Fundamentals Objectives Exam 1 Flashcards
Discuss the dental health care provider’s responsibilities in assessing vital signs and the rationale for obtaining accurate vital sign readings prior to providing dental hygiene treatment.
The only way to know if you have high blood pressure (HBP, or
hypertension) is to have your blood pressure tested. Understanding your
results is key to controlling high blood pressure.
Identify each part of the stethoscope and blood
pressure cuff and explain its purpose.
Stethoscope: Amplify sound
- 2 earpeices
- Binaurals- isolate ans transfer sounds
- Plastic or rubber tubing -transfers frequency
- Chest piece (2 sides bell and diaphragm)- bell picks up lower freq. sounds diaphragm wide freq.)
Sounds created from patient body are picked up through the diaphragm or bell end. Sound travels through rubber tubing into binaurals to earpiece
Blood Pressure Cuff:
Discuss the normal range of temperature
Average 98.6 degree F
Range 96.8-100.4 degrees F
Discuss the normal range of a pulse and respiration
Pulse 60-100
Respiration: 12-20
Discuss the importance of knowing the patient’s A1C and glucose levels prior to dental treatment
Students will perform a glucose test for all patients reporting diabetes. Glucose testing may be performed as a screening if a patient reports a family history or answers yes to pertinent diabetes related questions.
• A1C: patients should maintain 7% or less HbA1C with well controlled diabetes or 7.5% in elderly patients with well controlled diabetes.
• Blood glucose limit up to 250 mg/dl if the patient has a current A1C at 7% or below
• If the patient has not been diagnosed with diabetes and the blood glucose is at or above 200 mg/dl treatment will be delayed and a referral to the physician will be given.
• Any patient with a blood glucose of 300 mg/dl or higher receives an immediate referral to a physician and all treatment is delayed until a medical clearance is received.
Based on the Guidelines within the PU DHS clinic manual, identify which medical conditions require a prophylactic antibiotic prior to dental treatment
Joint Replacement Prophylaxis Recommendation
• All joint replacements DO NOT require premedication, unless otherwise directed by their surgeon and written documentation is received stating premedication is necessary.
• If the surgeon recommends the patient to be on premedication the premedication will be prescribed by the surgeon.
• A verbal statement from the surgeon is acceptable to proceed on with treatment for the initial appointment if NO premedication is indicated. Written documentation from the surgeon that NO premedication is necessary and must be on file prior to the patient’s second appointment.
• The student clinician and/or overseeing faculty will fill out the Medical Consult Consent form within axiUm for all individuals disclosing a joint replacement. Notification through messenger in axiUm is required to be sent to the front office personnel in order for the form to be faxed to the intended recipient.
Endocarditis Prophylaxis Recommendation
Only recommended for the highest risk of IE including those who have:
• Artificial heart valve or who have had a heart valve repaired with artificial material.
• A history of endocarditis
• A heart transplant with abnormal heart valve function
• Certain congenital heart defects including:
o Cyanotic congenital heart disease (birth defects with oxygen levels lower than normal), that has not been fully repaired, including children who have had a surgical shunt and conduit.
o A congenital heart defect that’s been completely repaired with artificial material or a device for the first six months after the repair procedure.
o Repaired congenital heart disease with residual defects, such as persisting leaks or abnormal flow at or adjacent to a prosthetic patch or prosthetic device.
History of Appetite Suppressant Drugs such as Fenluramine and Phentermine (fenphen)
Referral to the physician for a complete physical examination and echocardiogram is necessary prior to dental treatment due to the increased risk of significant bleeding.
Endocarditis Prophylaxis NOT Recommended
Negligible Risk Category (no greater than the general population)
• Surgical repair of atrial septal defect, ventricular septal defect or patent ductusarteriosus (without residues beyond 6 mos)
• Previous coronary artery bypass graft
• Mitral valve prolapse with or without regurgitation
• Physiologic, functional, or innocent heart murmurs
• Previous rheumatic fever without valvular dysfunction
• Cardiac pacemakers
• Implanted defibrillators
informed consent
Patient is aware of risks and tx and gives written consent
prophylactic antibiotic
Given ½ to 1 hour before treatment to limit chance of inflammatory endocarditis
auscultation
The act of listening/Stethescope
tachycardia
Rapid heart rate above 100 bpm
bradycardia
Slow heart rate below 80
tachypnea
Rapid breathing above 20 breaths per min
bradypnea
Slow breathing below 15 respirations per minute
hypertension
High blood pressure above 120/80
orthostatic hypotension
After standing for 3 minutes a drop in blood pressure
Discuss the rationale for performing a thorough head, neck and oral examination and accurately documenting findings.
Screening for Oral Cancer. Patient typically sees hygienist more than doctor so we make sure to screen.
Intra Oral Exam:
- Note early signs of disease
- Detect abnormalities and potentially life threatening oral malignancies
Extra Oral Exam:
A physical examination technique consisting of:
A systematic visual inspection of the skin of the head and neck
Palpation of the lymph nodes, salivary glands, thyroid, and TMJ
Thorough and accurate documentation of findings.
Identify conditions requiring referral to a physician or dental specialist.
Cancer does not show signs of healing and resolution within a 2 week (14 days) window of time.
Lesions:
Leukoplakia- white lesions
Erythroplakia- red lesions; greater potential for becoming cancer than leukoplakia
Symptoms:
- Soreness
- Hoarseness
- Feeling as if something is caught in throat
- difficulty chewing or swalling
Discuss findings of the head, neck and oral examination that have implications in planning dental hygiene treatment.
Herpatic Lesions must be dismissed while active
work related musculoskeletal disorder
Force+Repetition+Position+No Rest= Musculoskeletal Injury
ergonomics
The science of adjusting the design of tools, equipment, tasks, and environments for safe, comfortable and effective human use
supine position
The position of the patient during dental treatment, with the patient lying on his or her back in a horizontal position and the chair back nearly parallel to the floor
repetitive task
A task that involves the same fundamental movement for more than 50 % of the work cycle
neutral position
The ideal positioning of the body while preforming work activiites that is associated with decreased risk of musculosceletal injury. It is generally believed that the more a joint deviates from the neatral position, the greater is the risk of injury
carpal tunnel syndrome
Painful disorder of the wrist and hand caused by compression of the median nerve within the carpal tunnel
Causes
Poor posture (why?)
Repetitive bending wrist up and down or side to side
Gripping instruments without frequent rest periods
Symptoms
Numbness, pain and/or tingling
in the thumb, index, middle and ring fingers
ulnar nerve entrapment
Painful disorder of the wrist and hand caused by compression of the ulnar nerve as it
passes through Guyon’s canal
Causes
Bending up/down or side to side at wrist
Holding the little finger a full span away from the hand
Symptoms
Numbness/Tingling in pinky and ring fingers
Loss of (grip) strength
in the hand
rotator cuff tendinitis
Painful inflammation of the tendons in the shoulder region
Causes
Holding the upper arm away from the body (elbows pointed outward
Symptoms
Sharp pain near top of shoulder and impaired function of the shoulder joint
tendinitis
Painful inflammation of the tendons of the wrist and hand
Causes
Repeatedly extending up or down at the wrist
Symptoms
Pain in the wrist, especially on the outer edges of the hand
pronator syndrome
Painful disorder of the hand caused by compression of the median nerve between the two heads of the pronator teres muscle
Causes
Repetitive grasping, especially with the forearm rotated downward
Symptoms
Similar to carpal tunnel syndrome
Numbness, pain and tingling in the thumb, index and middle, and ring fingers (can be in the palm)
Discomfort in the anterior forearm near the elbow
tenosynovitis
Painful inflammation of the tendons on the radial side of the wrist and at the base of the thumb
Causes
Wrist deviation
Forceful pinching
Maintaining an extended thumb for prolonged periods
Symptoms
Pain of the thumb side of the wrist and near the base of the thumb
Discomfort with thumb opposition toward pinch and wrist deviation to same side
trigger finger
Painful inflammation of the tendons on the palm aspect of the hand at the base of an individual finger
Causes
Repetitive pinching
Sustained fist formation
Lack of stretching the small muscles of the hand
Symptoms
Pain in palm at base of affected finger
Locking of finger into flexed position
Palpable bump/nodule at base of finger in palm
parallel
Lines that run in the same direction and will never meet or intersect one another
perpendicular
Two lines that intersect (meet) to form a 90 degree angle
cross section
Formed by cutting through an object , usually at right angles to its longest dimension. A sickle scaler is triangular in cross section, a curet is semi circular in cross section
long axis
an imaginary straight line that passes through the center of a tooth and divides the tooth symmetrically
apical
toward the tooth apex
coronal
toward the crown of the tooth
midline
an imaginary line that divides an anterior tooth into two equal halves
quadrant
One fourth of the combined dental arches. There are two maxillary quadrants and two mandibular quadrants
sextant
One sixth of the combined dental arches. There are two anterior sextants and four posterior sextants
