Health History Flashcards
a comprehensive dental health history should include what 5 components?
- demographic information - name, address, number, dob, emergency contact, insurance coverage, physcian, implications
- chief complaint
- dental hx
- medical hx
- social hx- marital status, occupation, children
what does HIPAA stand for?
Health Insurance Portability and Accountability Act
what is transient bacteremia?
bacteria in the bloodstream
common after dental procedures and even chewing and routine oral care such as abrushing and flossing
host immune response generally resolves bacteremia within 15 minutes
distant infection sites if immunocompromised
when should prophylactic antibiotic premeds be taken?
1/2 to 1 hour before dental procedures that can cause bacteremia
name 6 cardiac conditions associated with the highest risk of adverse outcomes from endocarditis for which prophylaxis with dental procedures is recommended?
- prosthetic cardiac valve or prosthetic material used for cardiac valve repair
- previous infective endocarditis
- unrepaired cyanotic congential heart disease (CHD), including palliative shunts or condults
- completely repaired congenital heart defects with prosthetic material or device, during the first 6 months
- repaired CHD with resiudal defects at site of adjacent to site of prosthetic patch or prosthetic device
- cardiac transplantation recipients who develop cardiac valvulopathy
list 3 dental procedures for which antibiotic premeds may be beneficial in high risk patients
- manipulation of gingival tissues
- manipulation of periapical region of teeth
- perforation of oral mucosa during dental procedures
describe the protocol for monitoring ct compliance with antibiotic premeds (3 main things to do)
identify the prescribed antibiotic
ask ct what dose was taken and time of admin
record ct response in trmt record
if antibiotic not taken, it CAN be admin’d within 2 hours of appointment
what is the adult and child dose of amoxicillin 30 to 60 mins before procedure taken orally?
adults- 2g
children- 50mg/kg
what 3 antibiotic prophylaxis agents can be given when a ct cannot take oral medications?
ampicillin
cefazolin
ceftriazone
what dose of ampicillin, cefazolin or ceftriazone can be given to adults and children who cannot take oral medication 30 to 60 mins before a procedure?
ampicillin; adults- 2g IM or IV, children- 50mg/kg IM or IV
cefazolin or ceftriazone; adults- 1g IM or IV, children- 50mg/kg IM or IV
if a client is allergic to penicillin or ampicillin AND is unable to take oral medications, what 4 drugs may be given instead?
cephalexin
clindamycin
azithromycin
clarithromycin
list the adult and child doses given for the 4 drugs that can be provided to a ct 30 to 60 mins before a procedure if the ct CAN take drugs orally and is allergic to penicillin/ampicillin?
cephalexin; adults- 2g, children- 50mg/kg
clindamycin; adults- 600mg, children- 20mg/kg
azithromycin/clarithromycin; adults- 500mg, children- 15mg/kg
what 3 drugs can be given to ct’s as a premed when they CANNOT take oral drugs and are allergic to penicillin/ampicillin?
cefazolin/ceftriaxone
clindamycin
what doses of clindamycin or cefazolin/ceftiazone can be given to ct’s as a premed if they are allergic to penicillin/ampicillin and CANNOT take oral drugs? (list adult and child dose)
cefazolin/ceftriazone; adults- 1g IM or IV, child- 50mg/kg IM or IV
clindamycin; adults- 600mg IM or IV, child- 20mg/kg IM or IV
why are appointments for procedures requiring antibiotic prophylaxis scheduled 10 days apart?
to reduce the emergence of resistant microorganisms and allow repopulation of the ususal antibiotic-susceptible flora
how many hours after a procedure will a premed cease to work effectively?
3
common oral medication side effects
xerostomia caries chage in taste difficulty w/ mastication difficulty wearing appliances ulcerations atrophic mucosa hairy tongue infection mucositis or stomatitis burning mouth or tongue difficulty with speech difficulty swallowing increased periodontal disease progression opportunistic infections (candidiasis) bleeding gingival enlargement
classes of drugs that cause xerostomia
anorexiants antiacne agents antianxiety agents anticholingeric/antispasmotics antconvulsants antidepressants antidiarrheals antiemetics antihistamines antihypertensives anti inflammatory analgesics antinuaseants antiparkinsonian agents antipsychotics bronchodilators decongestants dieuretics muscle relaxants opate analgesics sedatives
dhi’s to manage oral side effects of medication related to:
caries and sensitivity
prescription fluorides; dentrifices, gels and rinses
professional in-office applications of topical fluorides
amorphouse calcium phosphate (ACP)
calcium sodium phosphosilicate
tricalcium phosphate
milk casein phosphopeptides (CPP) complexed w/ ACP (Recalident)
OTC dentinal hypersensitivity protection dentrifices
professional in-office trmt for sensitivity
xylitol
dhi’s to manage oral side effects of medication related to:
salivary replacement therapy
artifical saliva
water
dhi’s to manage oral side effects of medication related to:
salivary stimulations
pilocarpine (Salagen) (prescribed by dx)
cevimeline (Evoxac) (prescribed by dx)
sonic toothbrushing
dhi’s to manage oral side effects of medication related to:
daily antimicrobial therapy
0.12 chlorhexidine mouthrinse
essential oil mouthrinse
0.07% cetylpyridium chloride mouthrinse
dhi’s to manage oral side effects of medication related to:
antifungal therapy
prescription drugs: topical ointments, liquids, powders, troches (eg. nystatin [Mycostatin]), systemic meds (eg. flucazone [Diflucan])
daily antimicrobial therapy with 0.12% chlorhexidine or essential oil mouth rinse
dhi’s to manage oral side effects of medication related to:
antiviral therapy
prescription topical ointments, systemic medicatons (eg. acyclovir [Zovirax], penciclovir [Denavir)
OTC topical ointments (eg. docosonol 10% [Abreva], acohol/benzalkonium chloride [Viroxynl])
OTC topical ointments for pain control
dhi’s to manage oral side effects of medication related to:
topical pain control for ulcerations or mucositis
OTC benzocaine or tetracaine ointments OTC liquid Benadryl mixed with coating agent prescription lidocaine rinse prescription amlexanox (Aphtasol) ointment (aphthous ulcerations)
dhi’s to manage oral side effects of medication related to:
oral hygiene devices
powered toothbrush
power flosser
oral irrigator
interdental cleaning aids
