Final Study Guide Flashcards
What does cleft lip and palate represent
A failure of normal fusion of embryonic processes during development in the first trimester of pregnancy
Formation of the lip
Occurs between the 4th and 8th week in utero
When does a cleft lip become apparent
by the end of the secnd month in utero
Development of the palate
Takes place during the 6th-12th week
When is a cleft palate evident
by the end of the third month
The stage that clefting of the lip happens prenatally
First trimester
Oral manifestations of cleft lip and palate
Disturbances in tooth bud development
Have a higher incidence of missing/supernumerary teeth
Abnormalites of tooth form
Common missing teeth /max lateral/max premolar/ man 2nd premolar usually on side of cleft
Cleft of the top of the uvula
class 1
cleft of the uvula (bifid uvula)
class 2
cleft of the soft palate
class 3
cleft of the hard and soft palate
class 4
cleft of the soft and hard palates; continues thru the alveolar ridge on one side of the premaxilla; usually associated with cleft lip on the same side
Class 5
cleft of soft and hard palates that continues thru alvolar ridge on both sides, leaving a free maxilla; bilateral cleft lip
class 6
sub mucous cleft
muscle union is imperfect across the soft palate. The palate is short, uvula often bifid, groove at midline of soft palate and closure to the pharynx is incompetent
class 7
A prosthesis designed to close a congenital or an acquired opening such as a cleft of the hard palate
Obturator
What is a child with cleft palate at a greater risk for?
dental caries
Environment risk factors that can influence normal development and trigger clefting
use of tobacco alcohol consumption teterogenic agents: phenytoin, vitamin A, corticosteroids drugs of abuse maternal age >40 folic acid deficiency lack of prenatal care
Alveolar graft
placed before eruption of maxillary teeth at the celft site
Hard palate graft
provides closure of oronasal fistulae
helps to relieve a compromised airway
When is the best time to intiate ortho in a child with a cleft
After each stage of surgical treatment
At what interval should a patient with cleft palate be seen
3-4 months
Objectives of dental hygiene care prior to maxillofacial surgery
Reduce oral bacterial count
reduce inflammation of the gingiva and improve tissue tone
remove calculus deposits
instruct in presurgical oral care procedures
instruct in the use of foods
interpret the dentists directions
motivate the pt who will have teeth remaining
What dietary components are necessary for healing in maxillofacial surgery
Protein and vitamins, particularly vitamin A, vitamin C and riboflavin
Predisposing factors for a fractured jaw
Pathologic conditions such as tumors, cysts, osteoporosis, or osteomyelitis -> they weaken bone
What is compound comminuted fracture
Compound - has communication with outside
comminuted - shattered
How long does it take for an uncomplicated mandibular fracture to heal
6 weeks on average
The use of a surgical flap procedure to expose the gracture ends and bring them together for healing
open reduction
intermaxillary fixation
Applying wires and/or elastic bands between the maxillary and mandibular arches
When is intermaxillary fixation contraindicated
pts with chronic airway diseases who cough and expectorate: asthma, COPD
pts who vomit regulary (pregnant)
mental illness
What describtive words are used to describe a fracture
location, direction, nature, and severity
Objectives to planning a diet for the patient with a fractured jaw
prevent new carious lesions
help pt maintain adequate nutritional state
promote healing
increase resistance to infection
What clinical signs does a patient show in a fractured jaw
Pain
teeth may be displaced, fractures, or mobile
muscle spasm
crepitation
soft tissue - laceration, and bleeding, discoloration and enlargement
Horizontal fracture line that extends above the roots of the teeth, above the palate, across the max sinus, below the zygomatic process, and across the pterygoid plates
Le fort I
midface fracture extends over the middle of the nose, down the medial wall of the orbits, across the infraorbital rims, and posteriorly across the pterygoid plates
Le fort II
high level craniofacial fracture extends transverserly across the bridge of the nose, across the orbits, and zygomatic arches, and across the pterygoid playes
Le fort III
Inability to leave home because of illness or injury
ASA III
homebound patients
Barriers to access the dentistry in homebound patients
Few on site dental clinics limited avialibility of practitioners cost limited medicare coverage nonpayment of medicare limited mobility no transportation fear pts health attitudes and beliefs pts discomfort levels
What mouthrinses would be recommended post surgical
Physiologic saline
chlorhexidine gluconate
fluoride rinse
When should a patients HH be reviewed in preparing to see a homebound patient
before you see the patient
Should a patient who is terminally ill be treated dentally
YES
How often should a caregiver clean a patients mouth who is terminally ill
every day
What techniques can be used in treating a patient who is homebound and in a wheelchair
A portable headrest can be attached
can be backed up against a wall to provide headrest
some tilt or recline
a firm pillow can be inserted between the chair back and the pts head to provide a cushioned resting surface
How can poor oral health be prevented in houmbound patient
training caregivers
consulting with members of interprofessional healthcare teams
Contraindications for a patient who is homebound with xerostomia
Alcohol
glycerin
lemons
Why should oral tissues be examined daily in terminally ill patients
can cause discomfort or lead to infections
why are dentures ill-fitting in terminally ill patients
severe weight loss and oral lesions
Legal blindness
having central vision (or acuity) of not more than 20/200 in the better eye with correction, or having peripheral fields of no more than 20 diameters
Double vision
Diplopia
When treating a patient who is visually impaired, what should you do if you leave the room
tell them
What may you use when calling a patient who’s deaf to confirm an appointment
telecommunication relay service
Personal factors to consider with a patient who is visually impaired (child)
environment influences the child’s adjustment, and parental attitude affects the blind child as it does a sighted child
when the patient is overprotective the child may be dependent and emotionally less independent
