Stress Reduction

Question 1

Most emergencies are a sequelae of poorly managed ___ and ___.

Answer 1

pain; anixety

Question 2

You should attempt to know you patient through ___ history when reviewing the medical history. Are they healthy but extremely anxious (ASA ___) or are they unhealthy and cannot tolerate added stress (ASA ___).

Answer 2

dialogue; 2; 3

Question 3

restful sleep night before treatment

anxiolytic prior to appointment (best if in office)

Answer 3

premedication

Question 4

What should be done with appointment scheduling?

Answer 4

early morning appointments (patients best when rested and better able to tolerate stress)
minimize waiting time

Question 5

T/F. To reduce stress during treatment be open and honest with your patient about what they can expect.

Answer 5

True. Also, use music/videos (non-drug), oral sedatives, or nitrous oxide

Question 6

ASA ___ patients will not be able to tolerate the amount of endogenous catecholamines released during pain therefore you should use a local anesthetic with ____ such as epinephrine.

Answer 6

3; vasoconstrictor

Question 7

What medical emergencies are commonly provoked by anxiety?

Answer 7

1. hyperventilation
2. severe HTN
3. epilepsy
4. asthmatic bronchospasm
5. angina
6. myocardial infarction

Question 8

___ is the most frequent cause of respiratory difficulty in the dental setting.

Answer 8

Hyperventilation

Question 9

What are some signs/symptoms of patients under respiratory distress?

Answer 9

1. can’t get enough air
2. breathe rapidly (tachypnea), agitation
3. increased CO2 elimination causes alkylosis
   - light headed
   - tingling in fingers, toes, perioral region
   - carpopedal spasm
   - twitches, convulsions
   - loss of consciousness

Question 10

How do you treat hyperventilation?

Answer 10

1. recognize signs and terminate procedure
2. position nearly upright
3. verbally reassure patient
4. rebreathe CO2 rich air (small bag)
5. reschedule with better plan for anxiety reduction