Patient Management Flashcards
- Age ________ - infant, not responsible for actions
- Age ________- competent
- Age ________ - responsible
- Minors younger than ______ can give implied consent or
assent but not actual consent
- Age 1-7 -infant, not responsible for actions
- Age 8-14 - competent
- Age 15-17 - responsible
- Minors younger than 18 can give implied consent or
assent but not actual consent
Rapport is a Mutual sense of _____ and ________
trust and openness
Empathy is a reflection and showing _________
Reflection and showing understanding
__________ questions allow patient to explain
what is important to them
Open-ended questions
__________ questions direct the patient to
respond a certain way, DO NOT USE
Leading
_____________ questions ask patient to respond from a list of choices
Laundry questions
__________ questions elicit more specific
information
Closed ended
Probing questions is used to
gather additional information
Antecedent
factor that facilitates behavior
not considering behavior change comes under_______ stage
Precontemplation
Which stage requires suppport?
Action
cognitive perception that you
can execute behaviors necessary for a given
situation
Self-efficacy
Perceived susceptibility to given
disease or problem
prompts to engage or not engage in certain behavior
Cues to action
Negative punishment
do a bad thing and
remove a good stimulus
Negative reinforcement
Negative reinforcement= do a good thing and
remove a bad stimulu
making a behavior that has a higher probability of being performed contingent on a behavior that has a lower probability of being performed
- Premack Principle
setting small attainable goals and rewarding
yourself after each step is called
- Shaping
Motivational Interviewing OARS stands
OARS= open questions, affirmations, reflective
listening, summarizing
not ready to change is called _________ talk
Sustain talk
__________ Pain Rating Scale is
particularly useful for the ongoing assessment
of pain experience in children
Wong-Baker Faces
- Pain is a complex phenomenon involving
___________
cognition and emotion
Pharmacologic Pain Management
* Rx
– Mild-
– Moderate-
– Severe-
Pharmacologic Pain Management
* Rx
– Mild ibuprofen or acetaminophen
– Moderate ibuprofen and acetaminophen
– Severe ibuprofen and/or acetaminophen
and opioid
- Nitrous Oxide
– Sensation before onset -
– Side effect -
- Nitrous Oxide
– Sensation before onset - tingling
– Side effect - nausea
DMFT is a reversible/irreversible measure
Irreversible
Gingival Index
* 0=
* 1=
* 2=
* 3=
Gingival Index
* Uses four surfaces on six indicator teeth
* 0= normal gingiva
* 1= mild inflammation
* 2= moderate inflammation
* 3= severe inflammation, ulcerated tissue with tendency
toward spontaneous bleeding
Periodontal Index
– 0=
– 1=
– 2=
– 3=
– 4=
Periodontal Index
– 0= healthy
– 1= bleeding
– 2= calculus
– 3= shallow pockets
– 4= deep pockets
ECC
Mostly occurs in ages _________
Mostly involves
Mostly occurs in ages 3 to 5
Mostly involves maxillary incisors and molars
_________ is optimal amount of flouride
1 ppm (1mg fluoride per liter of water)= 2ml
1 ml of flouride is _______mg
0.5 mg F
Acidulated phosphate fluoride (APF) gel has
pH ___ and ____% fluoride
pH 3.0 and 1.23% fluoride
Stannous Fluoride _____ taste and _________ tooth staining
Astringent taste and extrinsic tooth staining
TOXIC DOSE IS ________
TOXIC DOSE IS
5MG/KG
LETHAL DOSE IS ________
FOR AN ADULT
LETHAL DOSE IS 5G FOR AN ADULT
- Hand wash= _______ seconds minimum
- Flush ultrasonic= _________ seconds minimum
- Hand wash= 15 seconds minimum
- Flush ultrasonic= 20-30 seconds minimum
Hep B
* ____% risk of transmission after percutaneous
injury
* Postexposure prophylaxis includes _________ and
_______________
30%
vaccine and possibly immunoglobulin
Hep C
* _________% risk of transmission after percutaneous
injury
Postexposure prophylaxis is ______
1.8%
now available
HIV
* ____% risk of transmission after percutaneous
injury
* Postexposure prophylaxis is a course of
_________
0.3%
antivirals
Patient with active TB should not be seen for
__________ dental care
elective
Regulates transportation of dental waste from
dental offices is amnaged by ______ agency
Environmental Protection Agency (EPA)
Sterilization
* Destruction of all life forms including__________
Sterilization
* Destruction of all life forms including bacteria,
viruses, and spores
Minimum exposure periods for sterilization of wrapped healthcare supplies are ______min and ______degree centigrade
minimum exposure periods for sterilization of wrapped healthcare supplies are 30 minutes at 121°C (250°F) in a gravity displacement sterilizer.”
Moist heat destroys bacteria by __________
of proteins
denaturation
Dry heat sterilization
– ______˚C for ____ min
– Only ________objects can be sterilized by this method due to high
temperatures
– Dry heat destroys bacteria by
__________ of proteins
Dry heat sterilization
– 160˚C for 60 min
– Only glass or metal objects can be
sterilized by this method due to high
temperatures
– Dry heat destroys bacteria by
coagulation of proteins
– Best preservation of cutting edges
– Best preservation of cutting edges
Dry heat sterilization
Glutaraldehyde
– Cold solution used for __________ items
heat-sensitive items
Disinfection
* Used on _________ objects
* Spores are not destroyed in this
process, but _________ is
Let it sit for ___ minutes and then
wipe
Inanimate
Mycobacterium tuberculosis
Let it sit for 10 minutes and then wipe
- Quaternary ammonium compounds (quats) à
disrupt cell membrane and lethal to a wide
variety of organisms except _________
endospores, TB, and non-enveloped viruses
Spaulding Classification System
1. Critical= contacts ______
– Requires
– Examples are
2. Semi-critical= contacts
– Minimum of
– Examples are
3. Noncritical= contacts
– Requires
– Examples include
Spaulding Classification System
1. Critical= contacts sterile tissue or vascular
system
– Requires sterilization
– Examples are needles
2. Semi-critical= contacts mucosa
– Minimum of high-level disinfection but sterilization if
material is heat stable
– Examples are mouth mirror
3. Noncritical= contacts skin
– Requires disinfection
– Examples include blood pressure cuffs
- Acute mercury toxicity affects include:
- Acute mercury toxicity
– Muscle weakness (hypotonia)
– Loss of hair (alopecia)
– Weight loss/GI disorders
– Exhaustion
Airborne Particles
* Splatter= visible _______µm, fall within ______feet of
patient’s mouth, can carry __________
pathogens
* Aerosols= invisible _____µm, can only carry _________
Airborne Particles
* Splatter= visible ≥50µm, fall within 3 feet of
patient’s mouth, can carry blood-borne
pathogens
* Aerosols= invisible <50µm, remain floating in air
for hours, can only carry respiratory infections
- Hearing loss develops slowly over time and
can be caused by_____
≥90dB
Water Lines
* EPA requires _____ CFU of heterotrophic
bacteria per mL of water
flush waterlines in the
≤500
flush waterlines in the morning and after each patient.
_________ Association color and number
– Blue= ________hazard and number_____
– Red= ______ hazard and number_________-
– Yellow= ________ and number _________
– White=
National Fire Protection Association color and number
– Blue= health hazard
– Red= fire hazard
– Yellow= reactivity of chemical
– White= required PPE
- Copayment=
- Copayment= predetermined rate you pay at time of
care
- Deductible=
what you need to pay before insurance
starts kicking in
Coinsurance=
percentage of charge that you pay
Premium=
monthly amount you pay to have insurance
Third-Party Payers include:
Third-Party Payers
– Usual, customary, and reasonable (UCR)
– Table of allowances
– Fee schedule
Fee-for-service
– Dentist is paid per
Procedure
dentist is paid flat fee for each patient seen
Per capita
Leading payer for dental treatment
Fee-for-service
- Sliding scale fee
Cost of treatment is adjusted based on patient income and ability to pay
Dentist is paid predetermined fixed amount before treatment is provided
Prospective reimbursement (FQHC)
code changed to a less complex or lower
cost procedure than was reported
Downcoding
the combining of distinct dental procedures
Bundling
Government Health Programs
– Medicare
– Medicaid
– Children’s Health Insurance Program (CHIP)
– Indian Health Service (HIS)
– Veterans Health Administration (VHA)
- Private Health Coverage
- Private Health Coverage
– Consumer-driven - Private fee-for-service
- Flexible spending account (FSA)
- Health savings account (HSA)
– Managed care - HMO
- PPO
- Insurance option that limits coverage to
medical care provided through specific
providers who are under contract of __________ organization.
Health Maintenance Organization (HMO)
In Health Maintenance Organization (HMO) doctors are paid on ________ plan
capitation plan
Centers for Disease Control
and Prevention (CDC)
* Provides
Centers for Disease Control
and Prevention (CDC)
* Provides oral health surveillance, dental
infection control, community water
fluoridation, cancer and tobacco-related
issues, and support for state oral health
programs
Ryan White CARE Act -
Ryan White CARE Act à funds medical and
dental care for people who have HIV/AIDS
Health Resources and Services Administration (HRSA) functions
- National Health Service Corps (NHSC)= and
provides loan repayment for health
professionals who work in underserved
communities (FQHC) - Ryan White CARE Act à funds medical and
dental care for people who have HIV/AIDS
Abuse and neglect
* Child=
* Adult=
* Elderly=
* Disabled=
- Child= report immediately to social services
- Adult= ideally ask them alone first (autonomy) and then report (beneficence) to DHHS
- Elderly= report immediately
- Disabled= report immediately
- The use of an open dental operatoryis not recommended in the treatment of ___________ patients.
autistic
itchiness, warm sensations, hypotension, airway constriction, and tachycardia are symptoms of _______
Anaphylaxis
- Hepatitis B viruses can live on a surface for up to ______week.
- Hepatitis C can live on a surface for up to ______ weeks.
- M. tuberculosiscan survive on surfaces for _________. Influenza Atypically lasts around _________ on surfaces outside the body.
HIV- It lasts on surfaces for a __________.
- Hepatitis B viruses can live on a surface for up to one week.
- Hepatitis C can live on a surface for up to six weeks.
- M. tuberculosiscan survive on surfaces for months. Influenza Atypically lasts around 24 - 48 hours on surfaces outside the body.
HIV- It lasts on surfaces for a matter of minutes to hours.
Administration control is a
change the way people work
Engineering control
Isolate people from the hazard
- The best disinfection method for a digital radiographic sensor covered with a disposable hygienic barrier is to spray and wipe with ___________.
70%isopropyl alcohol
.Chlorinecompounds such asLysolandbleachare typically used for ___________
* Phenol compounds are the best type of chemical disinfectantfor _____________
.Chlorinecompounds such asLysolandbleachare typically used for spills of human body fluids
* Phenol compounds are the best type of chemical disinfectantfor smooth surfaces
*__________ are effective tools to address the eating habits of those with a high caries risk
Diet journals
Common signs and symptoms of bulimia nervosainclude tooth erosion on ________
palatal surfaces of maxillary teeth and occlusal surfaces of posterior teeth
prescribing __________ppm fluoride toothpaste is appropriate in bulimia nervosa.
5000 ppm
- _____________ is a caries risk tool that considers risk factors, protective factors, and clinical features of caries.
CAMBRA
How often, at minimum, should an office spore test its autoclave for proper heat sterilization?
Weekly
