • Diffuse / patchy
  • Hyperpigmentation of the skin
  • ____
  • ____ syndrome
  • ____ tissue deposition in facial area

• Rounded facial appearance
“____”

> >

____ changes to bone

A

addison
brown
bronzing

cushing
fatty
moon facies

osteoporotic

20
Q

Adrenal disorders – Dental Management

  • Thorough baseline medical history
  • Diagnosis / management of condition to date
  • Review of systems
  • ____ of diagnosed disease
  • Recognition of undiagnosed disease
  • Need for medical consultation / referral
  • Update medical history at each visit
A

stability

21
Q

Adrenal Disorders – Dental Management

  • ____ insufficiency
  • ____-reduction protocols
  • Avoid ____ / NSAIDs if GI ulcers present
  • Determine need for steroid supplementation
  • Risk of adrenal crisis
  • ____

• ____ syndrome

• Adverse effects associated with secondary
diseases
• ____, HTN, CVD, ____, Psych
• Monitor VS

• Delayed wound healing

  • Increased risk of infection
  • Consider use of ____
A

adrenal
stress
ASA
rare

cushing
DM
osteo

antibiotics

ASA

22
Q

The physiology of pregnancy
• Endocrine changes are the most significant alterations during pregnancy
• ____ fold increase in estrogen levels
• ____ fold increase in progesterone levels
• Changes occur due to
• Increasing maternal and fetal requirements for growth • Preparation of mother for delivery

A

10

30

23
Q

Overall changes

1st Trimester (conception–13th week)
• ____
• Tendency for syncopal episodes
• Tendency for ____ and vomiting

2nd Trimester (14th – 27th week) • Relatively \_\_\_\_ symptoms
• General sense of well-being

3rd Trimester (28th week – childbirth) • Increasing ____
• Increasing discomfort
• Mild ____ may be evident

A 
fatigue
nausea
few
fatigue
medpression
24
Q

Cardiovascular changes
• ____ in total blood volume (TBV)
• ____ in cardiac output (CO)
• ____ in stroke volume (SV)
• The combination of increased CO and SV can produce a functional ____ in 90% of females
• These murmurs typically disappear after delivery
• ____ in blood pressure during 2nd trimester with return to ____ in 3rd trimester

A 
increase
increase
increase
murmur
decrease
baseline
25
Q

Supine Hypotensive Syndrome

  • Affects up to 8% of ____
  • Mainly after ____ trimester
  • When in supine position, there is compression of the ____ by the fetus
  • Results in impaired venous return to the heart
  • Symptoms
  • ____
  • Bradycardia
  • ____
  • Nausea
  • Dizziness
  • ____
  • Roll the patient on to her ____ side • Lifts uterus off the ____ • Rapid return to normal
A

females
second
IVC

hypotension
sweating
left
IVC

26
Q

Hematologic changes

  • Increased ____ count
  • Increase in ____ volume
  • Plasma volume is increased disproportionately to erythrocyte volume and creates a ____ anemia
  • 20% of females develop ____ anemia
  • Decreased levels of ____ seen
  • Additional iron and folate required
  • Clotting factors ____ are increased

• Anti-clotting factors ____ are
decreased
• Pregnant female is considered “____”
• Increased risk for ____

A

WBC
erythrocyte
physiologic

iron-deficiency
hemoglobin

VII-X
XI and XIII

hypercoagulable
thromboembolism

27
Q

Gastrointestinal changes

  • ____ and vomiting
  • 66% of females
  • Starts ____ weeks after last menstrual cycle
  • Peaks between ____weeks
  • Symptoms gradually decline for most females
  • May continue throughout pregnancy
  • Likely due to ____ alterations
  • Increased risk of dental erosion
  • Pyrosis
  • ____
  • Up to 50% of females
  • Due to
  • enlarging ____
  • slow rate of ____
  • decreased resting pressure of ____ sphincter
  • Increased ____
  • Cravings for unusual foods
A

nausea
5
8-12
hormonal

heartburn
fetus
lower gastroesophageal
appetite

28
Q

Gestational Diabetes

  • Occurs in 5% of pregnancies
  • Increased risk with maternal ____ / advancing age
  • Progressive maternal ____ to insulin
  • Maternal hyperglycemia→fetal ____
  • Normoglycemic state returns s/p ____
  • Increased risk of developing:
  • ____ (maternal / fetal)
  • ____ (maternal / fetal)
  • ____ disease (maternal)
  • ____ (fetal)
A

obesity
insensitivity
hyperinsulinemia
parturition

type 2 DM
metabolic syndrome
cardiovascular
obesity

29
Q

Oral and facial changes

• ____
• Results from an enhanced inflammatory response to local irritants due to elevated
hormone levels

  • Usually affects the ____ and interdental gingiva
  • Usually begins during ____ month of pregnancy
  • Most common oral complication of ____
  • Pregnancy does not cause ____ disease but may cause an existing condition to worsen
  • Possible association between periodontal disease and risk of ____ birth and ____ birth weight
A

pregnancy gingivitis

marginal
second
pregnancy
periodontal
preterm
low
30
Q
  • Pregnancy ____ (epulis gravidarum)
  • AKA “pregnancy tumor”
  • Etiology
  • Increased ____ coupled with local factors (i.e. plaque)
  • Primarily on ____ aspect of interdental papilla
  • Most common in first ____ and during ____ trimesters
A 
granuloma
angiogenesis
labial
pregnancies
first and second
31
Q
  • Melasma
  • “Mask of Pregnancy”
  • Increase in facial ____ appearing as bilateral brown patches on the face
  • Usually appears during ____ trimester
  • Observed in approx. 75% of pregnant females • Usually ____ after giving birth
A

paigmentation
first
resolves

32
Q

When to Consult with Prenatal Health Care Professional?

  • If ____ conditions are present that could affect management of the patient (i.e. diabetes, hypertension, pulmonary or cardiac disease and bleeding disorders)
  • If considering use of ____ sedation or general anesthesia
  • If considering the use of ____ as an adjunct to local anesthesia

Otherwise, consensus guidelines state that dental care can be ____ delivered during all trimesters of pregnancy

A

comorbid
intravenous sedation
nitrous oxide

33
Q

Radiographs

  • Dental radiographs may be ____ during pregnancy because radiation exposure to the fetus in utero is negligible
  • Fetal dose of radiation when completing a full mouth series using D speed film is equivalent to less than ____ hours of average daily background radiation in the U.S.
A

prescribed

2.5

34
Q
  • Minimize radiation exposure to mother and fetus via:
  • Using ____ x-rays instead of panoramic radiographs when appropriate (to minimize total radiation dose)
  • Using____ films (____ speed) or ____ radiography
  • Use of ____ collimation
  • Use of a properly ____ beam
  • Use of a ____ collar and lead apron over the abdomen
A

bitewing
high-speed
E
digital

rectangular
collimated
thyroid

35
Q

Drug Administration

  • Easy transfer of free (unbound) drug across the placenta exposing the fetus to the drug
  • Due to changes in drug metabolism and bioavailability in pregnant females
  • Caution must be used when prescribing drugs to pregnant females
  • Use only if expected ____ to mother > potential risks to fetus
  • Most drugs are excreted in ____ • Exposes newborn to the drug
A

benefits

breast milk

36
Q

U.S. FDA Guidelines
• Categorization of prescription drugs for pregnancy based on their potential risk of fetal injury
• Drugs in category____ are preferable for prescribing
• Drugs in category ____ typically present the most difficulty for the health care providers in terms of therapeutic and medicolegal decisions

A

A or B

C

37
Q
  • Category A—Controlled human studies indicate no apparent ____ to the fetus. The possibility of risk to the fetus is remote.
  • Category B—Animal studies do not indicate fetal ____. Well- controlled human studies have failed to demonstrate a risk.
  • Category C—Animal studies show an ____ effect on the fetus but there are no controlled studies in ____. The benefits from use of such drugs may be acceptable.
  • Category D—Evidence of ____ risk, but in certain circumstances the use of such a drug may be ____ in pregnant women despite its potential risk.
  • Category X—Risk of use in pregnant women clearly ____ possible benefits.
A 
risk
risk
adverse
humans
human
acceptable
outweighs
38
Q

Analgesics

  • Acetaminophen
  • Category ____
  • Most commonly used ____ to be used during pregnancy
  • ____ secretion in breast milk
  • Aspirin
  • Category ____
  • Prostaglandin inhibitor
  • Known to cause constriction of ____
  • ____ in breast milk
  • Ibuprofen
  • Category ____ in 1st and 2nd Trimester, Category ____ in 3rd Trimester
  • Similar to aspirin effects
  • ____ secretion in breast milk (less than aspirin)
A

B
analgesic
limited

D
ductus arteriosus
secreted

B
D
limited

39
Q

Local Anesthetics
• Lidocaine
• Category ____
• Safe to use for pregnant patients

  • Mepivicaine, bupivicaine, and articaine
  • Category ____

• Epinephrine use is considered to be ____ during pregnancy

A

B
C
safe

40
Q

Antibiotics / Antifungals

  • Penicillins and cephalosporins
  • Category ____
  • First choice for ____ infections
  • Safe when used in pregnancy
  • Clindamycin
  • Category ____
  • Recommended for pregnant patients with ____ allergy
  • Nystatin (antifungal)
  • Category ____
A

B
oro-facial

B
penicillin
B

41
Q

Oral Hygiene

  • Educate patient regarding importance of oral ____ during pregnancy
  • Maintain ____ / flossing regimen as per dental team recommendations
  • Rinse daily with over-the-counter ____, alcohol-free mouthrinse
  • After eating, chew ____-containing gum (↓ bacteria that can cause tooth decay)
  • After vomiting, rinse mouth with ____ (and 1 tsp of baking soda, if available)
  • (↓ acid that can affect tooth structure)
A 
hygiene
brushing
fluoridated
xylitol
water
42
Q

1st Trimester – Clinical Management
• Emphasize importance of ____
• Dental treatment may be provided on an as-needed basis
• Radiographs may be prescribed ____
• Patient may be ____ due to nausea and vomiting during 1st trimester

A

oral hygiene
selectively
uncomfortable

43
Q

2nd Trimester – Clinical Management

  • Emphasize importance of oral hygiene
  • Dental treatment may be provided on an as-needed basis
  • Radiographs may be prescribed selectively
  • Patients typically have ____ overall discomfort during the 2nd trimester
A

less

44
Q

3rd Trimester – Clinical Management
• Emphasize importance of oral hygiene
• Dental treatment may be provided on an as-needed basis • Radiographs may be prescribed selectively
• ____ dental appointments should be considered with appropriate positioning while in the chair
• Promote patient comfort
• Minimize risk of supine hypotensive syndrome

A

short

45
Q

Postpartum – Clinical Management

  • Return to routine oral hygiene regiment
  • Return to routine dental care recommendations
  • Monitor for resolution of any oral changes that may have occurred during pregnancy
  • Appropriate use of ____ in patients who are nursing
A

medications

BS VI, Module III (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions