CHAPTER 5 REVIEW – IE, TJR, Osteoporosis, Pregnanc

First, injury/damage to endothelial surface of heart or valves occurs 
second, fibrin and platelets stick to area which means it forms clusters 
3) bacteria (other microbe) get into in the clusters and begin rapidly multiplying which leads to vegetative mass 
4) bacteria are slowly and continuously released into bloodstream which forms BACTEREMIA 
5) fragments of vegetative masses break off and enter blood; EMBOLI 
sixth, Bacteremia and Emboli spread infection to other sites of body 

Bacteremia-

bacteria in blood 

Thrombus

blood clot in a blood vessel (not moving)

Embolus

ANY mass moving in bloodstream

(can be a blood clot / bacterial mass / air)

Know the clinical findings of I.E. 

Heart Failure, Stroke, myocardial infarction, & Peripheral Metastatic Abscesses 

Know the complications of ie

Fever, Heart Murmur, Petechiae of conjunctiva, Osler’s Nodes, Janeway Lesions,& Splinter Hemorrhages 

ORAL Antibiotic Regimens for IE

take Amoxicillin orally 1hr before appt

ORAL Antibiotic Regimens for IE If ALLERGIC to Penicillin's- 

Cephalexin (Keflex)/ Azithromycin (Z-Pak) 

INJECTABLE Antibiotic Regimens for IE:

 administer ampiclin 1hr before appt 

INJECTABLE Antibiotic Regimens for IE  If ALLERGIC to Penicillin

administer Cefazolin  1hr before appt  

anitbotics for tjr (total joint replacement)

 ORAL Antibiotic Regimen 
2g of amoxicillin or Cephalexin (Keflex) and take 1 hour before dental appt 

But really determined by orthopedic doctor 

Know the high risk dental procedures requiring antibiotic prophylaxis for I.E.  

nvolve manipulation of gingival tissue & periapical region of teeth 
involve putting a hole of the oral mucosa: scaling/probing; placing ortho bands; suture removal; biopsy 

Bisphosphonate-associated Osteonecrosis = BON / BONJ 

A condition of the jaws, usually after oral surgery / extraction

Clinical Presentation on bon/boj?  

area of exposed necrotic bone 
2) areas of inflamed soft tissue 
3) pain  
4) infection 

Fun facts on bon/ boj?  

-can mimic osteomyelitis on radiographs 
--more likely to occur after I.V. BIS Therapy 
--more likely to occur after more than 3 yrs of Oral BIS Therapy

when to provide dental treatment in pregnancy 

Emergency dental treatment = any time 
Elective dental treatment = during 2nd trimester/early 3rd trimester 

 the cause of Supine Hypotensive Syndrome 

where blood pressure drops significantly when a pregnant woman lies on her back

the treatment of Supine Hypotensive Syndrome 

position patient on LEFT side
--semi-reclined position