Patient Management (Mental dental) Flashcards
Respect pt’s right to self determination and privacy
Treat pt according to pt’s desire within the bounds of acceptable treatment
Safeguard the confidentiality of pt records
Autonomy
Do no harm
Keep skills and knowledge up to date thru CE
Know your limitations and refer difficult cases to specialists
Nonmalfiecene
Professionals have a duty to act for the benefit of others
Provide service to the patient and the public at large
Promote pt’s welfare
Same ethical standard exists no matter the financial agreement
Beneficience
Be fair in dealings with pts, colleagues, and society
Deal with people fairly and deliver dental care without
Never slander another dental professional
Justice
Be honest and trustworthy in dealings with public
Respect position of trust inherent in the dentist-pt relationship
Must not represent care being rendered, fees being charged, or any form of advertising in a false or misleading manner
Veracity
DUirng clinical interviewing, which type of questions should you never use? Leading, open ended or close ended?
Leading
_____ is part of behavior change that facilitates the behavior
Antecedent
What are the 5 stages of behavior change?
Precontemplation
Contemplation
Preparation
Action
Maintenance
____ stage of change:
not considering behavior change
Precontemplation
____ stage of change:
Begins to consider behavior change
Contemplation
____ stage of change:
Preparaing to take steps to change, often expresses a desire to change
Preparation
____ stage of change:
Engaged in taking action towards behavior change, often requires support
Action
____ stage of change:
Attempts to maintain a changed behavior
Maintenance
____ part of the social cognitive theory
Cognitive perception that you can execute behaviors necessary for a given situation
Self-efficacy
____ reinforcement: do a good thing and remove a bad stimulus
Negative reinforcement
_____ reinforcement: do a good thing and get rewarded
Positive reinforcement
____ punishment: do a bad thing and get punished
Positive punishment
____ punishment: do a bad thing and remove a good stimulus
Negative punishment
_____: setting small attainable goals and rewarding yourself after each step
Shaping
_____: making a behavior that has a higher profitablility of being performed contingent on a behavior that has a lower probability of being performed
Premack principle
What are the Motivational interviewing OARS principles?
Open quesitons
Affirmations
Reflective listening
Summarizing
______: deep breathing triggers physiologic relaxation response
PNS
Diaphragmatic breathing
______: tensing and relaxing certain muscle groups focusing on the difference between tension and relaxation
Progressive muscle relaxation
______: exposing pt to items from an agreed upon hierarchy of slowly increasing feared stimuli allowing them to pair a relaxation response with a feared stimuli
Systematic desensitization/graded exposre
The study of the distribution and determinants of ds
Epidemiology
What epidemiologic measures is irreversible?
DMFT
_____ uses for surfaces on six indicator teeth to determine amount of inflammation, redness, BOP of gingiva
Gingival index
What is the most common site for oral cancer?
Tongue
____ prevention: prevents ds bedore it occurs: sealants and water fluoridation
Primary prevention
_____ prevention: eliminates or reduces ds after it occurs: restorations
Secondary
____ prevention: rehabs pt after a ds has taken place: prosth
Tertiary prevention
What portion of teeth are topical fluorides best for?
Smooth surfaces
What is the toxic dose of fluoride in mg/kg?
5 mg/kg
What is the lethal dose of fluoride in g for an adult?
5 g
_____: proportion of a given population that is affected by a condition at a given time
Prevalence
____: survey or measurement taken to represent a snapshot in time: prevalence
Cross-sectional study
_________: ppl with a condition are compared to ppl without it in the past: odds ratio
Case control Study
______: cohort follwed thru time to see who develops a ds, incidence and relative risk
Prospective cohort
_____: look back after following the cohort and decide what ds you want to look for: incidence and relative risk
Retrospective cohort study
Does the retrospective cohort or case control look back at a ds and determine what risk facotrs exist that caused the ds?
Case control
Does the retrospective cohort or case control look back at a ds and determine what exposure factors exist that caused the ds?
Case control
____ test: measures the association btwn 2 categorical values
Chi Squeed test
____ test: measures the statistical difference between 2 means, small sample size
T-test
____ test: measures the statistical difference between 2 means, large sample sample size, variance is known
Z test
_____ test: used to test differences btwn 2 or more means
Anova test
_____: statisstical measure that represents the strength of relationship btwn two quantitiative varieable
Correlation coefficient
_____: probaility that 2 variables are unprelated
Satistical significane (p value)
What Hep viruses are transmitted fecal oral?
A and E (fEcAl)
What hep viruses are transmitted via contaminated blood?
B and C (Contaminated Blood)
Which hep is transmitted via direct contact prior infection with Hep B?
Hep D
30% risk of transmission after percutaneous injury
DNA virus
Vax available
PEP includes vax and possible iG
Hep B
1.8% risk of transmission after percutaneous injury
RNA virus
No Vax available
PEP now available
Hep C
0,3% risk of transmission after percutaneous injury
RNA virus
Dx via when antibodies are detected in blood via ELISA
No Vax available
PEP includes course of antivirals
HIV
Inhalation of infected droplet nuclei
Dx by symptoms, sputum culture, chest xray, or a positive TB skin test
Pt with active TB should not be seen for elective dental care
Health care workers should have a TB skin test at least once a year
TB
How often should a healthcare worker have a tb skin test be done?
ONce a year
What office personnel is most at risk for eye injury?
Dentist
Protets healthcare professionals from occupational hazards
ALl dental workers must be offered a free HBV vax
Any dental worker who experiences needle stick must get report, eval, and follow up
Clothing worn at work must not be washed at home
HazCom
OSHA
Established max exposure levels for Hg vapor
Regulates transportation of dental waste from dental offices
EPA
Destruction of all life forms including bacteria, viruses, and spores
Sterlization
How does autoclave work? Temp, pressure, and time; how it destorys bacteria
121 C, 15 psi 30 mins; destorys via denaturatoin
How does dry heat sterlization work? Temp time and how it destroys bacteria
160 C for 60 mins: Destorys bacteria by coagulation
_____ used on inanimate objects
Spores are not destoryed in this process, but Mycobacterium tb is
Let sit for 10 misn
Disinfection
Used on living tissue to reduce bacterial load
- Alcohol, CHX, Detergents, Quats
Antisepsis
______: (spaulding classification system):
COntacts sterile tissue or vascular system
Requires sterilization
Ex: needles
Critical
______: (spaulding classification system):
Contacts mucosa
Minimum of high level disinfection but sterilization if material is heat stable
Ex: mouth mirror
Semi-critical
______: (spaulding classification system):
Contacts skin
Requires disinfection
Ex: blood pressure cuff
Noncritical
______:
Muscle weakness
Loss of hair
Weight loss/ GI ulcers
Exhaustion
Acute mercury toxicity
___ airborne particles: visible more than 50 microns, fall within 3 feet of pt’s mouth can carry blood borne pathogen
Splatter
___ airborne particles: invisible less than 50 microns: remain floating in air for hours can only carry resp infections
Aerosols
EPA requires less than or equal to ____ CFU of heterotrophic bacteria per mL of water
Less than 500 CFU
Who is responsivle for MSDS?
Manufacturer
_____: dentist is paid a flat fee for each pt seen
Paid on capitation plan
HMO
IN an HMO, of value of service is greater than payment, is it dentist’s loss or gain?
Dentist loss
IN an HMO, of value of service is less than payment, is it dentist’s loss or gain?
Dentist gain
(Fraud terms) The separation of a dental procedure into component parts
Unbundling
(Fraud terms) the combining of distinct dental procedures
Bundling
(Fraud terms) reporting a more complex or higher cost procedure than was actually performed
Upcoding
(Fraud terms) code changed to a less complex or lower cost procedure than was reported
Downcoding
(Fraud terms) charging more than legally or ethically acceptable
Overbilling
Panel of providers agree to accept less than usual fees in exchange for higher volume of pts, since subscribers to this plan have a financial incentive to use providers from this panel
PPO
What gov agency should you contact in case of suspected elder abuse?
HHS
Headstart is under what gov agency?
ACF
Does medicare cover dental care?
NOpe
What type of sterilization is least likely to dull and corrode carbide instruments?
Dry heat
