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Oral medicine > Dental management > Flashcards

Dental management Flashcards

1
Q

What are the systemic manifestations of adrenal insufficiency?

A

Fatigue, weight loss, hypotension, hyponatremia, hyperkalemia, and hyperpigmentation.

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2
Q

What are the oral manifestations of adrenal insufficiency?

A

Hyperpigmentation of oral mucosa, particularly the gums, tongue, and buccal mucosa.

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3
Q

How does adrenal insufficiency impact dental treatment?

A

Patients may have delayed healing and an increased risk of infection.

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4
Q

What is Addison’s disease?

A

A chronic condition where the adrenal glands produce insufficient amounts of cortisol and aldosterone.

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5
Q

What are the primary systemic diseases associated with adrenal insufficiency?

A

Addison’s disease, secondary adrenal insufficiency, and congenital adrenal hyperplasia.

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6
Q

How can adrenal insufficiency be diagnosed?

A

Blood tests showing low cortisol levels, high ACTH levels, and imaging studies of the adrenal glands.

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7
Q

What precautions should be taken for dental management of a patient with adrenal insufficiency?

A

Ensure stress reduction, maintain stable blood pressure, and avoid abrupt discontinuation of steroids.

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8
Q

How should steroid supplementation be managed in dental procedures for adrenal insufficiency patients?

A

Administer appropriate steroid doses preoperatively and monitor for signs of adrenal crisis.

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9
Q

What should be done if a patient with adrenal insufficiency has an adrenal crisis during a dental procedure?

A

Stop the procedure, lay the patient flat, provide intravenous fluids and steroids, and seek emergency help.

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10
Q

How can a dental professional recognize an impending adrenal crisis in a patient?

A

Symptoms include severe fatigue, dizziness, abdominal pain, nausea, vomiting, and confusion.

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11
Q

What are the emergency management steps for adrenal insufficiency?

A

Immediate administration of intravenous hydrocortisone, saline, and dextrose.

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12
Q

Why is it important to recognize the dental implications of systemic diseases in adrenal insufficiency?

A

To prevent complications and provide appropriate dental care tailored to the patient’s condition.

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13
Q

What guidelines should be followed for antibiotic prophylaxis in patients with adrenal insufficiency?

A

Follow AHA guidelines, consider the need for prophylaxis based on individual risk factors.

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14
Q

What is the AHA guideline for prophylactic antibiotic use in adrenal insufficiency patients?

A

Prophylactic antibiotics are not generally required unless there are specific risk factors present.

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15
Q

Why might patients with adrenal insufficiency need special consideration during dental treatment?

A

They are at risk of adrenal crisis due to stress or inadequate steroid coverage.

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16
Q

What types of dental procedures might require steroid supplementation in adrenal insufficiency patients?

A

Major surgeries, extensive dental work, and procedures causing significant stress.

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17
Q

How should a dentist handle a minor dental procedure for a patient with adrenal insufficiency?

A

Generally, continue usual steroid regimen; additional steroids are usually not needed.

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18
Q

What are some signs of adrenal insufficiency that might be observed in a dental exam?

A

Oral pigmentation, hypotension, and poor healing of oral tissues.

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19
Q

What role do corticosteroids play in managing patients with adrenal insufficiency?

A

They replace deficient cortisol and help manage stress during medical and dental procedures.

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20
Q

How can a dentist minimize the risk of an adrenal crisis during treatment?

A

By thorough medical history review, stress management, and ensuring appropriate steroid coverage.

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21
Q

What is the primary treatment for adrenal insufficiency?

A

Lifelong hormone replacement therapy with glucocorticoids and mineralocorticoids.

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22
Q

How should a patient with adrenal insufficiency be prepared for a major dental surgery?

A

Increase steroid dosage according to medical advice and ensure close monitoring during and after surgery.

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23
Q

What is the significance of recognizing oral manifestations of adrenal insufficiency?

A

It aids in early diagnosis and management of the underlying systemic condition.

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24
Q

What factors increase the risk of adrenal crisis in dental patients with adrenal insufficiency?

A

Stress, infection, trauma, and inadequate steroid supplementation.

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25
Q

What are the systemic manifestations of Diabetes Mellitus?

A

Increased thirst, frequent urination, extreme hunger, unexplained weight loss, fatigue, irritability, blurred vision, slow-healing sores, frequent infections.

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26
Q

What are the oral manifestations of Diabetes Mellitus?

A

Dry mouth, burning mouth syndrome, candidiasis, periodontal disease, delayed wound healing, increased risk of oral infections.

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27
Q

How can systemic diseases with dental implications be investigated in Diabetes Mellitus patients?

A

Review medical history, blood glucose monitoring, HbA1c levels, consultation with the patient’s physician.

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28
Q

What dental implications should be considered for systemic diseases in Diabetes Mellitus patients?

A

Increased risk of infection, delayed healing, management of xerostomia, potential for hypoglycemic events.

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29
Q

What is the dental management for patients with Diabetes Mellitus?

A

Ensure blood glucose control, schedule morning appointments, maintain regular oral hygiene, use antibiotic prophylaxis if needed, manage dry mouth, avoid long fasting periods.

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30
Q

How should dental emergencies be managed in patients with Diabetes Mellitus?

A

Monitor blood glucose levels, have glucose tablets or gel available, recognize signs of hypo/hyperglycemia, provide immediate glucose in hypoglycemia, seek medical help if necessary.

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31
Q

What are the AHA prophylactic antibiotic guidelines for patients with Diabetes Mellitus?

A

Antibiotic prophylaxis is not specifically required for diabetic patients unless they have other conditions such as endocarditis risk. Follow general guidelines for those conditions.

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32
Q

What is the etiology of hypoglycemia in Diabetes Mellitus?

A

Excessive insulin or oral hypoglycemic medication, insufficient food intake, excessive physical activity, alcohol consumption without food.

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33
Q

What is the etiology of hyperglycemia in Diabetes Mellitus?

A

Insufficient insulin, excessive carbohydrate intake, stress, infection, certain medications, lack of physical activity.

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34
Q

What are the clinical features of hypoglycemia in Diabetes Mellitus?

A

Shaking, sweating, anxiety, dizziness, hunger, fast heartbeat, headache, irritability, confusion, fainting.

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35
Q

What are the clinical features of hyperglycemia in Diabetes Mellitus?

A

Increased thirst, frequent urination, blurred vision, fatigue, headache, difficulty concentrating, fruity-smelling breath, nausea, vomiting, shortness of breath.

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36
Q

How is hypoglycemia treated in Diabetes Mellitus?

A

Consume 15-20 grams of fast-acting carbohydrate (glucose tablets, juice), recheck blood glucose after 15 minutes, repeat if necessary, eat a small meal once stable.

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37
Q

How is hyperglycemia treated in Diabetes Mellitus?

A

Adjust insulin dose as advised by a healthcare provider, increase water intake, monitor blood glucose levels, exercise if levels are not too high, consult a healthcare provider if levels remain high.

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38
Q

What should be done if a Diabetes Mellitus patient experiences a hypoglycemic episode during a dental appointment?

A

Stop treatment, provide 15-20 grams of fast-acting carbohydrate, recheck glucose in 15 minutes, repeat if necessary, monitor the patient until they are stable.

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39
Q

What are the signs and symptoms of hypoglycemia a dentist should recognize in a patient with Diabetes Mellitus?

A

Shaking, sweating, anxiety, dizziness, hunger, fast heartbeat, headache, irritability, confusion.

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40
Q

What are the signs and symptoms of hyperglycemia a dentist should recognize in a patient with Diabetes Mellitus?

A

Increased thirst, frequent urination, blurred vision, fatigue, headache, difficulty concentrating.

41
Q

How can xerostomia be managed in a patient with Diabetes Mellitus?

A

Encourage regular sips of water, use saliva substitutes, avoid alcohol and caffeine, maintain good oral hygiene, use sugar-free gum or candies.

42
Q

What precautions should be taken for dental procedures in patients with uncontrolled Diabetes Mellitus?

A

Postpone elective procedures until diabetes is better controlled, monitor blood glucose levels, consult with the patient’s physician, use antibiotics if needed to prevent infection.

43
Q

How can periodontal disease be managed in a patient with Diabetes Mellitus?

A

Emphasize good oral hygiene, schedule regular dental cleanings, use antimicrobial mouth rinses, manage blood glucose levels, provide patient education on the link between diabetes and periodontal disease.

44
Q

Why is it important to schedule morning appointments for patients with Diabetes Mellitus?

A

Blood glucose levels are typically more stable in the morning, reducing the risk of hypoglycemic episodes during the appointment.

45
Q

What role does blood glucose monitoring play in the dental management of patients with Diabetes Mellitus?

A

Helps assess the patient’s current glucose control, guides adjustments in dental treatment plans, identifies risks for hypo/hyperglycemia during procedures.

46
Q

Why should diabetic patients avoid long fasting periods before dental appointments?

A

To prevent hypoglycemia, which can occur if blood glucose levels drop too low due to lack of food intake.

47
Q

What is the significance of HbA1c levels in managing Diabetes Mellitus in dental patients?

A

HbA1c levels indicate long-term glucose control, helping assess overall diabetes management and predict the risk of complications during dental treatments.

48
Q

How can dry mouth affect oral health in Diabetes Mellitus patients?

A

Increases the risk of tooth decay and gum disease, causes discomfort, and can lead to difficulties in speaking and swallowing.

49
Q

What lifestyle factors should be discussed with Diabetes Mellitus patients to improve their oral and systemic health?

A

Healthy diet, regular exercise, avoiding tobacco and excessive alcohol, managing stress, maintaining good oral hygiene.

50
Q

What is the impact of diabetes on wound healing in dental patients?

A

Diabetes can delay wound healing due to poor blood circulation, increased risk of infection, and impaired immune response.

51
Q

How can dentists help manage burning mouth syndrome in patients with Diabetes Mellitus?

A

Provide pain relief options, recommend saliva substitutes, address any underlying conditions like fungal infections, refer to a specialist if necessary.

52
Q

Why are diabetic patients more prone to oral infections?

A

High blood glucose levels create a favorable environment for bacteria and fungi to grow, impair the immune response, and reduce saliva flow.

53
Q

What are the potential complications of untreated periodontal disease in diabetic patients?

A

Increased risk of tooth loss, poor blood glucose control, systemic inflammation, higher risk of cardiovascular disease.

54
Q

What specific oral hygiene practices should be emphasized for diabetic patients?

A

Brushing twice a day, flossing daily, using antimicrobial mouth rinse, regular dental check-ups, managing blood glucose levels.

55
Q

How can a dental team prepare for managing a hypoglycemic emergency in the clinic?

A

Keep glucose tablets or gel readily available, train staff to recognize and respond to hypoglycemia, establish a protocol for managing diabetic emergencies.

56
Q

What are the long-term benefits of good oral hygiene in patients with Diabetes Mellitus?

A

Reduced risk of oral infections and complications, improved overall health, better blood glucose control, enhanced quality of life.

57
Q

How does stress management play a role in the health of diabetic patients?

A

Stress can affect blood glucose levels, so managing stress through relaxation techniques, exercise, and adequate sleep can improve overall diabetes control.

58
Q

Why is patient education important in managing diabetes-related oral health issues?

A

Educates patients on the link between diabetes and oral health, encourages adherence to oral hygiene practices, empowers patients to take an active role in their health.

59
Q

What are the common signs of periodontal disease that dentists should look for in diabetic patients?

A

Red, swollen, or bleeding gums, persistent bad breath, loose or separating teeth, changes in bite, gum recession.

60
Q

What are the systemic manifestations of infective bacterial endocarditis?

A

Fever, chills, night sweats, fatigue, muscle and joint pain, weight loss.

61
Q

What are the oral manifestations of infective bacterial endocarditis?

A

Petechiae on the mucosa, oral ulcerations, splinter hemorrhages, Osler’s nodes.

62
Q

How can dental procedures impact patients with infective bacterial endocarditis?

A

Bacteremia from dental procedures can lead to bacterial colonization on heart valves.

63
Q

What are Janeway lesions, and how are they related to infective endocarditis?

A

Painless, flat, red spots on palms and soles; indicative of septic emboli from infective endocarditis.

64
Q

Which systemic diseases have dental implications for patients with infective endocarditis?

A

Rheumatic heart disease, congenital heart defects, prosthetic heart valves.

65
Q

How do systemic diseases with dental implications affect dental treatment plans?

A

Increased risk of infection and need for antibiotic prophylaxis during invasive dental procedures.

66
Q

What systemic investigations are important for managing patients at risk of infective endocarditis?

A

Blood cultures, echocardiogram, complete blood count (CBC), C-reactive protein (CRP) levels.

67
Q

Why is it important to assess cardiac history in dental patients?

A

Identifying patients at risk of infective endocarditis helps prevent complications from bacteremia.

68
Q

What is the general approach to dental management for patients at risk of infective endocarditis?

A

Thorough medical history, antibiotic prophylaxis if indicated, maintaining excellent oral hygiene.

69
Q

Why is pre-treatment assessment crucial for patients with infective endocarditis?

A

To identify the need for antibiotic prophylaxis and prevent potential endocarditis.

70
Q

What dental procedures typically require antibiotic prophylaxis in high-risk patients?

A

Tooth extractions, periodontal procedures, implant placement, and other invasive procedures.

71
Q

What is the role of oral hygiene in preventing infective endocarditis?

A

Reducing bacterial load and preventing bacteremia that could lead to infective endocarditis.

72
Q

How should dental professionals manage routine cleanings for patients at risk of infective endocarditis?

A

Consider antibiotic prophylaxis and ensure meticulous plaque removal.

73
Q

What specific precautions should be taken during dental treatment for patients with infective endocarditis?

A

Aseptic techniques, minimizing trauma, and close monitoring for signs of infection.

74
Q

How often should patients at risk of infective endocarditis have dental check-ups?

A

Regularly, typically every 3-6 months, to maintain optimal oral health and monitor for potential issues.

75
Q

What is the protocol for dental emergencies in patients at risk of infective endocarditis?

A

Immediate evaluation, possible antibiotic prophylaxis, and urgent but cautious dental care.

76
Q

What should be done if a patient with infective endocarditis presents with a dental abscess?

A

Immediate drainage, appropriate antibiotics, and possibly hospitalization for further care.

77
Q

How should dental professionals manage postoperative care for patients with infective endocarditis?

A

Monitor for signs of infection, ensure proper healing, and maintain open communication with the patient’s cardiologist.

78
Q

Why is it important to recognize the symptoms of infective endocarditis during dental treatment?

A

Early detection and referral can prevent severe complications and improve patient outcomes.

79
Q

What are the clinical features of an emergency situation related to infective endocarditis in a dental setting?

A

Sudden onset of fever, chest pain, shortness of breath, or unexplained systemic symptoms.

80
Q

How should dental professionals respond to a suspected infective endocarditis emergency during treatment?

A

Stop the procedure, provide supportive care, and refer the patient to emergency medical services immediately.

81
Q

What emergency medications should be available in a dental office for patients at risk of infective endocarditis?

A

Antibiotics, oxygen, and medications to manage acute symptoms like pain and fever.

82
Q

How can dental offices prepare for emergency situations in patients with infective endocarditis?

A

Regular staff training, emergency protocols, and maintaining communication with local hospitals.

83
Q

What are the AHA prophylactic antibiotic guidelines for patients with infective endocarditis?

A

Single dose of amoxicillin (2g) 30-60 minutes before the procedure; alternative antibiotics for those allergic to penicillin.

84
Q

When are prophylactic antibiotics recommended for dental procedures?

A

For high-risk patients undergoing invasive dental procedures that involve manipulation of gingival tissue or perforation of oral mucosa.

85
Q

What are the contraindications for prophylactic antibiotics in dental patients?

A

Known allergy to the recommended antibiotic without a suitable alternative.

86
Q

Why is it important to follow AHA guidelines for prophylactic antibiotics?

A

To prevent bacterial endocarditis in at-risk patients while avoiding unnecessary antibiotic use.

87
Q

How should dental professionals manage patients with a history of allergic reactions to antibiotics?

A

Obtain a detailed history, consider alternative antibiotics, and consult with the patient’s physician.

88
Q

What are the potential complications of not using prophylactic antibiotics in at-risk patients?

A

Increased risk of developing infective endocarditis, which can lead to severe cardiac complications.

89
Q

How do the AHA guidelines help in standardizing care for patients at risk of infective endocarditis?

A

They provide evidence-based recommendations to reduce variability in practice and improve patient outcomes.

90
Q

What is infective endocarditis?

A

An infection of the inner lining of the heart chambers and valves, usually caused by bacteria.

91
Q

What are the common causes of infective endocarditis?

A

Streptococci, staphylococci, and other bacteria entering the bloodstream and attaching to heart tissue.

92
Q

What conditions increase the risk of developing infective endocarditis?

A

Congenital heart defects, prosthetic heart valves, previous endocarditis, and intravenous drug use.

93
Q

How can poor dental hygiene lead to infective endocarditis?

A

Bacteria from the mouth can enter the bloodstream during routine activities like brushing or dental procedures, potentially leading to endocarditis.

94
Q

What are Osler’s nodes, and what do they indicate?

A

Painful, red, raised lesions on fingers or toes, indicative of infective endocarditis.

95
Q

How does infective endocarditis present clinically?

A

Fever, heart murmur, petechiae, splenomegaly, and embolic phenomena.

96
Q

What complications can arise from untreated infective endocarditis?

A

Heart failure, stroke, organ damage, and death.

97
Q

Why is early diagnosis of infective endocarditis crucial?

A

Early diagnosis and treatment can prevent severe complications and improve prognosis.

98
Q

How do the AHA guidelines address antibiotic resistance concerns?

A

By recommending targeted antibiotic use only for high-risk patients, thereby reducing unnecessary antibiotic prescriptions.

99
Q

How should dental records be managed for patients at risk of infective endocarditis?

A

Detailed documentation of medical history, prophylactic measures, and treatment provided, ensuring continuity of care.

Oral medicine (7 decks)

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