Dental Hygiene Care: Conditions and Special Considerations

Flashcards covering ASA classifications, blood pressure protocols, antibiotic prophylaxis, and management of systemic conditions in a dental hygiene clinical setting.

ASA I

A normal healthy patient who is a non-smoker with minimal or no alcohol use and can walk up one flight of stairs without distress.

ASA II

A patient with mild systemic disease or ASA I with extreme dental anxiety. Examples include pregnancy, well-controlled HTN, or smoking.

ASA III

A patient with severe systemic disease that limits activity, such as poorly controlled DM, ESRD undergoing dialysis, or a history of MI over 3 months ago.

ASA IV

A patient with severe systemic disease that is a constant threat to life, such as a recent MI or CVA occurring less than 3 months ago.

Normal Blood Pressure

Blood pressure measured at $\le 120\,\text{mm Hg}$ systolic AND $\le 79\,\text{mm Hg}$ diastolic.

Elevated Blood Pressure

Blood pressure measured at $120-129\,\text{mm Hg}$ systolic AND $\le 79\,\text{mm Hg}$ diastolic.

Hypertension Stage 1

Blood pressure measured at $130-139\,\text{mm Hg}$ systolic AND/OR $80-89\,\text{mm Hg}$ diastolic.

Hypertension Stage 2 (Lower Range)

Blood pressure measured at $140-159\,\text{mm Hg}$ systolic AND/OR $90-99\,\text{mm Hg}$ diastolic; required action includes a Hypertension Stage 2 referral form.

Hypertension Stage 2 (Upper Range)

Blood pressure measured at $160-179\,\text{mm Hg}$ systolic AND/OR $100-119\,\text{mm Hg}$ diastolic; requires medical clearance to return to the DH clinic.

Hypertensive Crisis

Blood pressure measured at $\ge 180\,\text{mm Hg}$ systolic AND/OR $\ge 120\,\text{mm Hg}$ diastolic; no treatment is rendered and medical clearance is required.

HbA1c

A reliable measure of average glucose levels over a 3-month period by measuring the percentage of hemoglobin that became glycohemoglobin.

Well-controlled Diabetes (HbA1c)

An HbA1c level of $7.0$ or below.

Poorly Controlled Diabetes (HbA1c)

An HbA1c level of $8.0$ or higher.

Amlodipine

A calcium channel blocker used for hypertension that may produce gingival hyperplasia with a lobulated appearance.

Epilepsy

A brain disorder characterized by periodic and unpredictable seizures caused by abnormal and excessive neuronal firing.

Excitotoxicity

The excessive activation of glutamate receptors leading to neuronal death, often during uncontrollable convulsions.

Dilantin (Phenytoin)

A common medication taken by patients with epilepsy that can cause gingival overgrowth.

Kidney Dialysis Appointment Timing

In general, a patient on dialysis should be seen for dental hygiene care the day after their dialysis treatment.

Semi-supine Position

The recommended adjustment for a pregnant patient's chair position to ensure comfort during dental treatment.

Infective Endocarditis (IE) High-Risk Conditions

Cardiac conditions requiring AB prophylaxis, including prosthetic cardiac valves, history of IE, or certain congenital heart diseases (CHD).

AB Prophylaxis Timing

Antibiotics should be taken 1 hour before the procedure, or up to 2 hours after if not taken before.

Clindamycin

An antibiotic no longer recommended for AB prophylaxis due to high risks of causing Clostridium difficile infection.

Gingival Hyperplasia

A potential oral manifestation in patients taking calcium channel blockers.