Substance Abuse Flashcards
What is tobacco?
- Toxic to humans; nicotine naturally occurring
- Depletes nutrients and absorbs chemicals from soil
What are some different forms of tobacco?
- Smokeless tobacco
- Electronic nicotine delivery systems (ENDS)
- Waterpipes (hookah)
- Dissolvable and gel tobacco forms
- Not safe substitute
What is the risk for tobacco in the systemic health?
Causes cancer throughout the body
What are some oral manifestations of tobacco use
Pale pink, fibrotic gingiva
Halitosis
Leukoplakia
Stomatitis
Sialometaplasia
Periodontitis
Increased rate, severity, CAL,
bone loss, probing depths
Tooth loss
Delayed healing
Implant failure risk
Squamous cell carcinoma
Oral and pharyngeal cancer risk
Oral Manifestations of
Smokeless Tobacco Use
Leukoplakia
Nicotine stomatitis
Smoker’s melanosis
Hairy tongue
Periodontitis
Implant failure risk
Necrotizing gingivitis
halitosis
Medical Treatment Strategies
Self-help:Cold turkey, gradual decrease, ENDS substitute, OTC nicotine-replacement
Assisted interventions by HCP
FDA approved pharmacotherapies
Chantix, Wellbutrin
Counseling
Acupuncture, hypnotherapy
Nicotine replacement therapy
What are the dental management for
Review MH for tobacco
use history
Type of product? How
often used? How long?
Tried other forms?
Ask if interested in
quitting.
* If not, discontinue conversation
* Educate about oral effects
* You are a resource for
cessation services.
Conduct a thorough
IO/EO for signs of
tobacco use
Evaluate for increased
stain, calculus, caries,
inflammation, signs of
periodontal problems
NSPT: Jeopardizes
healing, lessened
outcomes of treatment,
cessation improves
results
What is the motivational interviewing ?
- Resist
- Understant
- Listen
- Empower
What are the 5A’s and R’s?
A- Ask, Advise, Asist, Assess, Arrange
R- Repition, Relevance, Risks, Rewards , Roadblocks
What are the causes of alcohol abuse?
- Genetics: GABRA2 and CHRMS2 (genes)
- Biopsychosocial: (children of alcohol dependednt parents)
- Environmental
What are the signs of Alcohol abuse?
Craving
Loss of control
Tolerance
Physical dependence
What are stages of alcohol metabolism?
- First: ingestion and absorption
- Second: Liver metabolism
- Third: Diffusion
Metabolized more slowly than absorbed: Rate dependent on: age, gender, adipose (fatty) tissue, food ingestion
What are some health hazards
Wernicke-Korsakoff’s Syndrome
Brain disorder of cerebellum: thiamine deficienc
What are some medical management:
- Abstinence
- Detoxification management
- Pharmacotherapy: anticonvulsant, alcohol-sensitizing agents, anticraving agents (naltrexone, acamprosate)
- Rehabilitation
What is dental management for alcholol abuse?
Health history / Screening
Medications?
Other intervention or treatment program?
Referral