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Clinical Dental Hygiene II > Chapter 34- Tobacco > Flashcards

Chapter 34- Tobacco Flashcards

Tobacco

1
Q

True or False: Advice from health professionals has been shown to be a great influence on patients decisions to stop or not begin using tobacco.

A

TRUE

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2
Q

What are the health hazards of tobacco?

A
  • Toxic to humans
  • Life expectancy is shortened
  • Women at the same risk as men (smokers or ETS, environmental tobacco smoking)
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3
Q

What is the single most preventable cause of death in the world?

A

tobacco

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4
Q

What percent of adults use some sort of tobacco?

A

25%

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5
Q

What drug is most addictive in tobacco?

A

Nicotine

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6
Q

Once tobacco is ignited, what does it put into the air?

A

Carcinogens (ETS)

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7
Q

True or False? Tobacco products contain 7,357 chemicals; over 90 of these are hazardous FDA.

A

True

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8
Q

What is the metabolism, of nicotine?

A

Occurs thru lungs, skin, oral, buccal, nasal mucosa, and GI tract

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9
Q

Nicotine enters the lungs quickly and passes into circulation by the blood vessels lining the what?

A

BRONCHI

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10
Q

Smoking: DISTRIBUTION

A

Nicotine is delivered to the brain by the bloodstream in less than 20 seconds

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11
Q

How many carcinogens are in smokeless tobacco?

A

28

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12
Q

Is nicotine directly absorbed through the gingiva and oral mucous membranes?

A

YES

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13
Q

True or False:
Once smokeless tobacco is placed in the mouth, the amount of nicotine absorbed is two to three times the amount delivered by a cigarette

A

TRUE

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14
Q

Do electronic cigarettes contain tobacco?

A

no, but they deliver vaporized nicotine

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15
Q

Has the FDA approved electronic cigarettes safety or effectiveness?

A

nope

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16
Q

Smoking and the development of atherosclerosis, is a major risk factor for what?

A

heart disease

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17
Q

What is the major cause of COPD, including emphysema and chronic bronchitis?

A

smoking

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18
Q

What percent of smoking is responsible for lung cancers in the U.S?

A

87%

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19
Q

Are those who smoke more likely to consume alcohol?

A

yes

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20
Q

Combining tobacco and alcohol can increase the risk for what?

A

neoplasms and other oral problems

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21
Q

true or false: Smoking is the primary cause of lung cancer

A

true

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22
Q

Cardiovascular effects:

A
  • Both ETS and mainstream smoke have similar effects on cardiovascular system
  • There is a relationship between second hand smoke and the risk of a stroke
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23
Q

What crosses the placenta and has higher levels than in the mother?

A

nicotine and carbon monoxide

24
Q

low placenta usually need c-section, pregnancy risk of ETS

A

Placenta Previa ( in utero )

25
Q

ETS Pregnancy risk factors:

A
  • low birth rate, pre-term delivery, and spontaneous abortion
  • cleft lip/palate, and delayed tooth formation
26
Q

ETS risk factors for infants:

A
  • chemical passed thru breast milk
  • Increase upper respiratory problems
  • Increases incidence of lower respiratory tract illness
  • Can increase chances of SIDS
27
Q

ETS risk factors for children:

A
  • affects lung development with symptoms of coughing, phlegm, and wheezing
  • higher risk for asthma
  • increased incidence of middle ear infections
28
Q

Tobacco use is a major risk for development and progression of __________ disease.

A

periodontal

29
Q

What are the effects of tobacco on periodontal tissues?

A
  • Can affect outcome of plaque-induced gingivitis
  • Increase rate and severity of perio destruction
  • Increase bone loss
  • Increase tooth loss
  • Gingival blood flow is diminished
  • Prevalence and severity decrease sensation
30
Q

Mechanisms of periodontal destruction:

A
  • no affect on rate of biofilm accumulation
  • altered antibody production
  • lowered immune response
  • negative effect on bone after menopause
31
Q

Response to treatment:

A
  • People who smoke have a weakened response to therapy
  • Negative impact on bone regeneration
  • Implants greater risk for failure
  • Delayed healing after procedures
32
Q

A chronic progressive, relapsing disease characterized by compulsive use of a substance.

A

addiction

33
Q

Tobacco cessation methods fall into two categories:

A
  1. self help

2. assisted strategies

34
Q

Reasons for quitting?:

A
  • effect ETS has on family
  • specific health problem
  • cost
  • effect of smoking while pregnant
  • social pressures
  • dangers of nicotine
35
Q

What are example of assisted strategies?

A
  • counseling
  • pharmacotherapies
  • social suport
  • combination
36
Q

True or false: About one-third of adult smokers attempts to quit, but only 2-3 are able to achieve long term results on their own

A

true

37
Q

Benefits of pharmacotherapies:

A
  • reduce withdrawals
  • fulfill cravings
  • provide some effects (mood, cognitive changes)
  • make it easier to abstain from tobacco by partial replacement of nicotine or by counteracting nicotines action
38
Q

Considerations of pharmacotherapies:

A
  • discourage casual use

- inform pt of sign and symptoms nicotine overdose such as nausea, vomiting, dizziness, weakness, or rapid heart beat

39
Q

CONTRAINDICTIONS OF PHARMACOTHERAPIES:

need to know ya’ll

A
  • Self medication without professional advice
  • pregnancy and breastfeeding
  • Nicotine patch- pt may be allergic
  • Nicotine gum/lozenge- hypertension, using meds for asthma, depression, diabetes, ulcers
40
Q

Transmucosal delivery, nicotine released in mouth during chewing. Sweetened by xylitol.

A

Nicotine gum

41
Q

Transdermal delivery, nicotine released through skin

A

Nicotine patch

42
Q

Transmucosal delivery, nicotine releasing in mouth during inhalation or puffing

A

nicotine inhaler

43
Q

Nasal mucous membrane delivery

A

nicotine nasal spray

44
Q

Transmucosal delivery, nicotine released in mouth as lozenge dissolves. Sweetened with mannitol. DIRECTIONS FOR PATIENT: do not bite or chew lozenge as it dissolves in mouth, this can cause more nicotine to be swallowed quickly may result in heartburn

A

Nicotine lozenge

45
Q

The first non nicotine medication shown to be effective for tobacco cessation

A

Bupropion SR

46
Q

Second non nicotine med shown effective for smoking cessation: it reduces cravings for nicotine and reduces the release of dopamine

A

Varenicline tartrate

47
Q

Majority of tobacco using patients

A

want to quit, almost 1/2 say they have tried in the past 12 mos

48
Q

Tobacco use status is considered

A

a Vital Sign, along with temp, pulse, respiratory rate, and blood pressure

49
Q

Extraoral exam for tobacco using pt

A

Observe breath/body odor
fingers-yellowish/brownish tint to fingernails
skin more wrinkling
lips-looking for lesions

50
Q

Why might pts who use tobacco may require longer and more frequent appointments, than nonusers

A

due to dental stains, calculus, caries, and perio problems

51
Q

The 5 As

A 
Ask
Advise
Assess
Assist
Arrange
52
Q

Brief advice to pts

A

significantly increases long term abstinence rates.

53
Q

If the patient is not ready to quit tobacco

A

Use the 5 Rs

54
Q

The 5 Rs

A 
Relevance
Risks
Rewards
Roadblocks
Repetition
55
Q

What is a preferred quitting date for tobacco users

A

within 2 weeks

56
Q

First report of a surgeon general that focused on oral health

A

Surgeons General’s Report on Oral Health

Clinical Dental Hygiene II (14 decks)

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