Oral and Otic Flashcards
Which factor determine exclusion from self-treatment?
-Signs of (systemic)infection: fever, pain, dullness of hearing
-Bleeding or trauma
-ruptured tympanic membrane
-cant follow instructions (technical help needed)
-hypersensitive to agents
-children <12 years bc they are prone to ear infection due to the anatomy
What would a patient complain of in case of excessive cerumen in the ear?
-Fullness or pressure in the ear
-Gradual hearing loss
-Dull pain
-Vertigo (feel dizzy)
-Tinnitus
-Chronic cough
What are Nonpharmacologic therapies used to treat excessive cerumen?
-use of wet washcloth draped over a finger (avoid use of swabs)
-Murine Earigate System: rinses away ear wax build-up with isotonic desalinated water
Ear drop technique:
-Wash hands and the ear
-Warm the eardrops to body temperature
-the head should be tilted and the ear must be pulled back and down (in kids over 3 pull up and back)
What is the active ingredient to remove cerumen from the ear?
The GOAL is to soften and remove excessive cerumen
Carbamide Peroxide 6.5% in anhydrous glycerin
-it creates effervescence when in contact with moisture which breaks down and loosens cerumen
-after loosening the cerumen -> Irrigation is used to rinse the ear with warm water
What is the dose of Carbamide peroxide?
-5-10 drops and let it remain for 15 min
-2x daily up to 4 days
Other products used for cerumen removal:
-Docusate sodium - for emollient effect, softener
-Dilute hydrogen peroxide
-Olive oil (sweet oil) - used as an emollient to soften ear wax
-Mineral oil
-Chamomilla – helps with inflammation
Causes and risk factors of water-clogged ears:
-can be caused by the shape of the ear or excessive cerumen -> cerumen can swell and trap water
-patients may have the sensation of water in the ear, hearing loss, itching, inflammation, infection
-risk factors: humid climate (summer), swimming, bathing, sweating, wax build up
How to treat water-clogged ear nonpharmacological:
The GOAL is to dry the ear
-tilt the ear downward and manipulate the auricle so that water can be expelled from the ear
-blow dryer around the ear (not in it)
-water-absorbing earplugs
-prevent water entry: bath cap, earplugs
The active ingredient for water-clogged ears:
-Isopropyl alcohol (alcohol as a drying agent, glycerin = emollient, solvent)
-Dose: 4-5 drops
-side-effects: Stichting, itching, burning
Causes and trigger of tooth hypersensitivity:
-Damaged teeth -> exposed Dentin -> fluid flow in dentin causes nerve stimulation and pain
-can be caused by injury, infection, acidic and sweet food, or dental procedures
-Trigger: heat, cold, pressure, sweet, acidic food
When do patients with tooth sensitivity need to be referred?
-Severe pain
-broken or loose teeth
-mouth sore associated with poor-fitting dentures
-bleeding, trauma
-fever or swelling
What are Pharmacologic Treatment Options for tooth sensitivity?
-Potassium nitrate 5%
-Arginine 8%
-> API in toothpaste
-have to be used for 2-4 weeks
-If hypersensitivity is not relieved within 14-21 days of using desensitizing toothpaste, refer to a dentist
Causes and risk factors of Recurrent Aphthous Stomatitis
(Canker Sores):
-cause not known
-ulceration inside the mouth: gum, tongue, cheek -> they are ROUND and FLAT
-risk factors: trauma (bite in your cheek), genetics, stress, smoking, food allergy
-persist for 5-14 days
When to refer patients with canker sores:
-present for more than 14 days
-it occurs frequently
-symptoms of infection (fever, swollen glands, rash)
-failure of self-treatment
-recurrence
Non-Pharmacologic Treatment Options for cancer sores
Avoid spicy, sharp or acidic foods until the lesion heals
* Apply ice to the lesion for 10 minutes
* Do not use heat
Pharmacologic Treatment Options for cancer sores
-Oral Debriding and Wound-Cleansing Agents:
Carbamide peroxide 10% - 15%, Hydrogen peroxide 1.5%
-Topical Oral Anesthetic: Benzocaine, Benzyl alcohol, Dyclonine, Hexylresorcinol
-topical Oral Protectants
-Oral Rinses: Original ListerneAntispetic, Saline Solution
-Systemic Analgesics: NSAIDS, Acetaminophenen
Example of a debriding/cleansing agent:
-Glyoxide: Cleansing -> remove anything around sore that can cause infection
API: Carbamide peroxide 10%
-apply a few drops and keep it for 1 min -> spit out
API: Hydrogen peroxide 1.5% -> Swish ½ capful (10 mL) for 1 min and spit out
What are examples of Topical Anaesthetics?
-Orajel, numbing agent (anything with -caine are numbing agents)
API: Benzocaine 20%, anesthetic
numbing sensation for pain relief
-Anbesol (liquid or Gel)
-Kanka (liquid)
Side effect: can cause irritation
Other pharmacological Options:
-Cancer sore patches: cover the lesion for pain relief and they will dissolve
-Mouthwashes like Listerine or saline rinses
Patient counseling point for cancer sours?
-if using multiple products use the rinsing agent first (to avoid rinsing away topical anesthetics)
-lesions that are not healed after 14 days should be referred
-Gels are the preferred DDS bc there easy to apply and not easily washed away
Causes of Herpes Simplex Labials (Cold Sores):
-caused by Herpes simplex virus, transferred through direct contact and recurrent!! due to the dormant state of the virus
-small, red, and fluid-filled, crusted when mature, commonly around the lips
-risk factors: UV light, stress, cold, immunosuppression, menstruation
How long do Cold sores last?
10-14 days and are self-limiting
When will patients with cold sores be referred?
-increased outbreaks
-lesion persistent for more than 14 days
-compromised immunity
-symtomps of infection (fever)
