Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

DH Theory 1 > test 4 > Flashcards

test 4 Flashcards

1
Q

define periodontal disease

A

Chronic disease initiated by microorganisms in the dental biofilm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q
  1. there is Significant research on the association between ___________ infections and many ___________
  2. The association makes early ________, __________, and ___________ of periodontal
    disease critical
A
  1. Significant research on the association between PERIODONTAL infections and many
    SYSTEMIC DISEASES/CONDITIONS
  2. Association makes early IDENTIFICATION, TREATMENT, and MANAGMENT of periodontal
    disease critical
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

t/f periodontal disease has been connected to the cause of systemic diseases

A

FALSE > Periodontal disease has NOT been shown to cause systemic disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what conditions/diseases are periodontal disease associated with

A

Cardiovascular disease
Adverse pregnancy outcomes, including premature low birth weight babies
Respiratory disease
Chronic kidney disease
Rheumatoid arthritis
Obesity
Cognitive impairment
Osteoporosis
Inflammatory bowel disease
Some cancers
Diabetes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what factors are involved in the risk factors for periodontal disease

A
  • Etiologic factor-actual cause of a disease/condition
  • Predisposing factor-renders a person more susceptible to disease/condition
  • Contributing factor-lends assistance to or adds to disease/condition
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Etiologic, predisposing, and contributing factors may be local or systemic

what determines if it is local or systemic

A

Local: in the immediate environment of the oral cavity

Systemic: results from or influenced by a general physical or mental disease/condition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what are the modifiable risk factors for PD

A
  • Tobacco use
  • Diabetes MELLITUS
  • Metabolic Syndrome-risk factors for heart disease and diabetes
  • Obesity
  • Alcohol Consumption
  • Diet
  • Psychosocial Factors-stress, anxiety, depression
  • Medications that cause gingival enlargement
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what are the non-modifiable risk factors

A
  1. genetic predisposition
  2. host response
  3. osteoporosis
  4. age
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Approximately ____ of the risk for periodontal disease is related to genetics

A

Approximately 1/3 of the risk for periodontal disease is related to genetics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

HOST RESPONSE

Way an individual’s immune system responds to _______ to resolve ____________

Certain diseases or medications impair the __________

A

Way an individual’s immune system responds to BACTERIA resolve INFLAMMATION

Certain diseases or medications impair the IMMUNE RESPONSE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

sulcus becomes a ________ in disease

A

pocket

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

POCKET

Has an inner wall (_____) and outer wall (______)

Contains substances such as _________, ____________, and ____________

Divided into _____ and _______ types

A

Has inner wall (TOOTH) and outer wall (FREE GINGIVA)

Contains substances such as MICROORGANISMS, GINGIVAL CREVICULAR FLUID, and DESQUAMATED EPITHELIAL CELLS

Divided into GINGIVAL and PERIODONTAL types

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is a gingival vs periodontal pocket

A
  1. Gingival (Psuedopocket): pocket formed by gingival enlargement. NO apical migration of junctional epithelium
  2. Periodontal Pocket: pocket formed as a result of disease-causing apical migration of the junctional epithelium along the cementum
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Periodontal pockets are further
categorized by their position in
relation to the _____________

A

Periodontal pockets are further
categorized by their position in
relation to the ALVEOLAR BONE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

suprabony vs intrabony periodontal pockets

A

Suprabony: base of pocket is
coronal (above) to the alveolar crest

Intrabony: base of pocket is apical (below) the alveolar crest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what are the two types of healthy periodontium

A

pristine periodontal health and clinical periodontal health

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what is pristine periodontal health

bleeding
probe depth
attachment loss
bone loss

A

bleeding: 0%
probe depth: 3 mm or less
attachment loss: none
bone loss: none

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what is clinical periodontal health

bleeding
probe depth
attachment loss
bone loss

A

bleeding: less than 10%
probe depth: 3mm or less
attachment loss: none
bone loss: none

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what is the clinical appearance of healthy periodontium (7)

A

> Uniformly pale pink, with or without pigmentation
Firm and resilient
Free gingiva = smooth
Attached gingiva = stippled texture
Gingival margin located 1 to 2 mm above CEJ; contour follows the contour of the teeth
Marginal gingiva is knife-like
Papilla is pointed and pyramidal, fills interproximal spaces

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

GINGIVITIS

-Bleeding ___% or _____
-______ of gingiva
-No _____ loss or _______ loss UNLESS
the client has ______ periodontium

A

-Bleeding 10% or GREATER
- INFLAMMATION of gingiva
-No ATTACHMENT loss or BONE loss UNLESS
the client has REDUCED periodontium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what are the 2 types of gingivitis

A

biofilm induced

non biofilm induced

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

BIOFILM INDUCED GINGIVITIS

  1. what is the primary etiology
  2. is it reversible
  3. what factors can cause/modify biofilm-induced gingivitis
A
  1. Primary etiology: biofilm
  2. Reversible through biofilm removal
  3. Can be modified by LOCAL or SYSTEMIC factors:
    - Hormones-puberty, menstruation, pregnancy
    - Poor glycemic control
    - Smoking
    - Malnutrition
    - Poor restoration margins
    -xerostomia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what is nonbiofilm induced gingivitis

what causes it

A
  1. Gingival diseases of viral, bacterial, fungal, and genetic origin
  2. Gingival manifestations of systemic conditions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what is the clinical appearance of gingivitis

color
consistency
surface texture
contour
marginal gingiva
papilla

A

color: bright/dark red or blue-red (pink if it’s fibrotic)

consistency: soft and spongy, dents easily when pressed with probe, bleeding upon probing

surface texture: loss of stippling, shiny, fibrotic with stippling; nodular, hyperkertotic

contour: Gingival margins may be irregular with edema, fibrosis, clefting, and festooning

marginal gingiva: may be rounded, rolled, or bulbous and more coronal to the CEJ, or it may show recession with an exposed anatomic root

papilla: bulbous, flattened, blunted, or crated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

REDUCED PERIODONTIUM

Clinical ______ loss

can be:
_________________ patient (possible _______ and probing depths __mm or less)

____________________
patient (has _______ and probe depth __mm
or less)

Can be ______ or __________ depending on bleeding

A
  • Clinical ATTACHMENT loss

Can be a:
- NON-PERIODONTITIS patient (possible BONE
LOSS and probing depths 3MM OR LESS)

  • previously TREATED STABLE PERIODONTITIS
    patient (HAS BONE LOSS and probe depth 4MM OR LESS)
  • Can be HEALTH or GINGIVITIS depending on
    bleeding
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

what is periodontitis (4)

A
  • chronic and multifactorial
  • shows apical migration of the junctional epithelium (JE)
  • radiographic evidence of clinical attachment loss
  • has bone loss
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

what are the stages of periodontitis

A

STAGE determines SEVERITIY

Stage 1: mild
Stage II: moderate
Stage III: severe
Stage IV: advanced

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

what are the grades of periodontitis

A

GRADE determines the RATE OF PROGRESSION AND ASSOCIATED RISK FACTORS

Grade A: slow
Grade B: moderate
Grade C: rapid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

for the extent and distribution of periodontitis:

what is localized vs generalized

what is the molar/incisal pattern

A

Generalized: more than 30% of teeth are affected

Localized: less than 30% of teeth are affected

Molar/Incisor pattern: bone loss limited to
molars and incisors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

know the periodontitis staging and grading chart(s)

A

slide 19 and 20 on first ppt

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

CLINICAL SIGNS OF PERIODONTITIS:

  • Development of Periodontal ______-
    pocket formed as a result of disease
    causing _______ migration of the ___________ along the cementum
  • Interdental clinical attachment loss in at least __ nonadjacent areas
  • furcation, _______, _________ on probing, exudate, ________ bone loss
  • interdental recession: reduction of the height of the __________ to a location ________ to the CEJ, signifies ___________
  • other contributing factors: frenal pull, _________, _________ forces, local ______ factors
A
  • Development of Periodontal POCKET-
    pocket formed as a result of disease
    causing APICAL migration of the JUNCTIONAL EPITHELIUM along the cementum
  • Interdental clinical attachment loss in at least TWO nonadjacent areas
  • furcation, MOBILITY, BLEEDING on probing, exudate, RADIOGRAPHIC bone loss
  • interdental recession: reduction of the height of the MARGINAL GINGIVA to a location APICAL to the CEJ, signifies ATTACHMENT LOSS
  • other contributing factors: frenal pull, FOOD IMPACTION, OCCLUSAL forces, local IRRITATING factors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

what are some notable clinical changes that indicate periodontitis

A
  • Erythema
  • Rolled, irregular margins
  • Bulbous, flat or cratered papilla
  • Spongy, loose consistency
  • Smooth or ulcerated
  • Attachment loss = apical migration of the JE
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

IMMUNOPATHOLOGY OF DISEASES OF THE PERIODONTIUM

in disease/infection, microorganisms shift to gram-______ species including:
-___________
-___________
-___________
-___________

A

in disease/infection, microorganisms shift to gram-NEGATIVE species including:

  • Porphyromonas gingivalis
  • Tannerella forsythia
  • Treponema denticola
  • Fretibacterium
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

PROCESS OF PERIODONTAL DESTRUCTION

  • undisturbed biofilm left at the ______ releases byproducts and toxins at the ________, ____________, and ____________
  • Host _________ imbalance and/or periodontal risk factors
  • Overproduction of _______________ occurs (cytokines, prostaglandins, matrix metalloproteinases)
  • __________ of periodontal tissue occurs
  • Collagen destruction in ___________ of gingiva, _______, and ______________= clinical manifestations of periodontal disease
A
  • Undisturbed biofilm left at the GINGIVAL MARGIN releases byproducts and toxins at JUNCTIONAL EPITHELIUM, CONNECTIVE TISSUE, and BLOOD VESSELS
  • Host DEFENSE SYSTEM imbalance and/or periodontal risk factors
  • Overproduction of INFLAMMATORY MEDIATORS occurs (cytokines, prostaglandins, matrix metalloproteinases)
  • DESTRUCTION of periodontal tissue occurs
  • Collagen destruction in CONNECTIVE TISSUE of GINGIVA, PDL, and ALVEOLAR BONE = clinical manifestations of periodontal disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

periodontal clinical assessment instruments include: (6)

A
  • source of light
  • gauze to dry the tissues
  • mouth mirror
  • explorer
  • periodontal probe
  • current set of radiographic images
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

More than ___% of adults have
periodontitis

11% of adults have ________

A

More than 50% of adults have
periodontitis

11% of adults have SEVERE
PERIODONTITIS

37
Q

gingiva

free gingiva

gingival margin

attached gingiva

junctional epithelium

A

Gingiva: Covers the cervical portion of teeth and the alveolar bone

Free Gingiva: Unattached gingiva

Gingival margin: edge of free gingiva
closest to incisal/occlusal surface

Attached Gingiva: Firmly attached to alveolar bone

Junctional Epithelium: Forms base of sulcus or pocket

38
Q

what is a healthy sulcus

A

1-3mm in depth

junctional epithelium is attached to the enamel

39
Q

what is a gingival pocket

A

also called a pseudopocket

increased sulcus depth from inflammation of the tissue

detachment of coronal portion of junctional epithelium

40
Q

what is a periodontal pocket

A

apical migration of the junctional epithelium

destruction of the PDL fibers and bone

41
Q

bleeding in healthy vs disease gums

A

healthy: less than 10% bleeding, no exudate

disease: spontaneous bleeding, bleeding upon probing, and exudate present

42
Q

what is normal vs abnormal position of the free gingival margin

A

Normal: At the CEJ

Abnormal:
- Coronal to CEJ (Sign of Inflammation)
- Apical to CEJ (Recession)

43
Q

what are the functions of the periodontal probe (5)

A
  • Detect/measure periodontal pockets
  • Measure clinical attachment loss
  • Assess bleeding on probing
  • Evaluate the success of periodontal therapy
  • Measure intraoral lesions
44
Q

what is the design of a periodontal probe

A
  • blunt, rod-shaped working end
  • circular or rectangular
  • millimeter markings
45
Q

PROBE DESIGNS

williams probe

UNC 12 and 15 probes

goldman fox probe

novatech probe

world health organization

electronic

plastic

A

williams probe: has millimeter GROOVES at 1, 2, 3, 5, 7, 8, 9, and 10 mm

UNC 12 and 15 probes: the preferred probe in clinical research; both are COLOR CODED at 4mm and 9mm; the UNC 15 is longer and also color coded at 14 mm

goldman fox probe: millimeter grooves at 1, 2, 3, 5, 7, 8, 9, and 10mm; FLAT working end

novatech probe: upward and right-angled shank; allows access to the distal surfaces of molars

world health organization: ball end of 0.5mm in diameter attached to the working end; markings at 3.5, 5.5, 8.5, and 11.5; advocated for epidemiology and routine periodontal screenings

electronic: computer assisted probe with a digital readout

plastic: used for assessing implants

46
Q

what is the proper probing technique
- vision
- grasp
- insertion
- stroke

A
  • Maintain Clear Visual Field: use Direct/Indirect Vision, maintain a Dry field

-Grasp: should be Light, Modified pen
grasp, Fulcrum on non-mobile teeth, light pressure

  • insertion: insert probe under the gingival margin; hold the probe flat against the tooth surface; keep the prove parallel with the long axis of the tooth; slide the probe vertically down to the base of the sulcus
  • stroke: WALK the probe along the tooth; maintain contact with the tooth; walk in 1mm steps; slide the probe UP about 1-2 mm and back down to attachment
47
Q

what is the probing technique for proximal surfaces

A
  • Start probing at the distofacial or distolingual line angle
  • Probe along tooth until reaching contact
  • Slant probe under contact into col area
  • Record measurement of col area
  • Do NOT remove probe from pocket after each
    stroke
48
Q

how do you get the distal of maxillary molars

A
  • Reposition the instrument handle to the side of the patient’s face
  • Keep probe parallel with long axis of tooth
49
Q

we record ____ reading for each tooth

what are they

record the ____ reading for each surface

___________ to the nearest measurement

A

we record SIX readings for each tooth

what are they: DISTOFACIAL, FACIAL, MESIOFACIAL, DISTOLINGUAL, LINGUAL, MESIOLINGUAL

record the DEEPEST reading for each surface

ROUND UP to the nearest measurement

50
Q

What is the probing sequence

A
  1. Start at the distal buccal of Maxillary right terminal molar to distal buccal of Maxillary left terminal molar
  2. Then go to the distal lingual of maxillary right molar to distal lingual of maxillary left
    terminal molar
  3. On mandible, start at distal buccal mandibular left terminal molar and go to
    distal buccal mandibular right terminal molar
  4. Then go to distal lingual of mandibular left molar to distal lingual of mandibular
    right terminal molar
  • Maxillary arch > right molar (#1) to left molar (#16)
  • Mandibular arch > left molar (#17) to right molar (#32)
  • Both arches > buccal first then lingual
51
Q

what naturally occurring factors affect probing

A
  • overhanging restorations
  • carious lesions
  • calculus
  • crowns contour
  • visibility
  • bleeding
  • limited opening
  • macroglossia
52
Q

what factors regarding the clinicians technique affect probing

A
  • incorrect technique
  • the amount of pressure
  • degree of inflammation in tissue
53
Q

what determines the level of the gingival margin

inflammation vs recession

A

Inflammation: Gingival margin coronal to CEJ

Recession: Gingival margin apical to CEJ

54
Q

what probe is used to determine furcation involvement

what is bifurcation

what is trifucation

A

Nabers probe: depth of insertion into the furcation determines the degree of furcation involvement

bifurcation: mandibular molars (two roots); probe from the facial/buccal and the lingual

trifurcation: maxillary molars (three roots); probe from the mesiolingual, buccal, and distolingual aspects

55
Q

distinguish the furcation classifications

A

Class I
- Early
- Probe enters furcation but bone is intact between roots

Class II
- Moderate
- Probe enters furcation,
- Some bone loss between roots, but does not extend all the way through

Class III
- Severe
- Probe can be passed all the way through furcation
- Gingiva still covers furcation

Class IV
- Severe
- Probe can be passed all the way through furcation
- Exposure of furcation from recession

56
Q

how do you perform a mobility examination

A
  • use modified pen grasp with fulcrum
  • use two single ended instruments with wide blunted ends (MIRROR AND YELLOW PROBE)
  • place the end of the instrument handle on the tooth
  • apply horizontal pressure first from both instruments in a rocking motion
  • then apply vertical pressure
57
Q

what is the mobility classification

A

class 1
- slight
- greater than normal

class 2
- moderate
- greater than 1mm

class 3
- severe
- moves in all directions
- depressible in socket

58
Q

FREMITUS

__________ vibration/movement

Can be caused from excessive ______

Determination made on ________ teeth

A

PALPABLE vibration/movement

Can be caused from EXCESSIVE CONTACT

Determination made on MAXILLARY teeth

59
Q

what is the procedure for fremitus

A
  • Seat patient upright (Occlusal plane
    parallel to floor)
  • Gently place index finger on cervical
    third of maxillary tooth
  • Request patient close back teeth
    together up and down repeatedly
  • Note teeth where vibration/
    movement felt
60
Q

what is the primary clinical representation of periodontitis

A

loss of attachment/clinical attachment loss (CAL)

61
Q

when the gingival margin is AT THE CEJ, how do we determine the CAL

A

PD = CAL

just measure the depth of the pocket

62
Q

if the CEJ is COVERED by the gingival margin how do we determine the clinical attachment loss

A
  • Presents in inflammation or gingival overgrowth
  • Measure pocket depth first
  • Then measure from gingival margin to CEJ
  • Distance between gingival margin & CEJ (FGM) should be subtracted from the pocket depth

> PD – FGM = CAL

63
Q

how do we calculate the clinical attachment loss if there is RECESSION

A
  • Measure from CEJ to gingival margin
  • Calculate CAL by adding pocket depth and recession

> PD + FGM = CAL

64
Q

alveolar mucosa

mucogingival junction

mucogingival defect

attached gingiva

purpose of the mucogingival exam

A

Alveolar Mucosa
- Located apical to MGJ
- Deeper red color than gingiva
- Shiny, loosely attached to underlying bone

Mucogingival Junction
- Demarcation between the alveolar mucosa and attached gingiva

Mucogingival Defect
- Recession near MGJ or into alveolar bone

Attached Gingiva
- Area from base of sulcus to MGJ
- Attached to cementum and alveolar bone

Purpose of Mucogingival Exam
- To detect adequate attached gingiva
- Locate frenal attachments

65
Q

if the attached gingiva is ADAQUATE, how do we measure

A
  • measure from the mucogingival junction to the free gingival margin (FGM)
  • Measure pocket depth
  • Subtract pocket depth from total distance from MGJ to FGM

> Distance from MGJ to FGM - PD=
Width of Attached Gingiva

66
Q

RADIOGRAPHIC ASSESSMENT

Clinical Use of Radiographs:
> Determines changes in __________
associated with ___________

Health:
> __________- Continuous
radiopaque line running parallel to CEJ
> Less than __mm distance from ___ to
______ of bone

Disease:
> Widening of _________
> Distance from CEJ to crest of bone is over
___mm
> __________ Bone loss- parallel to CEJ of
adjacent teeth
> __________ Bone loss- vertical to CEJ of
adjacent teeth

A

Clinical Use of Radiographs:
> Determine changes in ALVEOLAR BONE
associated with PERIODONTAL DISEASE

Health:
> CRESTAL LAMINA DURA- Continuous
radiopaque line running parallel to CEJ
 Less than 2mm distance from CEJ to
CREST OF THE BONE

Disease:
> Widening of the PERIODONTAL LIGAMENT (PDL)
> Distance from CEJ to crest of bone is over
2mm
> HORIZONTAL BONE LOSS- parallel to CEJ of
adjacent teeth
> VERTICAL BONE LOSS- vertical to CEJ of
adjacent teeth

67
Q

once periodontal charting is complete, determine the ________ ___________

-________
-________
-________

A

once periodontal charting is complete, determine the PERIODONTAL CLASSIFICATION

  • health
  • gingivitis: no bone loss, 10% or more bleeding, inflammation
  • periodontitis
68
Q

what are the two products used for pain control

A

topical anesthesia

oraqix

69
Q

what do people not like about the dentist

A
  1. getting an injection (68.1%)
  2. dental radiographs (61.4%)
  3. use of curets and scalers (56%)
  4. the sight of dental needles (54.1%)
  5. the sight of curets and scalers (49.4%)
  6. the use and sound of power instruments (45.7%)
  7. use of air or water spray (36.4%)
  8. wearing of personal protective equipment (7.5%)
70
Q

PAIN PERCEPTION

The physical process of receiving a _______ and transmitting the information through the nervous system to the ________ where it is __________ as pain

Little _____ in pain perception between individuals with working __________

A

Physical process of receiving a PAINFUL STIMULUS and transmitting the information through the nervous system to the BRAIN where it is INTERPRETED as pain

Little VARIABILITY in pain perception between individuals with a working NERVOUS SYSTEM

71
Q

PAIN REACTION:

Combination of the _______ and the_________

Highly _________ between individuals

Influenced by many factors: ____, ______, ________ state, both cultural and ________
learned behaviors

__________ has special significance: the ______ patient is ________ to feel pain

A

Combination of the INTERPRETATION and the RESPONSE TO THE PAIN MESSAGE

Highly VARIABLE between individuals

Influenced by many factors: AEG, FATIGUE, EMOTIONAL state, both cultural and ETHNIC
learned behaviors

ANXIETY has special significance: the ANXIOUS patient is PREDISPOSED to feel pain

72
Q

PAIN THRESHOLD :

Varies between individuals, some having a ___ pain threshold and some having a ____ pain threshold

Highly __________

May be _____ by _______ such as local anesthesia

A

Varies between individuals, some having a LOW pain threshold and some having a HIGH pain threshold

Highly REPRODUCIBLE

May be ALTERED by DRUGS such as local anesthesia

73
Q

t/f: people with a strong or rapid reaction to pain are said to have a HIGH pain threshold

A

FALSE. people with a strong or rapid reaction to pain are said to have a LOW pain threshold.

74
Q

what are the 5 pain control mechanisms

A
  1. remove the painful stimulus
  2. block the pathway of the pain message (LA)
  3. prevent pain reaction by raising pain reaction threshold (N2O-oxygen)
  4. depress the central nervous system (general anesthesia)
  5. use psycho-sedation/latrosedation methods
75
Q

what are psychosedation methods

A
  • nonpharmacologic technique that reduces patient anxiety
  • builds a trusting relationship
  • lets the patient feel more in control
76
Q

PURPOSE OF A TOPICAL ANESTHETIC

To desensitize the ____________
by anesthetizing the ____________
endings.

___________ anesthesia produced is
related to the amount of ___________ of
the ____ by the ______

A

To DESENSITZE the MUCOUS MEMBRANE
by anesthetizing the TERMINAL NERVE
endings.

SUPERFICIAL anesthesia produced is
related to the amount of ABSORPTION of
the DRUG by the TISSUE

77
Q

what are the 5 indications for use of topical anesthesia

A
  1. reduce the discomfort of an injection
  2. prevention of gagging in radiographic techniques and impression-taking
  3. temporary relief of pain from localized diseased areas, such as oral ulcers, wounds, or inflammation
  4. during instrumentation for probing and scaling
  5. suture removal
78
Q

NONINJECTABLE LOCAL ANESTHETIC (amide)

> what % of drugs is used
what is the max recommended dose (MRD)
what is the onset time
what is the duration it lasts

A
  1. 2.5% lidocaine and 2.5% prilocaine
  2. Five cartridges per appointment
  3. about 1 min
  4. 14-31 min (20min average)
79
Q

TOPICAL ANESTHETIC (first ester)

> what % of drugs is used
what is the max recommended dose (MRD)
what is the onset time
what is the duration it lasts

A
  1. Benzocaine (6-20%)
  2. no established MRD; follow manufacturers recommendations
  3. 30sec-2min
  4. 5-15 min
80
Q

TOPICAL ANESTHETIC (second ester)

> what % of drugs is used
what is the max recommended dose (MRD)
what is the onset time
what is the duration it lasts

A
  1. tetracaine (0.25-0.5%) combined with other drugs
  2. 20 mg (1ml of 2% solution)
  3. slow > up to 20 min
  4. 20-60 min
81
Q

TOPICAL ANESTHETIC (amide)

> what % of drugs is used
what is the max recommended dose (MRD)
what is the onset time
what is the duration it lasts

A
  1. lidocaine ointment (2% and 5%)
  2. 2% and 5% > 200 mg
  3. 1-2 min
  4. 15 min
82
Q

ADVERSE REACTIONS TO TOPICALS

_______ topical anesthetics have a higher
incidence of allergic reactions (_______ is an ester)

Allergic reaction signs: (4)

A

ESTER topical anesthetics have a HIGHER incidence of allergic reactions. (BENZOCAINE is an ester)

allergic reaction signs: redness, tissue sloughing, edema, pain and burning at site

83
Q

APPLICATION OF TOPICAL

Retrieve topical from container using __________ cotton tip applicator and __________- place on ___________. Close container and put away.

Explain _________ to patient

________ and ________ area

apply small amount with cotton tip applicator, in ________ motion.

If placing into ________, use ________ or ________

A

Retrieve the topical from the container using a COTTON TIPPED APPLICATOR and CLEAN HANDS > place on STERILE GAUZE. Close the container and put away.

explain RATIONALE to patient

ISOLATE and DRY the area

apply small amount with cotton tipped applicator, in a DABBING motion

if placing into POCKETS, use a CURET or PROBE

84
Q

what do we document for anesthetics

A
  1. type/dosage
  2. indication for use
  3. location
  4. 20% benzocaine applied to LR quad for sensitivity during probing
  5. SERVICES RENDERED: “Oraqix (2.5% prilocaine and 2.5% lidocaine) to LR quadrant.”
85
Q

ORAQIX

_________ local anesthetic

Dispensed into _______ prior to ________

Contraindications: (2)

A
  • NONINJECTABLE local anesthetic
  • dispensed into POCKETS PRIOR to SCALING

Contraindications:
1. amide local anesthesia hypersensitivity
2. methemoglobinemia

86
Q

what are the parts of an oraqix dispenser

A
  • mechanism reset button
  • paddle
  • sleeve that rotates to open and close
  • transparent portion of tip rotates for improved access
  • blunt tip applicator
  • tip
  • body
87
Q

how do we assemble oraqix (5)

A
  1. attach blunt tip applicator to the tip of the dispenser
  2. push the mechanism reset button
  3. load the cartridge into the body
  4. assemble body and tip; rotate the tip until it locks in place
  5. tip may be bent to increase access to periodontal pockets
88
Q

how to use and reload oraqix:

  1. Dispense Oraqix ______ and ______by depressing the _______
  2. Wait ______________ (average initial onset time) prior to scaling
  3. Maximum recommended duration of exposure: ____ hours and ____ grams (__ cartridges) of the Oraqix periodontal gel
  4. Effect lasts ___ minutes on average
  5. To reload, depress the _____ button and _____ tip sleeve to unlock the tip
  6. Discard of the _____________ and _______ in ______ container and replace both for
    additional treatments
A
  1. Dispense Oraqix SLOWLY and EVENLY by depressing the PADDLE
  2. Wait 30 seconds-1 minute (average initial onset time) prior to scaling
  3. Maximum recommended duration of exposure: 4 hours and 8.5 grams (5 cartridges) of the Oraqix periodontal gel
  4. Effect lasts 20 minutes on average
  5. To reload, depress the RESET button and ROTATE tip sleeve to unlock the tip
  6. Discard of BLUNT TIP APPLICATOR and CARTRIDGE in SHARPS container and REPLACE both for additional treatments
89
Q

how do we sterilize the oraqix

A
  1. SEPARATE the body and the tip and place both items into ONE autoclave bag for sterilization
  2. write “ODU” and the date on the bag

DH Theory 1 (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions