Unit 1-5 Flashcards
Goals of positioning
Access
Clinical comfort and occupational injury avoidance
Client comfort and safety
Ergonomics
Branch of ecology dealing with design and operation of machines and the physical environment
Visibility
What’s it part of and what does it include ?
Visibility is part of access.
Involves adequate light, mirror effectivity, clients head positioning and adequate retraction with finger, cotton roll and mirror head.
Definitions; Supine - Trendelenburg - Prone - Neutral -
Supine - flat head and feet (same plane).
Trendelenburg - flat, modified supine with head lower then heart.
Prone - flat with face down.
Neutral - clinician position that minimizes any medical stresses of the body.
Repetitive strain injures
Also known as? What’s the meaning? What’s it caused by?
Also known as - “work related musculoskeletal disorders.”
Meaning: injury affecting musculoskeletal peripheral nervous or neurovascular system.
Caused by: exposure to ergonomical hazards.
Common MSD’s
Thoracic outlet syndrome Rotator cuff tendinitis Pronator syndrome Extensor wad strain Carpal tunnel Ulnar nerve entrapment Tenosynovitis Tendinitis
Thoracic Outlet Syndrome
A painful disorder of the fingers, hand and/or wrist due to the compression of he brachial nerve plexus and vessels between he neck and shoulder.
Causes; tilting head forward, hunching shoulders forward, and continuously reaching overhead.
Symptoms; numbness, tingling and/or pain in the fingers, hand or wrist.
Rotator Cuff Tendinitits
A painful inflammation of the muscle tendons in the shoulder region.
Causes; holding elbow above waist level and holding the upper arm away from body.
Symptoms; severe pain and impaired function of the shoulder joint.
Pronator Syndrome
A painful disorder of he wrist and hand caused by compression of the median nerve between he two heads of the pronator teres muscle.
Causes; holding the lower arm away from the body
Symptoms; similar to those of carpal tunnel syndrome
Extensor Wad Syndrome
A painful disorder of the fingers due to injury of the extensor muscles of the thumb and fingers.
Causes; extending fingers independently of each other.
Symptoms; numbness, pain and loss of strength in fingers.
Carpal Tunnel Syndrome (CTS)
A painful disorder of the wrist and hand caused by compression of the median nerve within the carpal tunnel of the wrist.
Causes; the nerve fibers of the median nerve originate in the spinal cord in the neck; therefore, poor posture can cause CTS. Other causes include repeatedly bending hand up, down or from side to side at he wrist and continuously pinch-gripping an instrument without resting muscles.
Symptoms; numbness, pain and tingling in the thumbs, index and middle fingers.
Ulnar Nerve Entrapment
A painful disorder of the lower arm and wrist cause by compression of the ulnar nerve of the arm as it passes through the wrist.
Causes; bending hand up, down or from side to side at the wrist and holding the little finger a full span away from the hand.
Symptoms; numbness, tingling and/or loss of strength in the lower arm or wrist.
Tenosynovitis
A painful inflammation of the tendons on the side of the wrist and at the base of the thumb.
Causes; hand twisting, forceful gripping, bending the hand back or to the side.
Symptoms; pain on the side of the wrist and the base of the thumb; sometimes movement of the wrist yields a crackling noise.
Tendinitis
A painful inflammation of the tendons of the wrist resulting from strain.
Causes ; repeatedly extending the hand up or down at the wrist.
Symptoms; pain in the wrist, especially on the outer edges of the hand, rather than through the center of the wrist.
Neutral neck position
Head tilt of 0 - 20 degrees
The line from the eyes to treatment should be as near to vertical as possible.
Neutral back position
Lean forward slightly from the hips
0 - 20 degree trunk flexion
Neutral torso
Body is in line with axis
Neutral shoulder position
Shoulders in horizontal line
Weight evenly balanced when seated
Neutral upper arms
Upper arms hang parallel to long axis of torso
Elbows at waist level held slightly away from body 0 - 20 degrees
Neutral forearm position
Forearms parallel to floor
Foray me raised or lowered, if necessary, by pivoting at elbow joint keep angle less than 60 degrees
Neutral hand position
Little finger-side of palm is slightly lower than thumb-side of palm
Wrist aligned with forearm
Informed consent
Informing the client about expected successful outcomes and possible risks and alternative treatments.
Capacity of consent
The ability of the patient to fully understand the information.
Patient responsibilities involving medical history
Patient has a duty to provide accurate responses on medical history assessment regarding his/her health status.
2 main steps in collecting medical history
- Information gathering
2. Determination of medical risk
Medical history information gathering involves:
Reading thoroughly, prioritizing, researching conditions, researching drugs, formulating questions, interviewing, consulting.
Significance of medical history
Medical history directs and guides steps to be taken in preparation for, during and following appointments.
Oral conditions reflect general health conditions.
General health factors influence response to treatment.
Reveals conditions that necessitate precautions, modifications or adaptions.
Aid in identification of possible unrecognizable conditions.
Evidence for legal matters.
Help identify potential risk factors.
Brief History
Contains vital items during initial emergency visit. More information obtained at succeeding appointment.
Complete History
Made at initial visit and is a combination of interview and questionnaire.
Limitations of a history
Problems with method of obtaining information
Difficulty comprehending
Location where questionnaire is completed
Patients limited knowledge
Embarrassment
Medical conditions that require antibiotic premedication before dental and dental hygiene treatment
Prosthetic cardiac valve Previous endocarditis Cardiac transplantation Congenital heart disease (only; unrepaired cyanotic congenital heart disease, completely repaired with prosthetic material or device, or repaired with residual defects)
Four vital signs (5th new one)
Body temperature Pulse Respiratory rates Blood pressure Smoking status
If vital signs are not in normal ranges, what do we do?
Advise the clients to check with the physician
Normal body temperature
37.0 Celsius (98.6 Fahrenheit)
Range; 35.5-37.5 Celsius (96-99.5 Fahrenheit)
Normal pulse
Between 60-100/min
Normal respiration
14-20/min
Soft tissue lesions
An area of abnormal-appearing skin or mucosa that does not resemble the soft tissue around it.
Describing lesions
ABCD-T Anatomic location Border Colour and Configuration Diameter/Dimensions Type
Head and neck examination
A physical examination technique consisting of a systematic visual inspection of the skin of the head and neck combined with palpating of lymph nodes, salivary glands, thyroid gland, and temporomadnibular joint. Gathers general information on health of client, note early indications of some diseases and detect abnormalities and potentially life threatening malignancies.
Oral examination
A physical examination technique consisting of systemic inspections of the oral structures.
Risk factors for oral cancer
Age
Gender
Sunlight
Tobacco and alcohol use
Primary dentition
Formation of primary teeth begins in utero.
Mixed dentition
When primary teeth are being exfoliated and permanent teeth move in.
Permanent dentition
Mineralization of the permanent teeth starts at birth and continues to adolescence. Roots are normally completed by three years after eruption.
Types of etiology
Heredity - enamel is partly or wholly missing.
Systemic (environmental) - factors that may contribute to enamel hypoplasia during tooth development.
Local - a single tooth effected by trauma or periapical inflammation about a primary tooth cam injure the adjacent developing permanent tooth.
Attrition
Wearing away of a tooth as a result of tooth-to-tooth contact.
Erosion
Is the loss of tooth substance by a chemical process that does not involve known bacterial action.
Abrasion
Mechanical wearing away of tooth substance by forces other than mastication.
Dental caries
Localized, posteruptive, pathologic process of external origin involving softening of the hard tooth tissue and proceeding to the formation of a cavity.
Fulcrum
A finger rest used to stabilize the clinicians hand, ring finger on right hand.
Dental mirror
Indirect vision Retraction of tongue Retraction of lips Indirect illumination Transillumination
3 common types of dental mirrors
Front surface mirror - mirror on front surface, clear image, most common, easily scratched.
Concave mirror - mirror on front surface, magnifies image, distorts image.
Plane (flat surface) mirror - mirror on back side, produces double image, may be distracting.
Instrument weight
Optimal weight for instrument is 15g or less
Lightweight instruments cause less stress on muscles in hand.
Handle diameter
Optimal diameter is 10mm
Small handles require more pinch force to hold
Large diameter requires least
Handle texture
Term for texture is knuckling pattern.
Increases friction between the fingers and handle.
More control.
Parts of periodontal instrument
Handle, shank, working end.
Balanced instrumentation is when..
It’s working end are aligned with an imaginary line that runs vertically through the center of the handle lengthwise.
Why do we need balanced instruments?
Balance ensures finger pressure applied against handle if answered to the working end.
Simple shank design
Bent in one plane, or straight.
Used primarily on anterior teeth.
Complex shank design
Bent in two planes.
Another term used is angled or curved shank.
Used on posterior teeth.
Rigid shank
Shank that will withstand the pressure needed to remove heavy calculus deposits.
Flexible shank
Shank that will only remove small and medium size calculus.
Not heavy calculus.
Tactile sensitivity
Clinicians ability to feel vibrations transmitted from the instrument working-end with their finger that is rested on the shank.
Vibrations are created when..
Working end quivers slightly as it moves over irregularities.
Functional shank
Portion of the shank that allows the working end to be adapted to the tooth surface.
Begins below the working end and extends to the last bend in the shank nearest handle.
Lower shank
What it is and another name for it ..
Section of the functional shank that is nearest to the working end.
Also called terminal shank.
Provides important visual clue for clinician to select correct working end.
Extended lower shank
3mm longer than a standard lower shank, designed for deep periodontal pockets.
Unpaired working ends
Double ended instruments that are not similar
Paired working ends
Double ended instruments with exact mirror images
Toe and tip
Working end of instrument.
Toe is rounded surface.
Tip is pointed surface.
Cutting edge
Sharpe area of working end formed where the face and lateral surface meet.
Periodontal probe
Passes net instrument used to evaluate the health of periodontal tissues.
Explorer
Assessment instrument used to locate calculus deposits, tooth surface irregularities and defective margins on restorations.
Have flexible shanks and are circular in cross section.
Sickle scaler
Used to remove calculus deposits from crowns of teeth. Working-end is pointed back and pointed tip and is triangular cross section.
Curet
Used to remove calculus deposits from the crowns and roots of the teeth. Working end of curet has rounded back and rounded toe and is semi circular in cross section.
Periodontal file
Used to crush large calculus deposits. Working end has several cutting edges.
Motion activation, two types.
Is the muscle action used to move the working-end of the instrument across too surface.
1) Wrist motion activation.
2) Digital motion activation.
Adaptation
The act of placing 1 or 2 mm of the working ends lateral surface in contact with the tooth.
Leading-third
The anterior portion of the working end.
Toe/tip - middle - heel
Curet; toe-third
Sickle; tip-third
Instrument stroke
The act of moving the working end of a instrument against the tooth surface.
Junctional epithelium
The soft epithelial tissue that forms the base of a gingival sulcus or periodontal pocket.
Assessment stroke
Used to locate calculus deposits or other tooth irregularities hidden beneath gingival margin.
Design of periodontal probes
Blunt, rod shaped working end, may be circular or rectangular in cross section and is calibrated with mm markings.
Probe functions
Detect periodontal pockets to determine health status.
Measure, access bleeding, determine relationships, monitoring.
