T2: Management of Retching pt Flashcards
1
Q
What is Retching?
A
- physiological mechanism
- involuntary contraction of muscles of soft palate/ pharynx
- results in retching
- varies between patients
**gagging, boking, gypping
2
Q
Types of retching
A
- Psychogenic
- may occur by sight, smell or sound of dental surgery or just the thought of it - Somatic
- trigger zones, ie: palatoglossal & palatopharyngeal folds, base of tongue, palate, uvula, posterior pharyngeal wall
**worsened with anxiety
3
Q
What difficulties can be caused because of retching?
A
- impression taking
- jaw reg
- toleration of dentures
- denture retention as it needs to be reduced
4
Q
Management of retching
A
- identification of problem
- identify trigger zones
- anxiety reduction
- patience and empathy
5
Q
Relaxation technique
A
- passive - dim lighting, music, avoid sight of dental instruments
- active: controlled rhythmic/ relaxed abdominal breathing
6
Q
Distraction technique
A
- talk to patient
- get patient to concentrate in keeping their legs raised/ wiggle their toes
- get patient to press/ tap their temples
- put salt on tongue
- ask patient to close eyes
- rinse mouth with very cold water
7
Q
Desensitisation
A
- repeated brushing/ stroking anteiro palate/ tongue with finger/ tothbrush
- let the patient practice on brushing/ stroking pre treatment
- swallowing with mouth open
- hypnosis
- acupressure
- cognitive behaviour therapy
8
Q
How to modify impression taking
A
- modify stock trays
- lower trays in upper arch
- modify special trays with palatal reduction
- rapid setting impression materials
** dental composition and reduce exposure time
9
Q
Shortened dental arch
A
4-4 or 3-3
10
Q
Denture design
A
- provide a denture well adapted to tissues
- palate not too thick
- cusps of posteriors may need to be rounded so do not stimulate dorsum of tongue
- no 2nd molars on prosthesis
11
Q
A
