Menopause is the end of fertility due to decreased production of what hormones produced by the ovaries?
estrogen
progesterone
Describe 3 main symptoms of menopause.
vasomotor reactions: hot flashes; headache, flushing face, heart palpitations, dizziness, chill, few-more than 30 mins.
Vaginal changes: dry, irritated, thinning tissue, more infections, decreased estrogen
emotional disturbances: mood swings, depression, irritability, difficulty w/concentration or membory, decreased interest in sex, anxiety, tension, feeling useless, weight gain esp. around waist
Taste perception may be altered in women going through menopause, what are 3 ways they may describe taste?
salty
peppery
sour
What are 5 oral changes that are common in women going through menopause?
shiny tissue
burning mouth syndrome
altered salivary composition due to psychological stress
thin and atrophic epithelium, decreased keratinization
gingival changes representing an exaggerated response to biofilm
Appearance and adverse changes of the mucosal tissues from menopause frequently resemble those associated with vitamin deficiencies, particularly which vitamin?
vitamin B
What is a dynamic period of development marked by rapid changes in body size, shape, and composition? A sign of growing up?
puberty
Which gender usually goes through puberty first? At which age do the secondary sex characteristics begin to appear in girls? And in boys?
girls
10-13
13-14
erosion of enamel and dentin as a result of chemical and mechanical effects.
perimylolysis
The following psychosocial developmental factors describe which phase of adolescence?
less interest in parental activitieswide mood swingspreoccupation with self and pubertal changes
uncertainty about appearance
intense relationships with same-sex friends
increased cognition
increased fantasy world
idealistic vocational goals
increased need for privacy
lack of impulse control
early adolescence
The following psychosocial developmental factors describe which phase of adolescence?
peak of parental conflicts
general acceptance of body
concern over making body more attractive
peak of peer involvment
conformity with peer values
increased sexual activity and experimentation
increased scope of feelings
increased intellectual ability
feeling of omnipotence
risk-taking behavior
middle adolescence
The following psychococial developmental factors describe which phase of adolescence?
reacceptance of parental values
acceptance of pubertal changes
peer group less important
more time spent in sharing intimate relationships
practical, realistic vocational goals
refinement of moral religious and sexual values
ability to compromise and to set limits
late adolescence
What is the relationship of the parotid gland with bulimia nervosa?
the gland enlarges
enlarement may occur for 2-6 days after binge
cause is unkown
degree of enlargement increases with frequency of vomiting
gland functions normally and is not sensitive to palpation
What are 11 oral findings common with bulimia nervosa?
perimylolysis: chemical erosion of tooth surfaces by acid from regurgitation of stomach contents
evidence of bulimia on smooth palatal surfaces of teeth
restorations raised because of erosion of enamel
increase in caries
decreased saliva
xerostomia
hypersensitive teeth
trauma; from devices or fingers to induce vomiting
enlarged parotid gland
bruxism
impairment of taste perception
Which teeth typically exhibit erosion in pts with bulimia nervosa?
palatal surfaces of teeth
lingual surfaces of maxillary anterior teeth
What are 7 prenatal BIOMEDICAL risk factors for mental retardation?
chromosomal disorders
single-gene disorders
metabolic disorders
cerebral disorders
maternal illnesses
parental age
What are 3 perinatal BIOMEDICAL risk factors for mental retardation?
prematurity
birth injury
neonatal disorders
What are 6 postnatal BIOMEDICAL risk factors for mental retardation?
traumatic brain injury
malnutrition
meningoencephalitis
seizure disorders
fetal alcohol syndrome
congenital heart disease
What are 4 prenatal SOCIAL risk factors for mental retardation?
poverty
maternal malnutrition
domestic violence
lack of access to prenatal care
What is a perinatal SOCIAL risk factor for mental retardation?
lack of access to birth care
What are 5 postnatal SOCIAL risk factors for mental retardation?
impaired child-caregiver
inadequate parenting skills
family poverty
chronic illness in the family
institutionalization
What are 4 prenatal BEHAVIORAL risk factors for mental retardation?
parental drug use
parental alcohol use
parental smoking
parental immaturity
What are 2 perinatal BEHAVIORAL risk factors mental retardation?
parental rejection of caretaking
parental abandonment of child
What are 5 postnatal BEHAVIORAL risk factors for mental retardation?
child abuse and neglect
domestic violence
inadequate safety measures
social deprivation
difficult child behaviors
What are 2 prenatal EDUCATIONAL risk factors for mental retardation?
parental cognitive disability without supports
lack of preparation for parenthood
What is a perinatal EDUCATIONAL risk factor for mental retardation?
lack of medical referral for intervention services at discharge
What are 5 postnatal EDUCATIONAL risk factors for mental retardation?
impaired parenting
delayed diagnosis
inadequate early intervention services
inadequate special educational services
inadequate family support
What are 2 effective ways to help prevent caries in the mentally retarded pt?
fluoride therapy: fluoride varnish
sealants
What are 3 common oral manifestations of pts with autism?
dental caries: given food that will be accepted regardless of nutrition, diet limited by needs for sameness, sweet foods as a reward for good behavior
oral hygiene: daily oral care procedures may be inadequate
What are 9 appointment planning and managing tips for pts with autism?
work with pt: review histories, gather info about them
short orientation and familiarization apptmnts first
involve same members of dental team at each appt with the pt
four-handed dental hygiene
frequent apptmnts to include all phases of prevention: biofilm control, scaling, fluoride, sealants
provide predictable and consistent experience
quiet environment
desensitization
"show-tell-do" instructions
physical immobilization: may be necessary
Pt instruction for the autistic pt tak the form of ______________ repeated many times
show-tell-do
What is an atypical antipsychotic medication that has been shown to be significantly more effective than placebo in improving behavior, representing the largest positive effect by a medication ever observede in children with autism?
risperidone
What are 4 types of drugs that are used to pharmacologically treat autism?
stimulants: methylphenidate, ritalin
antidepressants
opiate blockers
tranquilizers
What is a collection of conceptual, social, and practical skills that have been learned by people in order to function in every day life? It includes:
conceptual: language, reading, self-direction
social: responsibility, self-esteem, law abiding
practical: daily living activities, occupational skills
adaptive behavior
What are 4 common characteristics in the autistic pt?
problems with social interactions
problems with verbal and nonverbal communication
ritualistic or compulsive behaviors
atypical responses to the environment
dentistry pertaining to or used in legal proceedings
forensic dentistry
clinical presentation of an initial HSV infection from HSV-1 (oral) or HSV-2 (genital) that can appear as multiple ulcerations on both keratinizing and gland-bearing mucosa
acute primary herpetic gingivostomatitis
baldness
alopecia
ill health, malnutrition, wasting (emaciating)
cachexia
discoloration on the skin that is blue-black with irregularly formed hemorrhagic areas. color changes with time to yellow or greenish brown
ecchymosis
What phase of dental hygiene treatment are you most likely to identify abuse?
intra and extra oral exam
What are 7 common extraoral signs of abuse in children?
skull injuries: edema with ecchymosis of varying phases
bald spots: traumatic alopecia
raccoon sign
nose fracture or displacement
lip bruises and lacerations
marks on skin that form a pattern of an object like a belt buckle or handprint
human bite marks
Wha are 3 common extraoral signs of abuse of domestic and intimate partner abuse?
bruises in various degrees of healing frequently involving the face, eyes, and neck
partner reluctant to admit abuse because of fear of threats
deny abuse
What are 4 common intraoral signs of abuse seen in children?
lacerations of tongue, buccal mucosa, or palate
lingual and labial frenal tears
teeth that are fractured, displaced, avulsed, or nonvital
radiographic evidence of fractures in different degrees of healing
What are 8 common intraoral signs of abuse seen in adults?
fractured, displaced, or avulsed teeth
bruising of edentulous ridge
STDs such as condyloma acuminatum and primary herpetic gingivostomatitis
lesions or sore areas in mouth from ill-fitting dentures
fractured denture
poor oral hygiene
rampant dental caries
untreated periodontal disease
What group of people are typically the primary elder abusers?
family members
What are 5 common signs of sexual abuse in children?
bruising or petechiae of the palate: forced oral sex
sexually transmitted gental lesions found intraorally
exhibits difficulty in walking or sitting
extreme fear of the oral examination
pregnancy, especially in the early adoscent years
What is the ability to endure without effect or injury. increased amount of the drug is needed to achieve the same effect?
tolerance
What is a feeling of well-being, elation; without fear or worry?
euphoria
What is a condition of deteriorated mentality characterized by a marked deline of intellectual functioning?
dementia
What percent of alcohol is absorbed by the liver?
90%
true or false. alcohol passes freely across the placenta
true
What is the brand name of the drug used to treat alcholism?
ANTABUSE
true or false. Alcohol CAN be spread through breast milk, so you should refrain from drinking.
true
What are 2 oral manifestations of the mucosa, lips, and tongue due to drug abuse?
dry: drug induced xerostomia, soft tissue abnormalities
tongue coated: glossitis related to nutritional deficiencies
What are 6 oral manifestations of the gingiva due to drug abuse?
poor oral hygiene; heavy biofilm
calc deposits generalized
mod to severe gingival inflammation
bleeding gingiva spontaneously or on probing
gingival lesions resulting from the direct application of cocaine
higher incidence of perio infections than peers
What are 3 oral manifestations of the teeth due to drug abuse?
chipped and fractured from falls and injuries; stained from tobacco
attrition secondary to bruxism
erosion secondary to frequent vomiting, wine consumption, and meth mouth
What are 5 oral manifestations of dental caries due to drug abuse?
increased risk factors: poor diet, lack of dental care, accumulation of biofilm, and xerostomia
diet high in cariogenic substances
root caries if gingival recession is evident
open rampant carious lesions, abuse of analgesic drugs results in indifference to pain
tooth loss
What are 3 oral manifestations of minimal professional care due to drug abuse?
substance abuse pt tends to put off dental and dental hygiene care
any available money is used in the purchase of the drugs
dental care is used on an emergency basis to alleviate any pain or discomfort, and to obtain prescriptions for drugs
true or false. Ultrasonic scalers and air-powder stain removal devices should be used with caution to prevent inhalation of oral microorganisms by the pt
true
warning sensation felt by some people immediately preceding a seizure; may be flashes of light, dizziness, peculiar tast, or a sensation of prickling or tingling
aura
true or false. When experiencing an aura, a pt may seek a safe place to sit or lie down in privacy
true
What are 4 seiqure 'triggers'?
psychological stress; apprehension
fatigue; sleep deprivation
sensory stimuli, such as flashing lights, noises, peculiar odors
use or withdrawal of alcohol or other addictive drugs
What type of seizure: the loss of consciousness begins and ends abruptly in about 5-30 seconds
most common in children
pt has blank stare, usually doesn't fall but becomes fixed and drops what they're holing
pale
twitching of eyelids, brows, head, or chewing
attack ends abruptly; pt is unaware
petite mal (absence seizure)
What type of seizure: has the epileptic cry
loss of consciousness is sudden and complete, pt may fall
tonic phase, followed by clonic movements
pale to bluish
loss of bladder
bite tongue
lasts 1-3 minutes
foamy saliva
has preictal, ictal, and postictal phases, may continue to status epilepticus
tonic clonic (grand mal) seizure
What are 3 different classifications of seizures?
partial: simple (w/out loss of consciousness) complex (impairment of consciousness
What are 4 different treatment options for seizures?
medications
surgery
vagus nerve stimulation
ketogenic diet
What are 8 emergecy procedure steps to do incase of a seizure in the dental office?
do not try to stop seizure or restrain pt
stop procedure and call for help
protect pt from injury
don't place anything between teeth
establish airway monitor vitals
stay with pt
check for consciousness
When do you activate the emergency medical system in the event of a seizure?
if the seizure is still recurring, or has recurred within 5 minutes
gingival overgrowth/ hyperplasia occurs in what percent of persons using phenytoin for seizure treatment?
25-50%
What mechanism of phenytoin causes gingival hyperplasia?
it may cause fibroblasts and osteoblasts to deposit excessive extracellular matrix
local irritants (biofilm) make response more excessive
if the gingival overgrowty appears as a painless enlargement of interdental papilla, with signs of inflammation, and eventually the tissue becomes fibrotic, pink, and stippled. with a mulberry or cauliflower like appearance, how sever is it?
early clinical features
If gingival overgrowth appear increased in size, extends to include the marginal gingiva, and covers a large portion of the anatomic crown, often, cleft-like grooves occur between lobules, how severe is it?
advanced lesion
If gingival overgrowth appears large, bulbous gingiva that may cover the enamel, tend to wedge the teeth apart, and interfere with mastication, how severe is it?
severe lesion
What are 6 medications that may cause gingival enlargment?
What is a substitute drug that may have less occurance of gingival overgrowth?
tacrolimus
What is the difference between primary and secondary seizures?
primary (idiopathic): genetic predisposition
secondary (symptomatic): congenital conditions
perionatal injuries
brain tumor
stroke
trauma
infection
degenerative brain disease
metabolic and toxic disorders
complication of cancer
involuntary movements of the mouth, lips, tongue, and jaws, usually associated with long-term use of antipsychotic medication
tardive dyskinesia
impairment in uttering words due to diseases that affect oral and pharyngeal muscles
dysarthria
inability to sit still
akathisia
When is the optimal time to treat a pt with schizophrenia?
when the pts symptoms are reasonably controlled by medication
What are 4 different types of anxiety disorders?
panic attack
panic disorder
posttraumatic stress disorder
generalized anxiety disorder
Which type of panic dosorder results in shortness of breath, dizziness, palpitations or accelerated heart rate, shaking, sweating, clammy hands, choking, nausea, numbness, flushes, chest pain, frear of dying or going crazy, may be uncued, or cued
panic attack
Which type of panic disorder is characterized by recurrent panic attacks? may occur with agoraphobia (fear of being in places that might be difficult or embarassing)
panic disorder
Which type of panic disorder, occurs when an initiating traumatic event has occured outside the range of human experience, flash backs occur, pt might feel they are reliving the event, may experience depression
posttraumatic stress disorder
Which type of panic disorder is there persistant anxiety and excessive worry not associated with life-threatening fears, and may be complicated by depression, alcohol abuse, or anxiety related to a general medical condition?
generalized anxiety disorder
What is a major oral health problem with medications for depression?
xerostomia
What are 4 common types of drugs taken for depression?
