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Final Flashcards

1
Q

Why do an EIO?

A
  • base line
  • oral cancer screening
  • detect from normal
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2
Q

oral cancer

A
  • Oral cancer accounts for 3-4 percent of cancers
  • With early detection the cure rate can exceed 90 percent
  • Observation by the dental professional is the principle method for detection of oral cancer
  • Early detection is going to reduce the risk of death
  • location: Lateral border of the tongue, Oropharynx, hard and soft palate, Lower lip (chew Tabacoo, sun), Floor of the mouth
  • malpractice: failure to detect oral cancer (top 10 reasons for malpractice)
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3
Q

observation/inspection

A

The act of viewing and watching the client to collect data

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4
Q

palpation

A

The act of using the sense of touch to collect data

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5
Q

auscultation

A

The act of listening to and detecting body sounds in order to determine variations from normal

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6
Q

olfaction

A

The act of sensing body odors to detect variations from normal and potential disease

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7
Q

When does the EIO start?

A

when you get them out of the waiting room

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8
Q

fruity breath indicates what?

A

diabetes

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9
Q

digital palpation

A

Use of a single finger to move or press against tissue

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10
Q

bidigital palpation

A

Use of one or more fingers and thumb to move or compress tissue

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11
Q

bimanual palpation

A

Use finger of one hand and fingers and thumb of other hand simultaneously to move or compress tissue

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12
Q

bilateral palpation

A

Use fingers of both hands simultaneously to move or press on contralateral sides of the head/neck

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13
Q 
Thyroid gland
-location
-shape
-what does it do
enlarges?
A
  • Secretes thyroid hormone that controls the body’s metabolic rate
  • Middle of lower neck over trachea
  • Shaped like a bow tie
  • Check for nodules during examination
  • Goiter is an enlarged thyroid gland: graves disease, hyperthyroid
  • hypothyroid: hashimoto’s
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14
Q

lymphatic system

A
  • Network of lymph nodes connected by vessels, which plays a role in defense against infection
  • Lymph fluid carries nutrients and waste between body tissues and bloodstream
  • Lymph nodes are bean-shaped structures that filter and trap bacteria, fungi, and waste
  • 400-700 in the body
  • 170–300 in neck
  • Major chains in anterior and posterior of neck and under chin
  • Vary in size from head of pin to baked bean
  • Enlarge when infected, if there is an inflammatory condition, or cancer (idiopathic-no cause, infection, cancers)
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15
Q

when doing EIO what are you looking or

A

lump, swelling, raised knob, freely movable node, fixed nodule, asymmetry, irregular shape, firm or hard consistency, tender areas, red or discolored area, wound, bruise, scar

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16
Q

exostosis

A

extra bone growth on buccal, normal unless it is causing issues

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17
Q

leukoedema

A

white film, common on darker skin

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18
Q

toris palatine

A

extra bone on the palate

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19
Q

nicotine stomatitis

A

minor glands that are irrupted, dry heat causing altered tissue, educate the pt

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20
Q

tonsilloliths

A

tonsil stones

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21
Q

geographic tongue

A

bengin migratory glossitis

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22
Q

scalloped tongue

A

wave like tongue on the borders

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23
Q

ankyloglossia

A

tongue tied

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24
Q

macule

A

A circumscribed, nonraised area of epidermis altered in color from its surroundings

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25
Q

patch

A

A circumscribed pigmented or textured area larger than a macule

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26
Q

erosion

A

A denudation of epithelium above the basal cell layer

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27
Q

ulcer

A

A loss of epithelium that extends below the basal cell layer

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28
Q

scar

A

A permanent mark indicating previous wound healing

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29
Q

fissure

A

A linear crack in the epidermis

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30
Q

papule

A

An elevated, solid lesion less than 1 cm in diameter

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31
Q

plaque

A

A flat, raised area larger than 1 cm in diameter

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32
Q

nodule

A

A raised, solid mass that has the dimension of depth and is less than 1 cm in diameter

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33
Q

tumor

A

A solid, raised benign or malignant mass that has the dimension of depth and is larger than 1 cm in diameter

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34
Q

vesicle

A

A circumscribed, fluid-filled skin elevation less than 1 cm in diameter

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35
Q

pustule

A

A vesicle filled with purulent exudate

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36
Q

bulla

A

A fluid-filled mucocutaneous elevation greater than 1 cm in diameter

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37
Q

when documenting EIO finding ask theses questions about the history

A
  • Is the patient aware of the lesion
  • How long has it been present
  • Changes in size and appearance
  • Symptoms
  • 7 to 10 days
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38
Q

when documenting EIO findings, be specific about location and document if it is

A

Localized
Generalized
Single lesion
Multiple lesion

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39
Q

when documenting EIO findings, document physical characteristics

A

Size and shape
Color
Surface texture
Consistency

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40
Q

when documenting EIO findings, document Attachment of lesion

A

sessile or pedunculated

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41
Q

excisional

A

entire lesion is removed

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42
Q

incisional

A

section of the lesion is removed

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43
Q

cancer screening adjuncts

A
  • vizilite: abnormal tissue will reflect light and appear white
  • velscope: abnormal tissue will appear dark and irregular
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44
Q

What is the most common dental emergencies?

A

syncope: pt has anxiety, psychogenic reaction
male: men don’t express that anxiety, more common to faint.

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45
Q

what are the risk factors in medical emergencies?

A
  • Increased number of elderly patients in society with natural teeth and dental diseases that require invasive procedures
  • Medical advances (more dental history, implants)
  • More complex dental procedures require longer appointments
  • Increased use of pharmacological agents for systemic conditions (more medicine)
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46
Q

what are preventative actions for an emergency

A

A. Medical History Assessment (allergies)

B.	Physical Observation (nervous, not communicating, seems rude, holding onto chair, arms crossed, you can ask them if they are nervous)

C.	Psychological Assessment

D. Medical Consultation (resent cardiac event 3-6 months)
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47
Q

what are preventative actions for an emergency

A
  • Medical History Assessment (allergies)
  • Physical Observation (nervous, not communicating, seems rude, holding onto chair, arms crossed, you can ask them if they are nervous)
  • Psychological Assessment
  • Medical Consultation (resent cardiac event 3-6 months)
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48
Q

compensation

A

pt vitals increase above base line

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49
Q

decompensation

A

pt vitals decrease below base line

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50
Q

what are the 8 vital signs

A

blood pressure, pulse, respiration, temperature, height, weight, age, medical alert tag

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51
Q

is it better to be compensation or decompensation?

A

compensation

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52
Q

why do we take vital signs?

A
  • baseline
  • consult if not WNL
  • monitor during medical emergency
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53
Q

temperature; normal ranges and not normal ranges, what reduces a fever

A

35.5°C – 37.5°C
96.0°F – 99.5° F
Fever (pyrexia) greater than 99.5°F
Anti- pyrexia: reduces fever
Hyperthermia greater than 105.8°F
Hypothermia less than 96.0°F

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54
Q

pulse; normal ranges and not normal ranges

A 
Normal adult rate 60-100 bpm
Normal child rate 90-120 bpm
Bradycardia: less than 50 bpm
Lower than normal
Tachycardia: more than 100 bpm
Higher than normal
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55
Q

blood pressure; normal ranges, Factors to observe during respiration

A 
Adult 14 – 20 respirations per minute
Child 20 – 25 respirations per minute
Factors to observe during respiration
Depth: shallow/deep
Rhythm: regular/irregular
Quality: strong/weak/labored
Sounds: gasping/wheezing
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56
Q

respiration; normal ranges and not normal ranges

A

normal: 160/>100

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57
Q

systolic pressure

A

The peak or highest pressure, caused by ventricular contraction

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58
Q

diastolic pressure

A

The lowest pressure, caused by ventricular relaxation

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59
Q

pulse pressure

A

The difference between the systolic and diastolic pressures

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60
Q

hypertension

  • primary
  • secondary
A
  • primary
  • 90%
  • etiology: idiopathic
  • predisposing risk factors: heredity, overweight, race, sex, age, environment, smoking
  • secondary
  • 10%
  • major underlying disease, i.e. kidney disease
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61
Q

hypertension

-clinical symptoms

A

headache, dizziness, shortness of breath, fainting

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62
Q

hypertension

-long term effect

A

hypertensive heart disease (heart attack)
cerebral vascular accident (stroke)
hypertensive renal disease (kidney failure)
ischemic heart disease (angina or heart attack)

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63
Q

hypertension

-treatment

A
  • life style changes: diet, exercise, smoking cessation

- antihypertensive drug therapy

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64
Q

how to minimize stress

A
  • Heightened anxiety can lead to acute exacerbation of medical problems
  • Identify anxious patients through health history questionnaire and observation
  • Take steps to reduce stress by developing a rapport and making the patient feel secure
  • talk to pt, ask what they would like
  • calm voice
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65
Q

when should pt with anxiety, diabetes, physical or mental handicaps have appointments

A
  • what works best for the pt

- shorter morning appointments

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66
Q

ASA stands for

A

american society of anesthesiologist

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67
Q

what does ASA physical status classification system do

A
  • estimates the risk for a pt to receive anesthesia

- valuable method

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68
Q

ASA I

A

normal healthy pt without disease and without stress

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69
Q

ASA II

A

pt with mild systemic disease, anxiety, fear of dental tx, smoker, age, taking medication

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70
Q

ASA III

A

pt with severe systemic disease, disease that isn’t well controlled

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71
Q

ASA IV

A

pt with incapacitating systemic disease that is constant threat to life, inhaler multiple times a day, oxygen, not a great time for a cleaning (talk with dr) but if it is emergency that needs to be addressed it can be addressed

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72
Q

ASA V

A

morbid pt not expected to survive with or without an operation, terminally ill pt, palliative tx only, 24 hours left

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73
Q

What is the most important thing that most be done prior to a medical consultation

A

obtain consent from pt to contact physician

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74
Q

What is C-A-B

A

Chest compressions, airway, breathing

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75
Q

CPR for an adult

A

Compression Rate: At least 100 per minute
Depth: At least 2 inches
Compression to Breath Ratio: 30:2 for 1 or 2 rescuer

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76
Q

Oxygen is useful in all medical emergencies except

A

hyperventilation

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77
Q

oxygen

A
  • Easily administered
  • (E) size cylinder, provides enough oxygen for 30 min, portable
  • Tanks are green, nitrogen is blue
  • Begin supplemental oxygen at 4-6 liters per minute
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78
Q

Epinephrine

A
  • Has a vasoconstrictor effect on the capillary which counteracts the vasodilation produced by histamine in an allergic reaction
  • allergic reactions/ anaphylatic shock
  • severe life-threatening asthma attacks
  • administration: intramuscular into arm or thigh
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79
Q

Benadryl (diphenhydramine)

A
  • An antihistamine with anticholinergic (drying) and sedative side effects. In the injectable form benadryl has a rapid onset
  • As an adjunct to epinephrine after the acute symptoms have been controlled
  • For uncomplicated allergic conditions
  • Administration: Intramuscular into arm or thigh
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80
Q

Diazepam

A

-Anticonvulsant that
produces CNS depression
-Treatment of overdose reactions to local anesthetic, epileptic seizures, and anxiety
-Administration: Intravenous or intramuscular into arm or thigh
seizure: let it take its course and if doesn’t go away then the pt needs this

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81
Q

Nitroglycerine

A
  • Produces relaxation of smooth muscle
  • Management of chest pain associated with angina pectoris and acute myocardial infarction
  • Administration: Place tablet or spray under the tongue, nitroglycerine increases blood flow, dosage: up to 3 doses in 15 minutes, usually every 5 minutes
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82
Q

Glutose (glucose)

A
  • Concentrated sugar
  • Used to control hypoglycemic reactions in patients with diabetes
  • Administration: Orally
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83
Q

Bronchodilator (albuterol)

A
  • An agent used with asthmatic patients and allergic reactions that manifest as respiratory difficulty
  • For asthma and for bronchospasm that may occur in association with bronchitis or emphysema
  • Administration: 1-2 inhalations, have at appt on counter, and not expired
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84
Q

Aromatic ammonia inhalants

A
  • Produces respiratory stimulation. It acts by irritating the mucous membrane of the upper respiratory tract which stimulates respiration
  • Vasodepressor Syncope
  • Administration: Crush and pass under patients nose
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85
Q

sialolith

A

salivary stone

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86
Q

diabetes (what do you smell)

A

fruity breath

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87
Q

Anaphylaxis

A

severe, sometimes fatal, allergic reaction that results in shock

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88
Q

angina pectoris

A

chest pain caused by a lack of oxygen to the heart muscles; common in individuals with blocked arteries; may or may not result in heart attack; treat with nitroglycerin

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89
Q

angioedema

A

localized, large swellings without the well-defined borders of hived, an allergic reaction to a food or medicine, affects the tissues of the hands, face, and genitals

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90
Q

antigen

A

foreign substance that causes an immune response

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91
Q

arterlosclerosis

A

hardening of the arteries caused by an accumulation of plaque

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92
Q

atherosclerosis

A

arteriosclerosis of the coronary arteries

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93
Q

avulsion

A

traumatic removal of a tooth from its socket

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94
Q

bradycardia

A

slower than normal pulse rate; less than 60 beats per minute (adult)

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95
Q

cerebrovascular accident (CVA)

A

a stroke caused by cerebral hemorrhage, embolism, thrombosis, or infarction

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96
Q

clonic

A

convulsive movements characterized by the contraction and relation of muscles

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97
Q

cyanosis

A

blue coloration of an area, particularly the lips, caused by a lack of oxygenated blood

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98
Q

dyspnea

A

difficult or labored breathing

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99
Q

embolism

A

blood clot, unattached to a blood vessel, carried through the blood stream

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100
Q

EMS

A

emergency medical system within a community; consists of trained personnel and communication, transportation, and medical facilities to provide emergency medical care; is activated in most communicated by telephoning 911; sometimes is referred to as phone first

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101
Q

gingival hyperplasia

A

an over growth of connective tissue component of the gingiva, occurs in direct response to medication use (dilantin) and plaque accumulation

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102
Q

hemorrhage

A

uncontrolled bleeding

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103
Q

hyperglycemia

A

high blood sugar

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104
Q

hypoxia

A

deficiency of oxygen in the air being breathed

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105
Q

ictal

A

relating to convulsion

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106
Q

insulin shock

A

low blood sugar

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107
Q

ketones

A

excess amounts of acetone and acetonic acid in the blood and urine of individuals with diabetes; contributes to an increased frequency of urination

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108
Q

kussmaul breathing

A

heavy, labored breathing that may be either rapid or slow, occurs during a hypoglycemic incident

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109
Q

myocardial infarction (MI)

A

heart attack

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110
Q

orthostatic hypotension

A

low blood pressure that results from remaining in one position for a significant length of time; may be characterized by dizziness, light-headedness, loss of balance, or syncope

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111
Q

Pericoronitis

A

inflammation of the soft tissue that surrounds an erupting tooth

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112
Q

postictal

A

relating to the final stage of a seizure, often involves extreme exhaustion and sleep

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113
Q

prodromal

A

relating to an initial phase of a seizure, during which an aura may be sensed

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114
Q

pruritus

A

itching, typically associated with allergy

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115
Q

syncope

A

fainting, caused by decreased blood flow to the brain

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116
Q

tachycardia

A

faster than normal pulse rate; more than 100 beats per minute for an adult

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117
Q

thrombosis

A

a blood clot attached to a blood vessel

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118
Q

tonic

A

stiff and rigid movements caused by muscle contraction

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119
Q

tonic-clonic

A

describes the sudden muscle contractions followed by convulsive movements during a seizure

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120
Q

transient ischemic attack

A

TIA, a temporary stroke, also termed incipient stroke, does not result in permanent neurological damage, although its occurrence indicates the presence of cerebrovascular disease

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121
Q

trismus

A

difficulty in opening the mouth

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122
Q

urticaria

A

hives, appear as raised areas of edema and erythema and are accompanied by prutius

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123
Q

vasodilator

A

a medication or drug that causes the arteries to dilate (nitroglycerin)

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124
Q

coronal polishing

A

cosmetic procedure designed to remove extrinsic stains from the enamel surfaces of the teeth

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125
Q

therapeutic procedure

A

dental procedure used to maintain health or treat disease to restore health.

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126
Q

effects of polishing

A 
Environmental contamination
Bacteremia
Iatrogenic damage to tooth structure
Gingiva
Restorations
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127
Q

dental aerosols

A

invisible airborne particles dispersed into the surrounding environment by dental equipment such as dental handpieces and electronically powered instruments.

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128
Q

how long do microorganisms in dental aerosols survive

A

24 hours

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129
Q

Splatter

A

consists of airborne particles that land on people and objects.
polishing paste, microorganisms, and saliva

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130
Q

What do the patients and clinicians need to wear during polishing and why

A

glasses, to prevent eyes from splatter
Constituents of prophylaxis pastes may include various chemicals that can cause a severe inflammatory response in the eye.

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131
Q

Examples of individuals who are susceptible to bacteremia include those with:

A

Damaged or abnormal heart valves,
Prosthetic heart valve,
Congenital heart disease,
Cardiac bypass surgery within the last 6 months,
Prosthetic joint replacement, and Dialysis patients

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132
Q

if patients need an antibiotic prior to a prophylaxis does that patient need to be pre med for coronal polishing

A

yes

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133
Q

iatrogenic

A

term used to describe a problem brought on by something that a clinician does.

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134
Q

what does polishing generate that should be taken in consideration when polishing?

A

heat, Care must be taken to use a wet polishing agent with minimal pressure at a low speed to prevent overheating the tooth.

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135
Q

what do primary teeth have that gets affected when polishing

A

large pulp chambers that make these teeth particularly vulnerable to the heat

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136
Q

can gingival margin get injured during polishing? if so, how?

A

yes, incorrect polishing technique

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137
Q

What are some dental contraindications for polishing?

A

Lack of stain, sensitive teeth, exposed cementum or dentin, restored tooth surfaces, newly erupted teeth, implant abutments, areas of demineralization, and gingiva that is inflamed

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138
Q

Why is lack of stain a dental contraindication for polishing

A

Polishing is contraindicated for tooth surfaces that either have no stains or have stains that are not visible when the patient smiles or engages in conversation.

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139
Q

Why is sensitive teeth a dental contraindication for polishing

A

Sensitive teeth should not be polished with traditional prophy paste.

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140
Q

Why is exposed cementum or dentin a dental contraindication for polishing

A

Polishing removes significant amounts of these structures.

Polishing should be limited to enamel surfaces

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141
Q

Why is restored tooth surfaces a dental contraindication for polishing

A

Restorative materials are not as hard as enamel and therefore may be scratched by abrasive pastes.
Air-powder polishing can scratch, erode, pit, or result in margin leakage.
Special polishing agents should be used when polishing these structures is indicated

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142
Q

Why is newly erupted teeth a dental contraindication for polishing

A

Because the mineralization of newly erupted teeth is incomplete, polishing should be avoided.

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143
Q

Why is implant abutements a dental contraindication for polishing

A

Titanium abutments should not be polished.

The implant superstructure–prosthetic crown or denture–can be polished if needed for stain removal

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144
Q

Why is areas of demineralization a dental contraindication for polishing

A

Conservation of demineralized enamel surfaces is indicated.

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145
Q

why is gingiva that is inflamed a dental contraindication for polishing

A

Polishing is not recommended for a patient with inflamed, enlarged, soft, spongy, or bleeding tissue.
If needed, polishing should be scheduled for a separate appointment after tissue healing has occurred.

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146
Q

What are some systemic contraindications for polishing?

A

Communicable disease, susceptibility to infection

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147
Q

Why is communicable disease a systemic contraindication for polishing

A

Patients with communicable disease that could be spread by the aerosols created by polishing

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148
Q

Why is susceptibility to infection a systemic contraindication for polishing

A

Patients with high susceptibility to infection that can be transmitted by contaminated aerosols
Examples: those with respiratory or pulmonary disease or debilitated or immunosuppressed individuals

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149
Q

What are some special consideration for polishing?

A

restricted sodium diet, respiratory disease, renal disease

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150
Q

Why is restricted sodium diet a special contraindication for polishing

A

Contraindicated because of the high sodium content of most polishing powders

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151
Q

Why is respiratoy disease a special contraindication for polishing

A

Respiratory disease or other condition that limits swallowing

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152
Q

Why is renal disease a special contraindication for polishing

A

Renal disease or metabolic disorders and in individuals on diuretics or long-term steroid therapy–because the high sodium content of the powder could cause an electrolyte imbalance in these individuals.

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153
Q

what are indications for stain removal?

A

To remove extrinsic stains not removed during tooth brushing and scaling
To prepare teeth for caries preventive agents
To contribute to patient motivation

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154
Q

What is the sequence for rubber cup polishing

A

Identify biofilm/stain (disclose)
Apply polishing agent
Activate the cup
Apply intermittent light pressure for 1-2 seconds
Work from posterior to anterior
Activate the cup from the cervical third to the incisal third
Irrigate and floss

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155
Q

What is the rubber cup adaptation and lateral pressure for polishing

A

The rubber cup should be applied using just enough pressure to make the rim of the cup flare slightly

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156
Q

If the pt has tooth color restorations what polishing agent should be used?

A

soft shine

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157
Q

if the patient has demineralization or is sensitive what polishing agent?

A

sensitive

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158
Q

If the patient has no sensitivity and not tooth colored restorations what polishing agent should be used?

A

fine grit

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159
Q

What are the indications for the porte polisher?

A

Patients with infectious diseases
To apply desensitizing agents
For homebound or bedridden patients

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160
Q

aesthetic prodcedure

A

Stain removal is a nonessential aesthetic procedure undertaken for cosmetic reasons—to
improve the appearance of the anterior teeth

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161
Q

extrinsic stain

A

occur on the external (outer) surfaces of the teeth and can be removed by polishing.

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162
Q

chlorhexidine stain

A

is caused by the use of antimicrobial mouth rinses that contain chlorhexidine. Chlorhexidine causes a yellowish brown stain on
the cervical and proximal tooth surfaces, restorations, and the surface of the tongue.

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163
Q

tobacco stain

A

is a tenacious dark brown or black stain that results from cigarette or cigar smoking or the use of chewing tobacco.

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164
Q

intrinsic stain

A

occur within the enamel of the tooth and cannot be removed by polishing

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165
Q

endogenous

A

occurring during tooth development, tetracycline, dental fluorosis

166
Q

exogenous

A

acquired after tooth eruption, silver amalgams, non-vital teeth, endodontic tx

167
Q

air-powder polishing

A

This technique uses a mixture of warm water, a polishing powder, and air for extrinsic stain removal. Other terms for air-powder polishing include airbrasive polishing and air polishing

168
Q

GV black classification I

A

pits and fissures, using Shepherd’s hook

169
Q

GV black classification II

A

interproximal posterior, bitewings

170
Q

GV black classification III

A

interproximal anterior, transillumination

171
Q

GV black classification IV

A

anterior incisal edge, transillumination

172
Q

GV black classification V

A

cervical third anterior or posterior

173
Q

GV black classification VI

A

incisal edges of anterior and cusp tips of the posterior, discolored, not common, griding

174
Q

Congenitally missing

A

circle in blue

175
Q

impacted molar

A

circle in red

176
Q

MOD amalgam

A

color in area in blue

177
Q

gold inlay/onlay

A

Blue diagonals

178
Q

corwns

A

out line in blue, black diagonals where metal is located

179
Q

Composite restoration

A

outline in blue

180
Q

temporary restoration

A

color in area in black

181
Q

Nonprecious metal

A

green diagonals

182
Q

Sealants

A

has: outline in blue and write PF in blue
needs: in red write PF

183
Q

caries

A

red where located

184
Q

Root canal

A

blue line down root, can only chart with x-ray

185
Q

Overhang

A

restoration is not flush with tooth

186
Q

fistula

A

opening to a draining abscess

187
Q

supernumerary/ hyperdontia

A

extra teeth

188
Q

pontic

A

fake tooth that is filling a space where a tooth should have been

189
Q

abutment

A

supporting structure for the pontic

190
Q

cantilever

A

when there is only 1 side of the pontic that has an abutment

191
Q

crossbite

A

when the mandibular teeth are in front of the maxillary teeth

192
Q

edge to edge

A

incisal (anterior) surfaces occlude

193
Q

end to end

A

cusp to cusp (posterior) surfaces occlude

194
Q

overjet

A

measurement horizontally between max incisors and mandible incisors

195
Q

underject

A

maxillary incisors are lingual to the mandibular incisors

196
Q

open bite

A

lack of incisal contact

197
Q

overbite

A

incisal edge of maxillary tooth on the facial surface on the mandibular anterior tooth (slight, moderate, severe)

198
Q

Malocclusion class I

A

mesiobuccal cusp of maxillary first permanent molar occludes with the buccal grove of the mandibular first permanent molar

199
Q

Malocclusion Class II

A

mesiobuccal cusp of maxillary first permanent molar occludes mesial (by the width of a premolar) with the buccal grove of the mandibular first permanent molar

200
Q

Malocclusion Class II

division 1

A

mandible is retruded and all maxillary incisors are protruded

201
Q

Malocclusion Class II

division 2

A

mandible is retruded and 1 or more maxillary incisors are retruded and some protruded

202
Q

Malocclusion Class III

A

mesiobuccal cusp of maxillary first permanent molar occludes distal (by the width of a premolar) with the buccal grove of the mandibular first permanent molar

203
Q

attrition

A

grinding and wearing down the insical and occulsal edges

204
Q

wear facets

A

caused by attrition

205
Q

craze lines

A

chewing on ice, parafunctional habit

206
Q

abrasion

A

brushing too hard, at gum line

207
Q

abfraction

A

deep v-shaped
occlusal forces
at gum line

208
Q

erosion

A

Lemons, eating disorders take involved vomiting, acid reflex

209
Q

ankylosis

A

rigid fixation of a tooth to the surrounding alveolus as a result of ossification of the periodontal ligament

210
Q

bruxism

A

grinding

211
Q

static occlusion

A

contacts between the teeth when the jaw is not moving

212
Q

functional occlusion

A

consists of all contacts during chewing, swallowing, or other normal actions

213
Q

functional contacts

A

normal contacts that are made between the maxillary teeth and the mandibular teeth during chewing and swallowing

214
Q

parafunctional contacts

A

those made outside the normal range of function

215
Q

tongue thrust

A

infantile pattern of suckle-swallow movement in which the tongue is placed between the incisor teeth or alveolar ridges; may result in an anterior open bite, deformation of the jaws and abnormal function

216
Q

labioversion

A

a tooth that has assumed a position labial to normal

217
Q

linguoversion

A

position lingual to normal

218
Q

buccoversion

A

position buccal to normal

219
Q

supraversion

A

elongated above the line of occlusion

220
Q

incipient caires

A

beginning caries or beginning of decay

221
Q

tooth avulsion

A

The tooth is completely displaced out of its socket. Clinically the socket is found empty or filled with a coagulum.

222
Q

hashimoto’s disease

A
  • thyroid is hypoactive.
  • Thyroid gland cant make enough thyroid hormone T3 and T4. These keep the the body’s metabolism normal.
  • There are many causes to the disease most of which are unknown.
  • Symptoms include becoming tired easily, dry skin, or depression.
  • Signs include weight gain from an increase in eating, low blood pressure, and a slow pulse rate.
223
Q

high cholesterol

A

-caused from a buildup of lipids in the heart.
-Excess cholesterol can form plaque between the layers of artery walls.
-Blocking an artery that feeds to the brain can cause a stroke.
It can cause ischemic heart disease because it can case less blood flow to the heart, which will cause less oxygen transportation.
-High cholesterol can be hereditary, or it can be caused by poor diet.
-Many people are not aware they have high cholesterol because there are no symptoms.
-A sign of high cholesterol is high blood pressure.

224
Q

Chemical dependency (alcoholism)

A
  • Alcohol dependency may run in families; passed though your genes.
  • It can also be influenced by the environment you grow up in.
  • Signs of alcoholism include: Heavy drinking,Easily agitated, Drinking more than one drink daily, Always intoxicated
  • Symptoms include: Depression, Withdrawal, Loss of control
225
Q

Simvastatin (20mg)

A

Use along with proper diet and exercise.
Helps lower “bad” cholesterol (HDL) in the blood.
It reduces the amount of cholesterol from the liver.

226
Q

Synthroid (100 mg)

A

Used to treat and underactive, deficient thyroid.

Provides thyroid hormones that would normally be produced by the thyroid gland.

227
Q

Allergies

A

anaphylaxis

epinephrine (epi pen)

228
Q

Diabetes

A

~Type 1 Diabetes:
Insulin dependent
The beta-cells of the pancreas, secreting insulin for lowering blood sugar, are destroyed by the immune system.
Once blood sugar is raised, it cannot be lowered, resulting in hyperglycemia
To control blood sugar, insulin is injected.
~Type 2
Body continues to produce insulin but does not produce enough or is unable to recognize insulin and use properly.
Lack of insulin, or improper use of insulin results in glucose not able to get into the body’s cells to be used as energy
Glucose builds up in the blood

229
Q

Humulin N

A

treat type 1 diabetes mellitus (insulin dependent, IDDM) and type 2 diabetes mellitus (noninsulin dependent, NIDDM) to improve glycemic control.

230
Q

Lantus

A

Treatment of type 1 diabetes mellitus (insulin dependent, IDDM) and type 2 diabetes mellitus (noninsulin dependent, NIDDM) to improve glycemic control.

231
Q

Depression

A

Takes antidepressant Zoloft
Affects physical and metal health
Symptoms:
Depressed mood most of day, nearly every day
Significant weight change or change in appetite
Sleep disturbance
Psychomotor agitation or retardation
Fatigue or loss of energy
Feelings of worthlessness or excessive guilt
Diminished ability to think or concentrate
Recurrent thoughts of death or dying

232
Q

Zoloft

A

Treatment of major depressive disorder (MDD) in adults)

Xerostomia

233
Q

cerebrovascular accident (stroke)

A

an interruption in blood supply to the brain1
Patient experienced CVA (stroke) in 2004
Patient takes 2.5 mg daily
Effected Psychomotor function on right side, has improved with therapy

234
Q

osteoporosis

A

porous bones as a result of loss of calcium and minerals, causing weak bones that are susceptible to fractures
Patient takes 150 mg once monthly

235
Q

Coumadin

A 
Anticoagulant (blood thinner)
Reduces risk of systemic embolism
Mouth ulcers and taste disturbance
Bleeding from gingival tissue
Increase risk of bleeding during dental surgery
236
Q

Boniva

A

Treatment and prevention of osteoporosis in postmenopausal females
Tooth disorder (cavities, pulpitis, periapical abscess, impacted teeth)
Osteonecrosis of the Jaw (ONJ)
Severe bone disease that effects the jaw
Delayed healing of extraction socket or exposed jawbone

237
Q

hemorrhage

A

Uncontrolled bleeding, From tooth socket

238
Q

xerastomia

A

reduction of salvia production

239
Q

dilantin

A

gingival hyperplasia and increased bleed

medication used to manage convulsing disorders and for the prevention of seizures.

240
Q

Klonopin

A

medication that is prescribed to control seizures and to relieve panic attacks or anxiety.

241
Q

benadryl

A

(antihistamine)- is used to relieve allergic symptoms such as nasal, dermatitis, and other allergic symptoms.

242
Q

clindamycin

A

used as a pre med for treatment of Mitral Valve Prolapse. Mother is allergic to amoxicillin so this is the safer route even if patient is not allergic to it.

243
Q

mitral valve prolapse

A

medical clearance from cardiologist

pre med

244
Q

Hepatitis B

A
  • Is a DNA virus that attacks the cells within the liver.
  • Transmitted through blood or bloody fluid, percutaneous or permucosal transmission.
  • Hepatitis B can be expressed as acute or chronic with no symptoms.
  • Treatment includes: Short term treatment – Interferons, Chronic treatment – - antiviral medications such as Lamivuding and Adefovir
  • Severe cases involving liver damage require a liver transplant
  • Vaccine is available for Hepatitis B.
245
Q

Arrhythmia

A
  • An abnormal heart rhythm. Such as Bradycardia and Tachycardia.
  • It can feel like a fluttering in the chest or neck.
  • Severe arrhythmia can cause the heart to be unable to pump enough blood to the body. This condition can be fatal.
  • Treatment includes:Pacemaker to stabilize the heart beat, Digitalis medication to make the heart beat stronger with a more regular pattern, Heart valve replacement in sever cases
246
Q

Pacemaker

A
  • This artificial device uses electrical impulses to help the heart pump properly.
  • Most pacemakers having a sensing mode that allows the pacemaker to control the heart beat.
  • Diagnostic radiation such as dental radiographs is believed to not have an effect on these devices
247
Q

Pneumonia

A
  • Common pulmonary infection which can be caused by bacteria, virus or fungi.
  • Inflammation of the alveoli, lung sacs, resulting in a buildup of fluid in the lungs and respiratory complications.
  • Treatments Include: Fluid, rest, anti-inflammatory (Naproxen), antiviral medication (viral strand), antibiotics (bacterial strand) (azithromycin, clarithromycin, or erythromycin), oxygen therapy
248
Q

Digitek

A
  • A digitalis medication that is used to make the heart beat stronger and with a more regular pattern. Used to treat arrhythmia.
  • Dental Implications: This medication may cause a sensitive gag reflex which could create difficulty during dental impressions.
  • Also, a vasoconstrictor should be avoided if possible because there is a risk of cardiac arrhythmia.
249
Q

Aspirin

A
  • An anti-inflammatory used to treat moderate pain, inflammation, or fever.
  • Dental Implications: Patient has potential risk of increased bleeding during treatments such as probing and debridement.
  • Physician consultation for medical clearance if the patient is taking more than 325mg or greater of aspirin daily.
250
Q

Cardiac arrest

A
  • A sudden, unexpected stop of the heart
  • Symptoms include: sudden loss of responsiveness/consciousness, no breathing or pulse.
  • Management requires: Activate EMS and initiate BLS
251
Q

Myocardial infarction

A
  • Damage of death of heart muscle due to a blockage of blood flow through a coronary artery.
  • Symptoms include: chest pain that can include arms, neck and back, nausea, fatigue, dizziness, anxiety, shortness of breath, palpations and sweating.
  • Management: Stop treatment and activate EMS, keep in the patient in an upright position, administer aspirin if not allergic, monitor vital signs, administer oxygen, initiate BLS as needed.
252
Q

Syncope

A
  • A brief loss of consciousness due to inadequate blood flow to the brain
  • Symptoms include: pale skin, dizziness, weakness, blurred vision, nausea, trembling or shaking, loss of consciousness.
  • Management: Stop treatment, put patient in a supine position, maintain airway, loosen clothing, place a cool damp cloth on their forehead, wave aromatic ammonia under their nose, monitor vitals.
253
Q

Crohn’s disease

A
  • Chronic inflammatory disease of the gastrointestinal tract
  • Etiology is unknown, but hereditary and immune dysfunction are associate with development
  • abdominal pain, diarrhea, fever, rectal bleeding, and weight loss
  • Gingival inflammation, dental caries, and most commonly oral lesions
  • Iron deficiency anemia
  • Affects patients in symptomatic flare-ups, and they are at a higher risk for infection and oral problems
  • Oral hygiene is very important and frequent recall appointments
  • Corticosteroid therapy can suppress the adrenal function and reduce the ability of the patient to withstand stress.2
  • increases the patient’s risk for infection and adrenal insufficiency
  • consultation with physician (drug interactions and adverse effects, adrenal insufficiency, infection, bleeding problems and impaired wound- healing)
254
Q

Human papillomavirus (HPV)

A
  • Viral infection spread by skin to skin sexual contact
  • Signs and symptoms can take up to a year to appear
  • Currently no cure
  • Medications taken for Crohn’s disease can cause suppression of the immune system, which prevents the body from fighting HPV
255
Q

Anemia

A
  • Condition where body does not have enough healthy red blood cells
  • People with Crohn’s disease are at higher risk for anemia
  • Anemia occurs with Crohn’s due to poor absorption of vitamins and minerals because of inflammation or diarrhea
  • Limits body’s ability to make more red blood cells
  • signs and symptoms: Fatigue, Dizziness, Irritability, Numbness/coldness in hands or feet, Pale skin, Shortness of breath and rapid heartbeat with mild exertion, Weakness, Chest pain
256
Q

Iron 65g

A

anemia
(Ferrous Fumarate)
Iron is a mineral
supplements taken to treat iron-deficiency anemia
Patients taking iron should not be prescribed tetracycline because the gastrointestinal tract
Iron increases risk of teeth staining

257
Q

Cyclosporine 2.5mg

A

crohn’s disease
(Sandimmune)
Immunosuppressant drug used to help decrease inflammation in the digestive tract
Can cause: gingival hyperplasia, mouth sores, swallowing difficulty, gingivitis, gum hyperplasia, xerostomia, abnormal taste, tongue disorder, tooth disorder, and gingival bleeding
**need consultation because patient is at risk for infection due to side effects of immunosuppressant

258
Q

Imuran 2mg

A

Crohn’s disease
(Azathioprine)
Immunosuppressant drug used with cyclosporine
Weakens the immune system in order to decrease inflammation of digestive tract
No dental side effects, but does increase risk of infection

259
Q

Systemic lupus erythematos (SLE)

A
  • chronic autoimmune disease which occurs when your body’s immune system mistakenly attacks healthy tissue and organs in your body.
  • inflammation that is associated with pain and swelling and it can affect many different body systems which include the joints, skin, brain, lungs, kidneys, nervous system, heart, blood cells, and other organs of the body.
  • range from mild to serious
  • genetics and your environment
  • The actual cause of lupus in most cases, however is unknown but things that trigger lupus include: sunlight, certain drugs, and infections.
  • difficult to diagnose
  • facial rash (butterfly)
  • lab testing
  • no cure, reduce inflammation
260
Q

arthritis

A

-Arthritis is inflammation of one or more joints.
It is a complex family of musculoskeletal disorders which is made of more than 100 different diseases.
-Arthritis is the leading cause of disability in the United States.
-Arthritis involves the breakdown of cartilage which causes swelling, and stiffness.
-Arthritis can affect people of all ages, races and genders
-Osteoarthritis, rheumatoid arthritis, juvenile arthritis

261
Q

cortisone-aristospan

A

adjunct treatment and temporary relief of symptoms from inflammatory/ulcer oral wounds. Oral wounds due to trauma to systemic lupus erythematosus (SLE), intra-articular (soft-tissue), and other diseases that involve immunosuppression and anti-inflammatory effects.

262
Q

Aspirin

A

increased bleeding, hemostasis, or hemorrhage. Patients with ischemic stroke prevention are safe to treat. Aspirin used with other antiplatelet medications like: clopidogrel (Plavix), ticagrelor (Brilinta), or prasugrel (Effient) are main preventive measures to stent thrombosis after placement of drug-eluting stent in coronary patients. Early delay or interruptions of the combination anti platelet therapy can cause increased risk of a tragic incident of stent thrombosis leading to myocardial infarcation and/or death.

263
Q

latex allergy

A
  • reaction to the protein in rubber latex
  • symptoms: Pruritus, Erythema, Hive/rash, Sneezing, Runny nose, Scratchy throat, Difficulty breathing, Wheezing/ coughing
  • treatment: avoiding latex products, anti-itch cream, epi-pen
264
Q

Asthma

A
  • respiratory disease of the lungs
  • irreversible
  • may be fatal
  • symptoms: Swollen airways, Coughing, Trouble sleeping, Wheezing, Tightness in chest, Shortness of breath
  • possible causes: Genetics, Childhood respiratory issues, Viral infections
265
Q

GERD

A
  • GER is when stomach acid backs up to esophagus
  • GER is experienced by everyone, GERD is not
  • Symptoms vary: Heartburn / chest pain, Sour taste in mouth, Difficulty swallowing / dry cough, Sore throat / something stuck in throat, regurgitation
  • Treatment: Anti-inflammatory drugs, Bronchodilators / inhalers
  • Causes: Stomach acid in the esophagus, Weakened esophageal sphincter, Irritation and inflammation of esophagus from acid
  • Treatment: Avoiding foods high in spice and acid content. Neutralizing substances. Early intervention to prevent cancerous conditions
266
Q

link between asthma and GERD

A

Occasionally asthma attacks can affect the lower esophageal sphincter (between esophagus and stomach) to relax and then causing stomach acid to go into the esophagus.
Asthma medications may increase GERD symptoms.
If GERD occurs during an asthma attack symptoms may worsen.
If GERD is well managed then asthma symptoms tend to be more controlled as well

267
Q

albuterol inhaler

A

known as a bronchodilator that opens the airways during an asthma attack. Associated dental implication is xerostomia.

268
Q

singulair

A

prevention and relief of inflammation of the airways to help minimize and reduce asthma attacks. Associated dental implications include dental pain and increased bleeding.

269
Q

pepcid AC

A

minimize the buildup of acid within the gastrointestinal tract, aids in the prevention of heart burn and ulcers. No dental implications

270
Q

tetralogy of fallot

A
  • more commonly known as blue baby syndrome
  • It is a congenital heart defect (present at birth), that results in low oxygenation of blood, due to the mixing of oxygenated and deoxygenated, leads to cyanosis.
271
Q

seizures

A

likely when someone is not getting enough oxygen.
Signs/symptoms: Aura, loss of consciousness, epileptic cry, involuntarily tonic-clonic, muscle contractions, altered breathing, involuntary urination and/or defecation.

272
Q

endocarditis

A

An infection of the heart chambers, and heart valves that is caused by bacteria formed by other infectious substances. Usually result of blood infection that happens during a medical procedure.
pre med
contact dr for inr (need to be between 2-3), med clerance

273
Q

plavix

A

taken for Infective Endocarditis
-anticoagulant; will thin the blood to prevent blood from clotting.
Dental implications: bleeding during treatment, and scheduling morning appointments due to anxious tendencies.

274
Q

paxil

A

taken for anxiety (20 mg daily)
-antidepressant agent that selectively blocks uptake of neurotransmitter serotonin.
Dental implications: Causes xerostomia and bruxism which causes a higher risk for caries, attrition, and TMJ pain.

275
Q

history of heart attack (myocardial infarction)

A

-occurs when the blood flow that brings oxygen to the muscle of the heart is severely reduced or completely cut off. This happens when the patient build up plaque in the coronary arteries (atherosclerosis).

276
Q

Angina pectoris

A

Chest pain or discomfort due to coronary heart disease
Happens when the heart muscle doesn’t get as much blood as it needs
Usually because one or more of the heart’s arteries is narrow or blocked
Patient may be pale and also experiencing faintness, sweating, difficulty in breathing, anxiety, or fear
stable vs unstable
nitroglycerin

277
Q

nitroglycerin

A

vasodilator

administered subgingivally

278
Q

lotrel

A

Fewer reports of gingival hyperplasia with Amlodipine and consult with the physician

279
Q

hydrochlorothiazide (HCTZ)

A

For management of mild-to-moderate hypertension

Effects on dental treatment: Orthostatic hypotension and hypotension

280
Q

high blood pressure

A

High blood pressure is a common and dangerous condition.
Having high blood pressure means the pressure of the blood in your blood vessels is higher than it should be.
Generally established guidelines are valves exceeding 140mmHg systolic or exceeding 90-mmHg diastolic blood pressures.
High blood pressure is also called the “silent killer” because it often has no warning signs or symptoms , and many people do not know they have it.
That’s why it is important to check your blood pressure regularly.

281
Q

factors to consider when selecting oral physiotherapeutic aids

A

Hard tissue variables include:
tooth position
root anatomy
restorations

Client variables include:
level of dexterity
adherence/compliance 
skill development 
personal preferences
282
Q

single - tufted brushed

A

Used to remove dental biofilm from surfaces not accessible with larger brushes, including areas of crowded or malpositioned teeth, distal surfaces of terminal molars, around pontics, in furcations, and on lingual surfaces of molars; also useful for cleaning fixed orthodontic appliances

283
Q

orthodontic brushes

A

used for pt with braces

284
Q

Factors to Consider when Selecting Interdental Cleaning Methods

A

Soft-tissue variables include the level of health or disease and the position and architecture of the gingiva and attachment
type of embrasure

285
Q

type I embrasures

A

occupied by the interdental papillae

286
Q

type II embrasures

A

have slight to moderate recession of the interdental papillae

287
Q

type III embrasures

A

have extensive recession or complete loss of interdental papillae

288
Q

unwaxed floss

A

unbound filaments spread on the tooth and have more friction for cleaning; filaments hold plaque and debris for easier removal; floss, being less bulky, slips through contacts more easily

289
Q

waxed floss

A

resists tearing and shredding on faulty restorations or when moved through very tight contacts

290
Q

polytetrafluoroethylene (PTFE) floss

A

slides through contacts easily; does not fray; equally effective when compared with waxed floss; may enhance client adherence because of high preference ratings

291
Q

powered flossing

A

Design-powered interdental cleaning devices use a multi-tufted nylon tip, designed for a single use, that extrudes and rotates on interproxirnal surfaces

Technique-requires only one hand to operate; tip is aimed into the interproximal space

Suggested use-alternative to hand-held floss; studies have demonstrated safety and effectiveness in removal of interproximal plaque, reduction of gingival inflammation and bleeding on probing

292
Q

floss holders

A

plastic device onto which the floss is threaded and held, forming a span between the prongs
holder is positioned for insertion, then adapted and activated in much the same manner as hand-held floss; special care should be taken not to snap the floss through contacts
Indicated for use-when an individual lacks the dexterity to floss properly, and client preference

293
Q

floss threader

A

Firm, flexible, blunt-ended device for moving floss through closed contacts or under pontics or orthodontic wires

position the floss in the threader with even lengths on each side; pass the threader through the embrasure, from the buccal to the lingual aspect, leaving sufficient length on the buccal aspect, floss in a normal manner, slide floss through space to remove

294
Q

interdental brushes

A

Soft nylon filaments are twisted onto a stainless steel wire to form either a tapered or nontapered small brush
Brushes can be attached to a special handle; or are attached small handles
Provide good access to root concavities, furcation areas, proximal surfaces where papillae do not fill interdental spaces, as in type II and type III embrasures and under orthodontic wires

295
Q

interdental brushes technnique

A

Choose a brush of appropriate size, insert interproximally, and use an in-and-out motion from the buccal to the lingual aspect and from the lingual to the buccal aspect
Brushes may be aimed into furcation areas in a similar manner
Filaments compress when moving through constricted areas and flare out to adapt to larger spaces

296
Q

interdental brush precautions

A

Avoid forcing through tight, tissue-filled areas to prevent trauma
Do not aim wire into tissue
Discard the tip when filaments lose their original shape
Do not use brush with a stainless steel wire on an implant; brush must have a plastic- coated wire to prevent damage to implant

297
Q

gauze strips

A

Used on proximal surfaces when large diastemas are present, teeth are isolated, or there is no adjacent tooth; type II embrasures‘
Use one 1-inch width of bandage gauze cut into a 6-inch length and folded the long way into thirds; adapt to the open proximal surface and move back and forth several times
Limitation: no subgingival plaque disruption

298
Q

knitting yarn

A

Used on proximal surfaces with type II embrasures, diastemas, and isolated teeth

Use synthetic yarn, not wool; wrap in a C shape against the tooth and move it up and down, like floss
Limitations: no subgingival access; seldom used because a variety of flosses and interdental brushes are available

299
Q

pipe cleaners

A

Used to remove bacterial plaque from exposed furcation areas and open inter- dental areas
Cut the pipe cleaner to a manageable length, approximately 2 inches; round off the sharp wire edges and adapt the end to the space; move back and forth several times
Precautions: if not properly adapted, wire can cause trauma to soft tissues
Limitations: less effective than interdental brushes, but cost may be lower
Do not use pipe cleaners on a dental implant; wire can damage the implant

300
Q

toothpicks

A

Used for proximal surfaces and concavities, furcation areas, type II embrasures, just under the gingival margin, and around fixed orthodontic bands
toothpicks can be used alone or inserted into special holders (periodontal aids); moisten the tip and adapt it to the surface to be cleaned; subgingivally (submarginally) use a 45-degree angle to the tooth; move it in and out several times for interproximal surfaces, and follow the tooth contour on facial or lingual surfaces
Ridged pointed tips can cause injury if forced into tight tissue areas; over time papillae will abrade if toothpicks are used improperly

301
Q

interdental wedge (stimudents)

A

Used for proximal surfaces or just under the gingival margin; triangular in cross sections; should be used interproximally only when there is adequate space for insertion (e.g., type II embrasures)
Moisten the tip, position the flat base of the triangle at the gingival margin, insert with the tip angled slightly toward the occlusal surface, and move the wedge in and out, with moderate pressure against the surface

302
Q

interdental wedge (stimudents) precaustions

A

discard tips as soon as splaying occurs; using a fulcrum position in- creases control and reduces the risk of inserting the wedge with too much pressure; repeated insertion with tip perpendicular to long axis of tooth may cause blunting of interdental papillae

303
Q

rubber tip

A

Used for proximal surfaces, in exposed furcations, and under gingival margins; authors differ on the rubber tip’s ability to remove plaque; may be used to maintain interproximal gingival contours or recontour papillae following periodontal surgery

304
Q

rubber tip technique

A

Bacterial plaque removal: trace gingival margin with tip aimed into sulcus
Contouring gingiva: place but do not force the tip into the interdental contour with the tip angled occlusally, press the side of the tip against the gingiva, and use a firm rotary motion to apply intermittent pressure

305
Q

rubber tip precaution

A

inserting the tip perpendicularly to the long axis of the tooth can result in flattened interdental papillae

306
Q

denture care

A

Remove and rinse dentures after eating. Place a towel on the counter or in the sink so that the dentures won’t break if you drop them.

Clean mouth after removing your dentures. Use a soft-bristled toothbrush on natural teeth and gauze or a soft toothbrush to clean tongue and palate.

Scrub dentures at least daily. Gently scrub dentures using a denture cleaner, mild soap or dishwashing liquid and a denture brush or soft toothbrush to remove food, biofilm and other deposits. Avoid stiff-bristled brushes, strong cleansers and harsh toothpaste, as these are too abrasive and can damage dentures. Toothpastes advertised as whitening pastes are especially abrasive and should be avoided with removable dentures.

Handle dentures carefully. Be sure not to bend or damage the plastic or the clasps when cleaning

Soak dentures overnight. Most types of dentures need to remain moist to keep their shape. Place the dentures in water or a mild denture-soaking solution overnight. Don’t soak dentures with metal attachments in solutions that contain chlorine because it can tarnish the metal.

Rinse dentures before putting them back in the mouth, especially if using a denture-soaking solution. These solutions can contain harmful chemicals that cause vomiting, pain or burns if swallowed.

Schedule regular dental checkups. The dentist can help ensure a proper fit to prevent slippage and discomfort. See the dentist promptly if dentures become loose. Loose dentures can cause irritation, sores and infection.

307
Q

dental caries

A

An infectious disease of the dental calcified structures (enamel, dentin and cementum) that is characterized by demineralization of the mineral components and dissolution of the organic matrix
Bacterially-based
Chronic
Infectious/Communicable

308
Q

dental caries incidence

A

In the United States, dental caries is the most common chronic disease in childhood, with 41% of children between the ages of 2 and 11 having caries in primary teeth
Among dentate adults aged 20 to 64, 92% have caries in permanent teeth

309
Q

essentials for dental caries

A 
-Susceptible tooth surface (Host)
Less than optimum fluoride exposure
-Microorganisms
Streptococcus mutans
Streptococcus sobrinus
Lactobacillus  
-Cariogenic food source
Sucrose, glucose, fructose 
Carbohydrates (starch)
310
Q

contributing factors for dental caries

A

-Time
The longer the pH is lowered the greater the risk for caries to form
The response after exposure of dental plaque to a fermentable carbohydrate is that pH decreases rapidly, reaching a minimum in approximately 5 to 20 minutes.
This is followed by a gradual recovery to its starting value, usually over 30 to 60 minutes
-Plaque pH
Critical pH for enamel 4.5-5.5
Critical pH for root surface 6.0-6.7
-Frequency of carbohydrate intake
The more frequent the exposure the greater the risk for caries to form

311
Q

lymphadenopathy

A
  • enlarged lymph nodes
  • Nodes swell in area of infection
  • Usually enlarge to ½ to 1 inch across with virus
  • Will enlarge over 1 inch with bacterial infection
  • Painless with cancer
  • Lymphatic system can transport cancer cells throughout the body
  • firm, tender, enlarged, freely movable, swollen grape
312
Q

hydroxyapatite

A

An inorganic crystallized structure comprised of calcium, phosphorus, and hydroxide

313
Q

demineralization

A

is the breakdown of the tooth structure with a loss of mineral content, primarily calcium, phosphorus, and fluoride

314
Q

remineralization

A

is the process by which minerals are restored to the tooth structure and tooth destruction is arrested

315
Q

calcium and phosphate in remineralization

A

Calcium and phosphate diffuse into the tooth via saliva
Results in crystal formation
Hydroxyapatite: the principle crystalline mineral component of the teeth

316
Q

formation of enamel caries

A

Phase I

Phase II

317
Q

Phase I

A

incipient lesion
Subsurface demineralization (not visible)
Vizualization (not visible)
First clinical evidence (visible)

318
Q

Phase II

A

untreated incipient lesion
Breakdown of enamel
Progression of carious lesion
Spread of carious lesion

319
Q

white spot lesions

A

Active lesions feel rough when the tip of the explorer is moved gently across their surface.

Inactive lesions feel hard and smooth when the tip of the explorer is moved gently across their surface.

320
Q

types of dental caries by location

A
  1. Pit and Fissure
  2. Smooth Surface
  3. Root surface
    - Cemental
    - Cervical
    - Radicular
321
Q

Early childhood caries

A
  • Baby bottle caries
  • First effects maxillary anterior teeth followed by molars
  • Least evident on mandibular anterior teeth
322
Q

primary caries

A

occurs on surfaces not previously effected; also called initial caries; early lesion may be referred to as incipient

323
Q

arrested caries

A

carious lesion that has become stationary and does not show a tendency to progress further; frequently has a hard surface and takes on a dark brown or reddish-brown color

324
Q

rampant caries

A

widespread formation of chalky white areas and incipient lesions that may increase in size over a short time

325
Q

recurrent caries

A

occurs on a surface adjacent to a restoration; also called secondary caries

326
Q

tx as an infectious disease

A

Change from “surgical” approach to a “medical” approach
Surgical: focuses on restoring symptoms of the disease
Medical: focuses on treating/managing causes of the disease
Goal: prevent the need for restorative Tx.

327
Q

CAMBRA stands for

A

Caries Management by Risk Assessment

328
Q

Caries Management by Risk Assessment

A

Treat patients by risk
Identify patients with higher risk
Treat higher risk patients more aggressively
Identify risk factors and disease indicators
Manage risk factors to alter the caries balance in favor of health

329
Q

key protective factors

A

Saliva
Fluoride, calcium, phosphate
Antibacterial agents

330
Q

Key Pathological (Risk) Factors

A 
Cariogenic bacteria
Fermentable Carbohydrate
Decreased salivary flow
Poor oral Hygiene
Smoking 
Ortho
331
Q

disease indicators

A

White spot lesions
Cavity in past 3 years
Radiographic lesions
Visible cavitations

332
Q

Pathologic factors (bad)

A

bacterial infection
absence of saliva (xerostomia)
dietary habits poor

333
Q

Protective factors (safe)

A

saliva and sealants
antimicrobials
fluoride
effective diet

adequate saliva flow
fluoridated water/rinse
xylitol gums/mints

334
Q

disease indicators

A

visible cavitations
radiographic lesions
white spot lesions
cavity in last 3 years

335
Q

risk factors

A

visible plaque
inadequate saliva
acidic beverages
deep pits/fissures

336
Q

Fluoride

A

Inhibits demineralization
Enhances remineralization process
Inhibits bacteria
Structure is less soluble than original

337
Q

Fluorapatite

A

the crystalline structure that forms when fluoride ions are incorporated during the remineralization process

338
Q

counseling for dental caries control

A 
Biofilm control
Pit and fissure sealants
Dietary assessment 
Fluoride therapy
Antimicrobial therapy 
Remineralization
339
Q

antibacterial therapy

Chlorhexidine

A

-0.12% Chlorhexidine
-Indicated for high risk patients
-Protocol for use:
Reduces MS; not effective against LB
10ml for 1min at bedtime for 1week/month
Follow with 3 weeks of NaF rinse

340
Q

antibacterial therapy

povidone iodine

A

-Povidone iodine
-Indicated for high risk patients
-Protocol for use:
Reduces MS and LB in children
Professional application only
Swish 10ml for 1min or swab 1-2ml for 2min

341
Q

fruity breath indicates what?

A

diabetes

342
Q

digital palpation

A

Use of a single finger to move or press against tissue

343
Q

bidigital palpation

A

Use of one or more fingers and thumb to move or compress tissue

344
Q

bimanual palpation

A

Use finger of one hand and fingers and thumb of other hand simultaneously to move or compress tissue

345
Q

bilateral palpation

A

Use fingers of both hands simultaneously to move or press on contralateral sides of the head/neck

346
Q 
Thyroid gland
-location
-shape
-what does it do
enlarges?
A
  • Secretes thyroid hormone that controls the body’s metabolic rate
  • Middle of lower neck over trachea
  • Shaped like a bow tie
  • Check for nodules during examination
  • Goiter is an enlarged thyroid gland: graves disease, hyperthyroid
  • hypothyroid: hashimoto’s
347
Q

lymphatic system

A
  • Network of lymph nodes connected by vessels, which plays a role in defense against infection
  • Lymph fluid carries nutrients and waste between body tissues and bloodstream
  • Lymph nodes are bean-shaped structures that filter and trap bacteria, fungi, and waste
  • 400-700 in the body
  • 170–300 in neck
  • Major chains in anterior and posterior of neck and under chin
  • Vary in size from head of pin to baked bean
  • Enlarge when infected, if there is an inflammatory condition, or cancer (idiopathic-no cause, infection, cancers)
348
Q

lymphadenopathy

A
  • enlarged lymph nodes
  • Nodes swell in area of infection
  • Usually enlarge to ½ to 1 inch across with virus
  • Will enlarge over 1 inch with bacterial infection
  • Painless with cancer
  • Lymphatic system can transport cancer cells throughout the body
  • firm, tender, enlarged, freely movable, swollen grape
349
Q

when doing EIO what are you looking for

A

lump, swelling, raised knob, freely movable node, fixed nodule, asymmetry, irregular shape, firm or hard consistency, tender areas, red or discolored area, wound, bruise, scar

350
Q

exostosis

A

extra bone growth on buccal, normal unless it is causing issues

351
Q

leukoedema

A

white film, common on darker skin

352
Q

toris palatine

A

extra bone on the palate

353
Q

nicotine stomatitis

A

minor glands that are irrupted, dry heat causing altered tissue, educate the pt

354
Q

tonsilloliths

A

tonsil stones

355
Q

geographic tongue

A

bengin migratory glossitis

356
Q

scalloped tongue

A

wave like tongue on the borders

357
Q

ankyloglossia

A

tongue tied

358
Q

macule

A

A circumscribed, nonraised area of epidermis altered in color from its surroundings

359
Q

patch

A

A circumscribed pigmented or textured area larger than a macule

360
Q

erosion

A

A denudation of epithelium above the basal cell layer

361
Q

ulcer

A

A loss of epithelium that extends below the basal cell layer

362
Q

scar

A

A permanent mark indicating previous wound healing

363
Q

fissure

A

A linear crack in the epidermis

364
Q

papule

A

An elevated, solid lesion less than 1 cm in diameter

365
Q

plaque

A

A flat, raised area larger than 1 cm in diameter

366
Q

nodule

A

A raised, solid mass that has the dimension of depth and is less than 1 cm in diameter

367
Q

tumor

A

A solid, raised benign or malignant mass that has the dimension of depth and is larger than 1 cm in diameter

368
Q

vesicle

A

A circumscribed, fluid-filled skin elevation less than 1 cm in diameter

369
Q

pustule

A

A vesicle filled with purulent exudate

370
Q

bulla

A

A fluid-filled mucocutaneous elevation greater than 1 cm in diameter

371
Q

when documenting EIO finding ask theses questions about the history

A
  • Is the patient aware of the lesion
  • How long has it been present
  • Changes in size and appearance
  • Symptoms
  • 7 to 10 days
372
Q

when documenting EIO findings, be specific about location and document if it is

A

Localized
Generalized
Single lesion
Multiple lesion

373
Q

when documenting EIO findings, document physical characteristics

A

Size and shape
Color
Surface texture
Consistency

374
Q

when documenting EIO findings, document Attachment of lesion

A

sessile or pedunculated

375
Q

excisional

A

entire lesion is removed

376
Q

incisional

A

section of the lesion is removed

377
Q

cancer screening adjuncts

A
  • vizilite: abnormal tissue will reflect light and appear white
  • velscope: abnormal tissue will appear dark and irregular
378
Q

What is the most common dental emergencies?

A

syncope: pt has anxiety, psychogenic reaction
male: men don’t express that anxiety, more common to faint.

379
Q

what are the risk factors in medical emergencies?

A
  • Increased number of elderly patients in society with natural teeth and dental diseases that require invasive procedures
  • Medical advances (more dental history, implants)
  • More complex dental procedures require longer appointments
  • Increased use of pharmacological agents for systemic conditions (more medicine)
380
Q

what are preventative actions for an emergency

A
  • Medical History Assessment (allergies)
  • Physical Observation (nervous, not communicating, seems rude, holding onto chair, arms crossed, you can ask them if they are nervous)
  • Psychological Assessment
  • Medical Consultation (resent cardiac event 3-6 months)
381
Q

compensation

A

pt vitals increase above base line

382
Q

decompensation

A

pt vitals decrease below base line

383
Q

what are the 8 vital signs

A

blood pressure, pulse, respiration, temperature, height, weight, age, medical alert tag

384
Q

is it better to be compensation or decompensation?

A

compensation

385
Q

why do we take vital signs?

A
  • baseline
  • consult if not WNL
  • monitor during medical emergency
386
Q

temperature; normal ranges and not normal ranges, what reduces a fever

A

35.5°C – 37.5°C
96.0°F – 99.5° F
Fever (pyrexia) greater than 99.5°F
Anti- pyrexia: reduces fever
Hyperthermia greater than 105.8°F
Hypothermia less than 96.0°F

387
Q

pulse; normal ranges and not normal ranges

A 
Normal adult rate 60-100 bpm
Normal child rate 90-120 bpm
Bradycardia: less than 50 bpm
Lower than normal
Tachycardia: more than 100 bpm
Higher than normal
388
Q

respiration; normal ranges, Factors to observe during respiration

A 
Adult 14 – 20 respirations per minute
Child 20 – 25 respirations per minute
Factors to observe during respiration
Depth: shallow/deep
Rhythm: regular/irregular
Quality: strong/weak/labored
Sounds: gasping/wheezing
389
Q

blood pressure; normal ranges and not normal ranges

A

normal: 160/>100

390
Q

systolic pressure

A

The peak or highest pressure, caused by ventricular contraction

391
Q

diastolic pressure

A

The lowest pressure, caused by ventricular relaxation

392
Q

pulse pressure

A

The difference between the systolic and diastolic pressures

393
Q

hypertension

  • primary
  • secondary
A
  • primary
  • 90%
  • etiology: idiopathic
  • predisposing risk factors: heredity, overweight, race, sex, age, environment, smoking
  • secondary
  • 10%
  • major underlying disease, i.e. kidney disease
394
Q

antibacterial therapy

povidone iodine

A

-Povidone iodine
-Indicated for high risk patients
-Protocol for use:
Reduces MS and LB in children
Professional application only
Swish 10ml for 1min or swab 1-2ml for 2min

395
Q

antibacterial therapy

xylitol

A

Xylitol is a 5 carbon “sugar alcohol”
It looks like sucrose and has about the same sweetness by weight
It is used in some foods, chewing gum, candies, lozenges, and dental products as a sweetener
Cariogenic bacteria can not metabolize it
Humans can metabolize it and use it as an energy source
Decreases level of S. Mutans
1gram xylitol per stick
Chew 5-10 sticks per day for 5 min/stick

396
Q

Remineralization

calcium phosphate technologies

A

-ACP (amorphous calcium phosphate)
-CPP-ACP (milk protein casein phosphopeptide as carrier for ACP)
Avoid in patients with milk allergy

397
Q

Dietary assessment for dental caries

A

To provide an opportunity for the patient to assess their dietary habits
To obtain an overall picture of the types of foods in the patients diet
To assess snaking patterns
To determine the overall consistency of the diet
To identify the nutritional status of the individual
To provide a basis for making recommendations for changes in the diet important to oral health

398
Q

Salivary assessment

unstimulated normal

A

0.3-0.4 ml/min

399
Q

Salivary assessment

unstimulated abnormal

A
400
Q

Salivary assessment

stimulated normal

A

1-2 ml/min

401
Q

Salivary assessment

stimulated abnormal

A
402
Q

stimulated salivary flow rate

normal, low, dry

A
  1. 0 ml/min or greater = Normal
  2. 6 - 0.9 ml/min = Low
  3. 5 ml/min or less = Dry
403
Q

Which of the following physical traits of food presents the highest potential for dental caries?

a. Soft and mushy
b. Liquid
c. Sticky
d. Hard and brittle

A

sticky

404
Q

Once exposed to fermentable carbohydrates,
how long does it take on average for plaque
pH to reach its minimum?
a. 5 to 20 minutes
b. 1 to 3 minutes
c. 30 to 60 minutes
d. There is no average; it depends entirely on the individual.

A

5 to 20 minutes

405
Q

Why does cheese have a beneficial effect on saliva?
a. Cheese has the advantage of raising the plaque
concentrations of calcium and phosphate, increasing
the chance of remineralizing teeth.
b. Cheese is a strong sialogogue (causing salivation), an agent that increases
the flow of saliva.
c. The chewing of cheeses rich in nitrogenous
compounds gives rise to pH increases, despite the
cheese itself being acidic.
d. All of the above.

A

all of the above

406
Q

At what pH does tooth enamel begin to demineralize?

a. 8.3
b. 7.5
c. 5.5
d. 3.2

A

5.5

407
Q

What is the clinical appearance of the initial stage of a carious lesion?
a. A large cavitation that extends into the dentin.
b. A chalky white spot on the tooth surface.
c. Evidence of tooth erosion caused by acid
attack.
d. Completely demineralized tissue.

A

A chalky white spot on the tooth surface.

408
Q 
Which of the following should be avoided if 
the patient is allergic to milk?
a. ACP
b. MI Paste ™
c. Recaldent™
d. Fluoride
A

Recaldent™

409
Q

Which sugar substitute can promote remineralization?

a. Sorbitol
b. Xylitol
c. Sucralose
d. Aspartame

A

xylitol

410
Q

fluoride

A

Fluoride is a salt of hydrofluoric acid

It is found in all tissue but has an affinity for calcified tissue (bones and teeth)

clinic (6 decks)

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