CTP Flashcards
SRP if
CAL is 5 or more, or if its 4 with BOP
RPD
What teeth will be replaced and where rest will be
RPD distal extension
put rest on mesial
Perio prognosis good
health or slight CAL, no mobility, no furcation, and control of etiological factors
perio prognosis fair
Moderate CAL, class 1 mobility, class 1 furcation
perio prognosis poor
severe cal, class 2 or 3 furcation, class 2 or 3 mobility
perio prognosis hopeless
therapy is unlikely to improve situation
what you must say with restorations
tooth, surface, indirect or direct
specialist referrals
must include diagnosis and proposed tx plan
rheumatic fever
Ask if the patient has a history of endocarditits, has ever had a heart valve replacement, or have any other heart conditions.
heart mumor
physcians consult
heart surgery
abx prophylaxis
valve replacement
abx
pacemaker
dont use cavitron or elecrosurge
stroke
check for blood thinners, dont treat if stroke was less than six months
HBP
Reduce stress
Do not treat when patient is over 160/100
Medical consult may be wanted – refer to physician as needed
limit anesthetic to .04 mg epi?
bleeding disorder
Check INR (ok to treat <3) Medical consult on how to control bleeding if dental procedure will cause bleeding.
tb
dont treat if active
asthma
Determine last asthma attack (hospitalized?)
Determine medications that are being taken for control – use prophylactically
Determine triggers for asthma
Administer O2 or Nitrous Oxide
Have fast acting bronchodilator on hand in case of emergency (not steroid – takes too long to act)
COPD
dont use nitrous
diabetes
Check HBA1C - > 10 treat with caution
Check fasting blood glucose - <160
Make sure patient ate prior to apt if Type I
-Normal HbA1c <6.5 (for diabetics, goal is <7)
kidney failure
reduce amount of LA used, treat on non dialysis days
hepatitis
Check liver function
Limit acetaminophen and LA amount with decreased liver function
Use univerisal precautions
DONT PRSCRIBE NORCO-> ibuprofen
HIV
Use universal precaustions
Check statuse of HIV virus
Check white blood cell count – if low may require antibiotics for treatments.
epilepsy/seizure
med consult
joint replacement
abx if orthopedic presccribes and recommend or history
cancer
Chemotherapy –> pre-medicate, wait 7 days following chemotherapy, avoid extractions
ulcerative colitis
avoid clindamycin
depression/anxiety
monitor for xerostomia
schizphrenia
med consult, early morning appointments if patient is taking antipsychotics
pregnancy
do not do elective treatment in 1 or 3 trimester, avoid nitrous, limit LA
hyperthyroidism/graves
Take caution with using epinephrine. May cause hypertensive crisis if patient has a heigtened sympathetic nervous system.
(HR, anxiety, sweating, palpatations – fight or flight)
hypertenisve crisis
risk for stroke or heart attack
addisons disease
Give them a boost of corticosteroid prior to treatment – to avoid an adrenal crisis
cushings disease
Med consult – no speciific treatment modifications
chronic steroid treatment
act’s like Addison’s Disease - natural ability to produce corticosteroid is decreased)
Give them a boost of corticosteroid prior to treatment – to avoid an adrenal crisis.
propranalol and lidocaine
LA last longer bc propranalol slows heart
bisphosphonatees -aldronate
IV (history) – refer patient to oral surgeon
Oral – 6 months wait period prior to extensive treatment
Wait 6 months before and 6 months after treatment
IV Bisphosphonates: Refer to oral surgeon, avoid surgeries at all cost
Breast and Prostate Cancer – will typically take for inhibition of metastasis to bone (high risk)
Oral Bisphosphonates: 6 months delay for treatment
Taken less than 3 years – not high risk
More than 3 years – high risk
If patient has been taking bisphosphonates for 10 years refer to primary care physician – patient really shouldn’t be taking it for that long.
Emergent treatment educate patient of risk of oral bisphosphonates
blood thinners
Coumadin (Warfarin) -- INR below 3 Avoid erythromycin and ketoconazole Plavix – affects platelets Dabigatran (Blocks Thrombin) -- Pr Eliquis (Block Factor Xa) – get supplemental factor Xa from physician Chronic Ibuprofen
Amoxicillin premed
2 g
4 x 500mg tabs
amoxi course
500 mg 30 tabs
Sig: Take 2 tabs stat, 1 tab QID until gone
clinda premed
600 mg
4 x 150mg tabs
clinda course
300 mg 21 tabs
Sig: Take 1 tab TID 7 days
azithromycin permed
500 mg
(2 x 250 mg tabs
axithro course
500 mg 3-6 tabs
Sig: Take 1 tab 1x a day for 3-5 days
premedicate
Heart valve replacement History of endocarditis Heart transplant Congenital heart defects cyonotic Not repaired Repaired - first 6 months Repaired with continued defects
anesthetic adult
lidocaine 4.4 mg/kg
premed child
50 mg/kg Amoxicillin
20 mg/kg Clindamycin
15 mg/kg Azithromycin
pedo abx course
-Amoxicillin 20-40 mg/kg/day
In 3 divided doses
-Clindamycin 8-20 mg/kg/day
In 3-4 divided doses
pedo anesthetic
1 kg=2.2 lbs
1 carpule per 25 lbs
lido 4.4mg/kg
arti 7 mg/kg
norco
norco 5/325 8 tablets take 1-2 every 4-6 hrs prn
metabolism of nsaids
all in liver except ibuprofen-> kidney
allergic to cephalosporins
dont do penicillins or cephalosporins
sulfa allergy
dont give sulfonamides (articaine)
sulfites/bisulfites allergy
avoid LA with epi
anesthetic amounts in carpule
lido 36 mg per carpule
arti 72 mg per carp
children anelgesics
ibuprofen 8 mg/kg/dose every 8 hours
ibuprofen max
800 mg 3 times a day (give this to liver issue patients)
abx pill sizes
amoxi - 500 mg
clinda - 150 mg
azithro- 250 mg