CP2 Flashcards
How do you Measure BEWE?
- for each sextant
- scores
0 = no erosive tooth wear
1= intial loss
2 = <50% hard tissue loss
3 = >50% hard tissue loss
add all of the scores together
What are the Risk Levels of Total BEWE and Responsibilities?
< or equal to 2
= no risk
- routine maintenance and obvs
- repeat every 3 years
3-8
= low risk
- OHI, diet assessment
- routine maintenance and obvs
- repeat every 2 years
9-13
= medium risk
- OHI, diet assessment
- identify aetiology and develop strategies to reduce
- fluoridation
- avoid restoration
- monitor wear with study casts, photograph or silicone impression
- repeat every 6-12 months
14+
= high risk
- same steps as medium risk
How do you Take a Record in Clinic?
- read notes
- history
- dental history
- social history
- medical history
- general examination
How do you Present a Case to a Tutor?
check in
formulate treatment plan
sign off
write notes in Salud
notes signed off and CAFS
What Infection Control and Prevention Measures Should there be?
washing hands before seeing patient and before putting gloves on
eye protection
new gloves mask and gloves
dont touch anything with dirty gloves
How should Patient Complaints be Noted?
all in their own words their chief complaint
history of the complaint
do SOCRATES
How Should History Taking be done?
check patient details - confirm details
check medical history
start consultation with open question
find out referral source
What is SOCRATES?
Site
Onset
Character
Radiation
Association
Time
Exacerbating Factors
Severity
What are the Steps in Discussing with a Patient (5)
Diagnosis
Risk Assessment - caries, perio
Prognosis
Treatment Options
Treatment Plan
What is Part of the Diet Analysis? (6)
meals
pattern of eating habits
all sugar intakes and acid attacks
frequency and quantity
tooth recovery time
teeth brushing
What are Instrisic and Extrinsic Sugars
intrinsic - fruit and milk
extrinsic - sugar added by consumer/by manufacturer/fruit juices
What is VBA
30 seconds on very brief advice on smoking cessation
ASK - is patient a smoker
ADVISE - best way of quitting, know local support
ACT on patient response, build confidence, give information, refer to local clinics and communities and prescribe
- 4x more likely to stop with NHS support
** let patient know about cancer risk in smoking cessation
What is IBA?
alcohol Identification and Brief Advice
- no more than 14 units a week
- try to stretch out over a week
- if preggers dont drink
What is the Risk of Oral Cancer from High Alcohol Intake?
30%
What is the FRAMES model for Alcohol Advice?
Feedback - risks and negative consequences
Responsibility
Advice
Menu of Options
Empathy
Self-efficacy
What is Binge-Drinking
high number of units in a short amount of time
How can Patient find out their Own Unit Intake?
drink aware calculator website and enter the drinks
How do you Work out PFS
Plaque Free Score
- use plaque disclosing tablets, plaque stains dark, 30 seconds chew and spit, apply vaseline on lips
- split tooth into 4 areas for inter proximal surfaces
- add up all the stained surfaces and divide by the total x 100 = plaque score
If patients find it hard to brush, what can you recommend?
affordable electric toothbrush
help from carers
modified handles - weight and design
What do you Need to Know in Regards to Teeth Brushing?
Technique
toothpaste used - fluoride?
flossing - interdental cleaning aids
if toothpaste needs to be changed, shape, size
What is Important to Note when Writing a Prescription? (9)
patients name and details
age and DOB
the drug
- dosage
- frequency
- strength
- the form to be dispensed
- quantity
signature and address of practise
tips:
- number how many drugs you are prescribing
- leave no space beneath - scribble it out so people cant write another prescription in
- ask for sugar free prescriptions if possible
What Should be the Quantity Written for Drugs?
no decimals
should be grams, milligrams or nanogram
- no abbreviations
Relating to Prescriptions, what should be Recorded in the Patients Clinical Records? (3)
the drug, dosage and frequency
the tracking number at the bottom
justification why you have prescribed
How Would you Describe Dental Caries to a Patient?
caries is tooth decay that is caused by bacteria and plaque feeding on sugars from our diet
this results in changes of the saliva environment and changing our pH, when the balance is off it causes dimineralisation and causes the tooth structure to become damaged.
can show diagrams and pictures
How can you Describe a Healthy Gingiva
pink firm gingivae with knife edged papilla, no inflammation or swelling, absence of bleeding and no pocketing beyond 3mm
What is the importance of healthy gingiva?
health
aesthetcis
confidence
function
smelly breath
How would you Explain Gingivitis to a Patient?
Gingivitis is known as the early stages of gum disease
- it is caused by plaque accumulation and bacteria build up on your teeth
- it is expected to have swollen, red and bleeding gums
- it is reversible with treatment
- including regular check up cleaning and oral hygiene at home
How would you Explain Any Disease to Patient?
what is it
is it transmissible
is it preventable
causes
symptoms
risk factors
treatment
what if there is no treatment, complications
What should be Recorded in a Radiographic Report? (10)
Type of Radiograph
Date
Justification
Quality
Systemic Report
Report Which Side - left or right
Teeth Present
Bone Levels - horizontal, vertical etc
Radio Opacities - calculus
Radiolucencies
- do not give diagnosis or treatment plans
What are Common Justifications for Radiographs? (4)
- caries detection - esp if hasnt been done 2+ yrs
- periodontal disease
- endodontics
- managing developing dentition
How do you BPE Probe
Divide into sextants
run a probe at the base of pockets
black band = 3.5mm-5.5mm
record the highest score
What are the BPE Scoring Codes, alongside Treatment.
0 = no pocket, no calculus/overhangs, no bleeding after probing
- no need for periodontal treatment
1 = no pocket, no calculus/overhangs, bleeding on probing
- OHI advice
2= no pocket, supra/subgingival calculus/overhangs, bleeding on probing
- OHI
- remove PRF
3 = 3.5-5.5mm pocket
- OHI
- RSD - root surface debridement
4 = probing depth is more than 5.5mm
- OHI
- RSD
- assess need for more complex treatment, may need specialist
- = furcation
= where there is bone loss at the branching point of the roots - looks like small black triangle just under the base of the tooth - assess need for more complex treatment, may need specialist
When Should BPE Be Scored?
- new patients
- code 0,1,2 - every 12 months
- code 3 - record full probing depth for each tooth in the 3 sextant
- code 4 - record full probing depth for entire dentition
what waste goes in a yellow bin with a purple lid?
sharps that are contaminated with cytotoxic waste
what waste goes in a yellow bin with a yellow lid?
regular sharps bin with medical waste
what is the alcohol paradox?
states that people with lower socio-economic status = greater susceptibility to harmful effects of alcohol
what days should be in a diet sheet?
4 days of a week, one of which has to be a weekend
what is the recommended dietary intake of sugar?
30g a day/7 sugar cubes
define offensive waste
material that is not infected or contaminated but has come into contact with chemicals or pharmaceuticals
3 reasons which it is important to record keep.
1 - there are increased risk of litigation and negligence claims
2 - higher patient expectations
3 - poor records are impossible to defend
4 reasons to dental chart.
1 - identify correct teeth for treatment - risk managenment
2 - universal language for dentists
3 - forensics
4 - up to date with patient
what waste goes in a blue bin, with a purple lid?
cytotoxic medicinal waste
what is important about dental charting
IT STARTS ON RIGHT HAND SIDE AND GOES TO THE LEFT
- as if your charting looking at the persons mouth
the difference between black and yellow waste carts.
black = domestic waste
yellow = clinical waste
What are the 2 most common methods of charting?
- FDI - federation dentaire international
- Zsigmondy-Palmer notation
what does in a yellow waste bin, with a red lid?
sharps in contact with blood
what tool should you examine soft tissues with?
WHO621 ball ended probe
How would you Explain Periodontitis?
- it is the later stages of gum disease
- the bacteria has continued to grow and progress undisturbed and not removed
- the bacteria gets stronger
- infection increases
- as a result, there has been breakdown of the supporting structures of bone and tissue
- this is irreversible as it cannot grow back
- if left untreated, teeth can become loose, gums to recede and eventually tooth loss
- good news, periodontitis can be halted from progression and maintained with correct oral hygiene
