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what are some intraoral assessment findings with patients with diabetes?
- + cheilosis
- + xerostomia
- + glossodynia
- + enlarged salivary glands\
- + increased glucose in saliva
- + fungal infections
- + dental caries
- +periodontal disease
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List pt's that need to receive antibiotics before dental treatment?
- +heart surgery within past 6mnths ( replaced artery, prosthetic valves, hemograft valves)
- + previous bacterial endocarditis
- + first 2yrs after prosthetic joint replacement
- +history of rheumatic fever
- +congenital heart defect
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Pseudomembranous candidiasis
- + a.k.a thrush, creamy white patches (cottage cheese/curled milk)
- + soft white plaque on oral tissues when wiped underlying
- + mucosa is red. bleeding
- +metalic taste can result (burning sensation may result)
- + can be scrapped off
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Describe Candidiasis
- + a.k.a maniliasis/ thrush
- + occurs from overgrowth of yeastlike fungus
- + most common oral infection
- + overgrowth of candida albicans can result from: antibiotic therapy, cancer/chemo, corticosteroid therapy, dentures, diabetes, HIV infected, infancy, xerostomia
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what is aphthous ulceration?
side of mouth/lips have burning sensation, small blisters yellow to gray surrounded by a red margin
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What is hyperplastic candidiasis?
white patches, cannot be removed, HIV infected patients
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Well controlled diabetes HbA IC levels less than? ____percent and poorly controlled diabetes HbA ic levels greater than _____?
9% and 9%
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Atrophic Candidiasis?
- a.k.a denture stomatitis
- - presents as smooth, red patches on the tongue, palate, mucosa,
- - petechiae-like, feels like burn palate
- - most common on the palate and maxilla/alveolar ridge/asymptomatic
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Erythematous candidiasis?
- - often painful mucosa is present
- - may be localized to one are or generalized
- - usually missed as white patches
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Angular cheilitis
- - redness cracks, fissures at the corner of the mouth
- - moderately painful, fissured and eroded
- - treatment: topical/systemic antifungal drugs
- - frequently accompanys intraoral candidiasis
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what are some signs and symptoms with patients with asthma?
- - periodic wheezing
- - dyspnea(difficulty in breathing, coughing, and chest tightness
- = acute asthmatic attic
- - nasal flaring
- - increase pulse rate
- - rise in blood pressure
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Some contraindications for patients with asthma?
- - aspirin *very important*
- - nonsteroidal anti-inflammatory drugs
- - barbiturate/ narcotics\
- - erythromycin
- - ciprofloxacin
- - airpower abrasive system
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What are the steps for a patient having an asthmatic attic?
- 1. stop procedure
- 2. make client comfortable
- 3. administer clients medication (inhaler)
- 4. administer oxygen
- 5. call 911
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some contraindications for using an ultrasonic scaler?
- - immunosuppressed
- - uncontrolled diabetes
- - chronic pulmonary disease
- - dysphagia (swallowing difficulties)
- - children
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Phemphigus Vulgaris list some details about this autoimmunne disease
- - severe progressive disease that effects the skin/mucous memebranes
- - intra epithelial blister formation
- -
most cases in the oral micusa - - shallow ulcers to fragile vesicles or bullae
- - no cure disease treatment are corticosteroids which could lead to complications for prolong use of drug
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Cerebral Palsy
- - most common neurologic impairment in childhood
- - chronic disorder caused by damage to mainly motor areas/affecting the ability to control posture and movement
- - factors occuring before birth or first few years of life are : traumatic brain injury, child abuse/neglet, infections like meningitis
- - patients are spastic/spasticity in the muscles leading to stiffness, resistance to movement and
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Treatment for patients with cerebral palsy?
- -physical/occupational therapy
- - speech/language therapy
- - biofeedback, orthopedic devices, medications
For DH treatment can use IV sedation in general anasthetic
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Acute Perio abscess
- - localized accumulation of pus in perio pocket
- - lateral aspect of tooth
- - edematous, red, shiny
- - dome-like appearance
- -throbbing pain, localized swelling
- -deep red blue tissue, sensitivity, tooth mobility, cervical lymphadenopathy
- - systemic systems (fever, malaise)
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Chronic Perio Abscess
- - overgrowth of perio pocket
- - ass with sinus tract
- - permits vegukar drainage\
- - painless, dull pain
- - seeping pus, intraoral cavity
- - scaling requires local anasthetic
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What is chorhexidine used for and what are its benefit factors?
- -before during and after periodontal debridment
- - decrease severity of mucositis in clients receiving chemotherapy
- - effective in implant plaque retention
- - #1 antiplaqe and antigingivitis agent
- - reduce plaque 55%, gingivitis 45%
- - mode of action of chlro. is to bind the hydroxyapatite and glycoprotein to prevent pellicle formation
- - active for 8-12hrs in the mouth
- - stains teeth, tongue, tooth colored restorations, bitter taste, soft tissue ulcerations, loss of taste
- - use twice a day for 30secs
- - irrigation below gums
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Periapical Abscess
- - non-vital
- - sharp pain
- - sinus tract
- - localized swelling
- - localized redness
- - history of infection
- - round radiolucent apex
- - tooth caries present
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Periodontal Abscess
- - vital
- - constant pain
- - less severe
- - localized
- - no tooth caries
- - lateral readiolucency
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common periodontal microogranisms:
gram + bacteria and gram - Bacteria
- Gram + Bacteria
- - lacultative cocci
- - streptococcus sanguis
- - anaerobic cocci
- - peptostreptoccus micros
- - eubacterium lentum
- Gram - Bacteria
- - eikenella corrideris
- - actinobacillus
- - porphyromonas gingivitis
- - provetella intermedici
- - bacteroides forsythus
- - fusobacterium nucleatum
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Health----- Disease in perio disease
Health- gram positive, aerobic, non-motile, saccharolytic
Disease- gram negative, anaerobic, motile, assacharolytic
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Specific Bacteria Associated with Periodontal Disease
actinobacillus actinomycetemcomitans= Aggressive perio
Porphymonas gingivalis= Chronic Perio
Bacteroides forsythus= Chronic perio
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Hyperthyroidism
- - graves/ plummers disease
- - toxic goiter
- - excessive production heat, neuromuscular, sensitivity to pain, protruding eyes
- - accelerated tooth eruptions
- - rapidly progressing perio disease
- - ( no dental tx for patients with visible goiter)
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Hypothyroidism
- - Cretinism or myxedema
- - mental/physcial retardation
- - puffy face/ edematous tongue
- - delayed tooth eruption
- - bad malloclusion
- - increased perio disease
- - pooly shaped teeth
(partial or complete absence of the thyroid gland at birth)
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Tuberculosis
- -HIV patients are highly susceptile to TB
- - mycobacterium tuberculosos/ serious disease
- - tuberculosis us an Aids defining illness
- - inhalation of fresh droplets containing tubercle bacilli
- - may infect lymph nodes
- - incubation period 10 weeks
- symptoms: low grade fever, loss of appetite, weight loss, slight cough, night sweats, weakness, pesistant cough
- - enlarged nodes
- - oral ulcers may appear on soft/hard palate
- tx: chemo, isoniazid, rifampin, pyrazinamide medication
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What are oral effects of Radiation
- - xerostomia/ salivary gland dysfuntion
- - alteration of taste
- - mucositis/ stomatitis+ infection
- - trismus/ tmj disfunction
- -caries (with first yr of radiation tx)
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Which barrier might be declined with special needs patients?
attittude of the DH
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What are the advantages of sharp/ dull instruments?
increase tactile sensitivity, decrease lateral pressure, decrease burnished calculus
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how does desensitizing toothpaste work?
It relieves sensitivity, stimulates the deposition of substances in the dentin
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What causes build up of cementum?
occlusal trauma
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How does the patient change their hygiene behaviour?
perceive need for change
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Patient has gingivitis, no attachment loss, radiolucent areas around the cervical third of the tooth what is this?
burnout
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which patients are contraindicated to using the ultrasonic scaler?
- - uncontrolled diabetes
- - emphysema
- - gag reflex
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What condition is associated with the aging process?
- small pulp chambers
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Client has overhangs, generalized bone loss, pooly control hypertension what initial tx should the DH propose?
Refer to the physcian - poorly controled hypertension
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