Medical Management: Summary Pages Immune/Sensory/Behavioral

Question 1

dental treatment modifications for HIV/AIDS patients

Answer 1

1. B/c most patients infected with HIV are undetectable by med Hx, use standard precautions
2. Avoid tissue trauma
3. Minimize stress.
4. Schedule frequent recall appointments with emphasis on disease prevention.

Question 2

complications of HIV/AIDS as it relates to the oral cavity

Answer 2

candidiasis (treated with anti-fungal agents), herpes simplex (treated with acyclovir), chlorhexidine in oral mucosal infections

Question 3

drugs to avoid with HIV/AIDS patients

Answer 3

none unless specified by physician

Question 4

potential emergency situations with HIV/AIDS patients

Answer 4

none

Question 5

drugs to avoid in glaucoma patients

Answer 5

closed-angle glaucoma = avoid anticholinergic drugs that
block the PNS since an increase in intraocular
pressure may occur

Question 6

potential emergency situations for glaucoma

Answer 6

none

Question 7

dental modifications for glaucoma patients

Answer 7

1. provide assistance
2. provide verbal explanations for all procedures
3. provide disease prevention education on FEEL rather than LOOK
4. be careful with word choice

Question 8

prior to starting chemotherapy, these are things to do…

Answer 8

• implement aggressive caries/PD prevention plan
• treat all non-vital teeth
• eliminate areas of infection/irritation
• remove ortho bands
• for pediatric patients, mobile teeth should be extracted as those expected to be lost during chemotherapy

Question 9

only _______ should be done during chemotherapy; even then, consult with patient’s _____ before treatment

Answer 9

emergency treatment, oncologist

Question 10

prior to head/neck radiation therapy…

Answer 10

goal of Tx is to establish a dentition that will be maintained the rest of the patient’s life

Question 11

during head/neck radiation therapy…

Answer 11

include instructions for jaw muscle exercises to minimize trismus development

Question 12

home exercises for trismus prevention

Answer 12

open and close mouth as far as possible 20x, 3 times per day

Question 13

following head/neck radiation therapy…

Answer 13

3-4 MRC, construct new appliances 3-6 following active therapy

Question 14

drugs to avoid in depression patients

Answer 14

vasoconstrictors in large doses

Question 15

dental modifications in depression patients

Answer 15

Avoid excessive use of epinephrine as it may interact with antidepression
medications causing severe hypotension. Two cartilages of 2% lidocaine
with 1:100,000 epinephrine can safely be used.

Question 16

drugs to avoid in dementia/Alzheimer’s patients

Answer 16

atropine, reduce dosage of sedatives/hypnotics/narcotics

Question 17

potential emergencies with dementia/Alzheimer’s patients

Answer 17

seizure, arrhythmia, tachycardia

Question 18

drugs to avoid in schizophrenic patients

Answer 18

atropine, reduce dosage of sedatives/hypnotics/narcotics

Question 19

potential emergencies in schizophrenic patients

Answer 19

seizure, arrhythmia, tachycardia

Question 20

how long do you need to wait before treating a patient who uses cocaine?

Answer 20

6 hours

Question 21

how long do you need to wait before treating a patient who uses methamphetamine?

Answer 21

24 hours

Question 22

potential emergencies in patients who use cocaine/methamphetamine

Answer 22

Hypertensive crisis
Cerebrovascular Accident
Myocardial Infarction