Pt Management/liability Flashcards
Which ethical principle requires clinicians to inform their patients about treatment risks and benefits and to protect their confidentiality?
Autonomy
Which ethical principle describes the ability of the patient to independently choose between different treatment plans?
Autonomy
How long should you keep the dental records of an employee who just terminated their employment?
30 years
The joint commission on national dental examinations recommends that all dental records should be kept as long as possible. They are patient property, and the police may require them for forensic identification.
The ADA recommends that records may be destroyed for inactive adult patients who have not been seen in 7 year or ath the expiration of the statute of limitation in contract and tort actions
When a dentist thinks he or she knows what is best for the patient and tries to control a patient’s behavior, it is referred to as ___. It infringes on the patients right to ___
Paternalism
Autonomy
Define autonomy
A patient’s right to self-governance
Define nonmaleficence
Doing no harm to the patient
Define beneficence
Doing good for the patient
Define justice
Treating the patient fairly
Define veracity
Communicating truthfully to the patient
___ is a practice in which dental patients receive care at specialized facilities from a limited group of clinicians on a prepayment basis
Closed panel
Dentists must accept any beneficiary of a closed panel as a patient
True or false… dental public health is considered an ADA officially recognized specialty
True
Health care professionals who provide emergency treatment at the scene of accidents are legally protected by the ____
Good Samaritan Act
It offers legal protection who provide “reasonable assistance” to individuals who are in an accident, i’ll, in danger, or incapacitated. Such laws are meant to reduce bystanders’ hesitation to help for the fear of being sued or prosecuted for unintentional injury or wrongful or accidental death.
which ethical principle requires clinicians to inform their patients about treatment risks and benefits and to protect their confidentiality?
Autonomy
A group of 100 dental students were followed for 10 years to determine whether their health was affected by exposure to mercury. What kind a study is this?
Longitudinal study
What are longitudinal studies? What are cohort studies?
A longitudinal study is an observational correlation research study that involves repeated observations of the same variables over long periods of time.
Cohort studies are a type of longitudinal study in which risk factors are analyzed for the group of people who do not have the disease and use correlations to determine the astute risk of subject contraction
What are cross sectional studies?
They examine two or more variables. For example, university of Iowa dental students were tested against university of michigan students
What are double blind studies?
Exposes a control group to an experimental variable and an experimental group to the control after a period of time to see whether there is a correlation
Define leading question.
A leading question that is designed to verify particular information by leading a person to a suggested answer.
“You’ve never had problems with needles before, have you?”
Define funneling questions
Provides questions that may ask information from a specific detail to more general information or vice versa
What are the differences between open and closed questions?
Open - can be answered in unlimited ways and manner and usually requires elaborative and long answers
Closed - questions answerable by a specific or particular word or phrase. Most common is “yes” or “no”.
True or false… MSDS are not required under OSHA’s bloodborne pathogen standard because they serve no purpose in dealing with bloodborne pathogens
True
What to MSDS’s contain?
Information about the products physical data, storage, toxicity, health effects, disposal, and other relevant data
What is the difference between prevelance and incidence?
Prevalence - describes the proportion of a population who have a condition. It is computed by comparing the total number of people affected with a condition against the overal number of people being studied. The result is usually written as a percentage, fraction, or by noting the number of known cases per 10,000 or 100,000 people
Incidence - describes the number of NEW cases that occurred in a given population within a certain TIME PERIOD
What is the EPA and what is their role in dentistry?
Environmental protection agency
They established maximum exposure levels for Hg vapor. They are intended to be highly protective at 0.1ug/kg body weight per day. The EPA also regulates transportation of dental waste from dental offices.
Chlorhexidine gluconate elicits an antimicrobial effect that lasts for ___. It is a chemical antiseptic that has an effect against ___ bacteria. It has a bacteriostatic and bacteriocidal effect by _____.
12 hours
Gram + and gram -
Disrupting the bacterial membrane
_____ like benzalkonium chloride are believed to act by disruption the cell membrane and are lethal to a wide variety of organism except ___, ___, and ____. They are cationic detergents as well as disinfectants that need to be rinsed off and are not substantive due to the rinsing.
Quaternary ammonium compounds
Endospores
Mycobacterium tuberculosis
Non-enveloped viruses.
What age group is child abuse/neglect most commonly found?
Ages 0-3
Approximately 70% of children that die from abuse are under the age of 4
About ___% of abused and neglected children will later abuse their own children which reinforces the ongoing cycle of abuse
30%
What is the proper way for cleaning spilled mercury?
Use a vacuum system to aspirate the liquid mercury into a trap, then dusting the area with sulfur powder. F
What are the 3 major effects of mercury exposure?
Weight loss
GI disorders
Exhaustion
True or false… most states prohibit the hand over mouth technique
True
True or false… pts suffering from mitral valve stenosis do NOT need to undergo prophylactic antibiotics prior to any dental surgery
True, they do not
When are prophylactic antibiotics indicated?
Artificial heart valves and heart repaired with prosthetic devices
Cardiac transplant patients with a heart valve problem
Congenital heart conditions and those treated but still have a residual defect
Infective endocarditis history
What is the antibiotic regiment indicated for a 40 kg pediatric pt with a congenital heart defect requiring prophylaxis according to american heart association standards?
2g amoxicillin 30-60 minutes before the procedure
What is the recommended dose for pediatric prophylaxis of oral amoxicillin?
50mg/kg body weight
If the child is unable to take oral medication, what antibiotic should be used for prophylaxis when indicated?
Ampicillin, ceftriaxone or cefazolin - 50mg/kg body weight intramuscularly or intravenously
What are some other options of antibiotic prophylaxis for children who are allergic to penicillins?
Cephalexin 50mg/kg
Clindamycin 20mg/kg
Azithromycin or clarithromycin 15mg/kg
The oral microflora of [younger/older] people is usually more cariogenic due to the inclusion of sweets in their daily diet.
Younger
Which database contains current electronic dental literature?
Pubmed: MEDLINE
What is the best way to discern patient comfort during dental treatment?
Observing eyes/eyebrows
Pts most likely squint their eyes or move their eyebrows when they are experiencing discomfort during dental treatments because moving the eyes or eyebrows won’t move the positioning of the mouth or body
The ___ valve type should be used on their handpieces and water spray hoses to prevent cross contamination from patient to patient.
Anti-retraction
What is the route of transition for hepatitis A?
Transmitted from individual to individual through ingestion or the oral route
What are the 4 routes of transmission of hepatitis B?
Direct blood-blood contact
Prenatal transfer
Percutaneous inoculation
Sexual intercourse
What are occult lesions?
They are not easily detectable by clinical methods alone. They are problematic to distinguish because even with a direct observation the lesion would be difficult to visualize as it appears normal. Occult lesions most of the time are asymptomatic and do NOT show signs of disease progression
Occult lesions are also difficult to find even with the use of conventional radiographs. It is best to evaluate such lesions histologically and through an MRI
The ADA seal of approval if it has what three things?
It must be tested in a randomized, cross-over, or parallel clinical trial
It must have a documented antimicrobial effect that shows significant supragingival plaque reduction and reduction of gingivitis. Must be nontoxic
It must have no negative effects to teeth and soft tissues and should not affect the balance of the normal oral flora
Following a surgical procedure, a dentist can be legally liable for patient contracting hepatitis is the dentist…
Uses cold sterilization exclusively for their surgical instruments
It is required to sterilize via autoclave, dry heat, or chemical vapor in sterilizing critical and semi-critical instruments to ensure eradication of bacteria and viruses that can infect other patients.
What are semi-critical items?
Instruments that do not penetrate soft tissues or bone but are used inside the mouth and contact the mucosa. These instruments must be heat sterilized after every use or must undergo high-level disinfection if they are not heat stable
What 5 things do the blood borne pathogens standard of OSHA involve?
Management of sharps and disposal of regulated wastes
Communication of hazards to employees
Training and hepatitis B vaccination of employees
Exposure incident plan
Sterilization and storage of instruments
What is the best way to verify that an autoclave is working and can still sterilize instruments?
Run the autoclave with a biological monitor test.
The ___ method is the brushing technique that involves the angulation of the toothbrush bristles at a 45 degree angle apically, allowing the bristles to debride the gingival sulcus.
Bass
The bass brushing method allows the bristles to penetrate __-___mm into the sulcus to clean it.
2-3mm
What kind of study design would compare the caries relates of a city with fluoridated water to one with non-fluoridated water?
Cross-sectional study
Cross-sectional studies examine two or more variables simultaneously (for example, roseman students vs university of utah students)
a ___ survey is an observational correlation research study that involves repeated observations of the same variables over long periods of time.
Longitudinal
____ studies are a type of longitudinal study in which risk factors are analyzed for the group of people who do not have the disease and use correlations to determine the absolute risk of subject contraction.
Cohort
A ___ study is one in which both the examiner and subject do not know which is the experimental group and which is the control group
Double-blind
What type of financial arrangement allows the dentist to charge the patient the difference between what the insurance plan agrees to pay and the dentist’s usually customary rebate?
Balance billing
What is prospective reimbursement?
Pays the dentist before the treatment is provided
How often should sterilizing units undergo quality control testing to ensure proper sterilizing of instruments?
Weekly
In addition to conducting routine biological monitoring of equipment users should perform biological monitoring at which 4times?
Whenever a new type of packaging material or tray is used
After training new sterilization personnel
After a a sterilizer has been repaired
After any change in the sterilizer-leading procedures
Define incidence
The rate at which new disease cases occur. It gives the number of disease cases or people becoming i’ll during a given period in a specified population
Define prevalence
The percentage of the population that has the disease or condition. It gives a figure for a factor at a single point in time. Prevalence can tell only what is happening at a certain point.
Define attributable risk
The difference in rate of a condition between an exposed population and an unexposed population. Attributable risk is most commonly used in cohort studies to measure individuals that are assembled on exposure status and followed over a period of time
Define penetrance
Penetrance describes the extent to which a particular gene or set of genes is expressed in the phenotypes of individuals carrying it. It is measured by the proportion of carriers in showing the characteristic phenotype
What is the insurance policy in which there is an agreement between an insurance company and a group of dentists in which the dentists accept a discounted payment rate?
Preferred provider organization
Arrange a discounted rate accepted by dental providers in exhange for a higher volume of patients.
What are health maintenance organizations?
In health maintenance organizations (HMOs), individual practice organizations combine the risk of capitation with fee-for-Service reimbursement. HMOs and other managed-care plans can contract with an insurance provider assocaiteion, which then contracts with independent physicians to treat members at discounted fees or on a capitation basis. HMOs usually limit coverage to care from doctors who work for (or contract with) the HMO. An HMO generally will not cover out-of-network care, except for an emergency
Define capitation.
Capitation is a payment method in which an entity pays the dentist a fixed amount irrespective of the services provided by the dentist
