iatrogenic factors (overhangs, open contacts residual calc)
genetic factors
t/f periodontal infection is a contributing factor to a variety of systemic conditions
true
what are 5 systemic conditions that can be affected by periodontal disease
infective endocarditis
cardiovascular disease and atherosclerosis
diabetes mellitus
respiratory disease
adverse pregnancy outcomes
what are three risk factors for oral cancer?
tobacco use
alcohol use
sun exposure
what are 8 risk factors for dental caries?
behavior factors (inadequate biofilm removal)
diatary factors
low fluoride
tooth morphology and position
xerostomia
personal and familiy history
developmental factors
genetic factors (immune response
the patientes overall health status is determined by the pt's ______, ______ and ______ risk
medical
physical
psychological
what are the two systems or guides used to help determine modifications necessary when providing pt care
ASA
OSCAR
what modifications to treatment are needed for ASA I
no modifications necessary
what ASA class is without systemic disease a normal healthy pt with littler or no dental anxiety. Able to walk one flight of starits with no distress
ASA I
what ASA class is mild systemic disease or extreme dental anxiety, must stop after walking one flight of staris because of distress. Could be a well controlled chronic condition, upper respiratory infection or healthy pregnant woman or person with allergies
ASA II
what dh tx considerations are needed for ASA class II
minor modifications to tx and or pt education may be necessary
what ASA class is a systemic disease that limits activity but is not incapacitiating. Must stop en route of walking one flight of stairs, chronic caridovascular conditions, controlled insulin dependent diabetes, chronic pulmonary disease, elevated blood pressure
ASA III
what dh tx considerations are there for ASA III
elective tx not contraindicated but serious condsideration of treatment and or pt/caregiver education modifications may be necessary
what ASA class is incapacitiating disease that is a constant threat to life, unable to walk up one flight of stairs, unstable cardiovascular conditions, extremely elevated bood pressure, uncontrolled epilepsy, uncontrolled insulin dependent diabetes
ASA IV
what are the DH tx considerations for ASA IV
conservative non invasive management of emergency dental conditions; more complex dental intervention may require hospitaliztion during tx, caregiver training for daily oral care may be necessary
what ASA class is pt is moribund and not expected to survieve, end stage renal, hepatic, infectious disease or terminal cancer
ASA V
what is the DH tx consideration for ASA V
only palliative tx delivered, caregiver training for dialy oral care may be necessary
what are the five parts of the OSCAR planning guide?
oral
systemic
capability
autonomy
reality
what are the factors of concern for the oral issue (OSCAR) 11
what are the factors of concern with the systemic issue (OSCAR) 4
nomative age changes
medical diagnoses
pharmacologic agents
interdisciplinary communication
what are the factors of concern with capability (OSCAR) 6
functional ability, self care, caregivers, oral hygiene, transportation to appts, mobility within dental office
what are the factors of concern with autonomy (OSCAR) 2
decision making ability
dependence on alternative or supplementa decision makers
what are the factors of concern for reality (OSCAR) 3
prioritization of oral healht
financial ability or limitations
significance of anticipated life span
what are the four parts for the basis for a dental hygiene diagnosis
pt interview data
physical assessment data
treatment or education needs
referalls to specialists/consultation
_____ means a look ahead to an anticipated outcome or end point
prognoses
what are four factors determining prognoses
current disease status
risk factors
OHI
Tx Options
what would the prognosis be for a pt with adequate control of etiologic factors, pt has self care ability and periodontal support
Good
what prognoses would a pt be with adequate control of etiologic factors, pt has self care ability, has less thatn 25% attachment loss and has class I or less furcation involvement
Fair
what prognoses would a pt be that has greater than 50% attachemnt loss with class II furcation and pt self care is difficult due to location and depth of furcation
poor
what prognoses would a pt be with greater than 50% attachment loss with poor crown to rot ratio, poor root form, inaccessible class II furcation or Class III furcation, greater than 2+ mobility, significant root proximity
questionable
what prognoses would a pt be with inadequate attachment to maintain the tooth?
hopeless (if their teeth fold over while taking radiographs I think they could be considered hopeless, poor Molly)
what is the three part care plan for expected out come?
gingival/periodontal
dental caries
prevention
what are seven examples of expected outcome for prevention?
elimination of iatrogenic factors (calc, restoration overhangs)
increased % of biofilm free areas
pt demonstration of oral care procedures
compliance w/daily care
compliance with maintenance care interval
tobacco free
modification/stabilazation of systemic risk factors
what are the seven examples of expected outcome for gingival/periodontal?
biofilm reduction
reduce/eliminate BOP
reduced probe depths
maintain attachment level
decreased/maintain mobility
resolve erythematous tissue
reduce swelling/edema
what are the five examples of expected outcome for dental caries
