Relevance of MH Flashcards
Why do we take a medical history
It gives you an opportunity to take a holistic approach to patient care.
e.g. patient may have spina bifida, be in a wheelchair, have latex allergy and be fearful of dental injections
It allows an understanding of all medical aspects, including drug therapy which might impact upon the provision of dental care.
It allows an understanding of all medical aspects, including drug therapywhich might impact upon the oral cavity (oral manifestations of systemic diseases and drug therapy).
What to look out for when taking a drug history
- Write down list of drugs
- If you don’t recognise a name, look the drug up in the British National Formulary (BNF)
- Generic -v- Proprietary (trade) names
- Include OTC and herbal remedies
-Illicit drugs - Look to see if each drug has any oral side effects
- Record any allergies and ask what happens!
What questions should be included in dental history
Previous experience – are you anxious about dental treatment?
How often do you brush? When? Fluoride Use? What toothpaste?
Interdental cleaning?
Diet? : Sugar/ Fizzy Drinks
Any problems
Any preferences (e.g. avoiding amalgam?)
Problems with local anaesthesia?
Denture wearer? How old?
What factors are included in social history
Age
Where do they live?
How easy is it to travel to see you?
Smoking – How many? How Long For? What type?
Alcohol (14 units); other drugs ( legal or illegal)
Relationship; sexual history
Occupation
Questions about Family History (FH)
Capacity to Consent
When is a new medical history used
Use for every new patient
Use where existing history in case-notes is inadequate, illegible etc
Use if the patient has not attended for over a year
Use if it is more than two years since a full history was taken previously
Why/when do we use a shortened history or update
Use if a patient is attending for routine care following initial consultation
A full history must be available in the case notes
Helps to update drug regimes etc
If patient has changed medication or has had medical intervention since the last visit, a FULL history should be taken
What does a full medical history include
Current medical problems
Past medical history
Specific disease questions
Systematic enquiry (if appropriate)
Relevant family and social history
What are active problems
-Problems with their health at present that require treatment and/or require attendance at a doctor or clinic
-Allergies
-GA (general anaesthetic)
-Recent operations or hospital admitions
What is ABCD
What to look for as you meet the patient
-Activity and appearances
-Breathing
-Colour
-Disability
What breathing factors should we be assessing at the begining of an appointment
-Rate
-Depth
-Assistance, O2, CPAP (sleep apnia)
What parts of the body often discolour with illness/disease
Skin
Eyes
Nails
How should you work through the initial questions to a new patient (what to look for and rule out)
Allergies
Bleeding disorders
Cardiorespiratory disorders
Drug treatment
Endocrine disorders
Fits or faints
Gastrointestinal disorders
Hospital admissions and attendances
Infections
Jaundice and liver disease
Kidney and genitourinary disorders
Likelihood of pregnancy
Mental state
Neurological problems
What general enquiry should be considered
Appetite, weight loss
Lethargy or fatigue
Fevers
Presence of lymps, bumps or swellings
Skin rashes
What systems aproach should you work through in an appointment
Cardiovascular
Respiratory
Gastrointestinal
Liver disease
Neurological
Epilepsy
Musculoskeletal
Genito-Urinary
Kidney disease
