Midterm Review

What are the three steps in making a dental hygiene diagnosis?

identifying UHN, eitologies and evidence

Dental hygiene diagnosis recognizes the client as an _______ _______ _____ rather than a disease entity

integrated human being

What is the etiology in dental hygiene diagnosis?

cause of the UHN

what is the evidence of a dental hygiene diagnosis?

proof, signs/symptoms

how to write a dental hygiene diagnosis statement?

UHN due to ….. as evidenced by …….

What does the dental hygiene diagnosis statement do?

gives us a clear client centered evidence and etiology that will help us build goals and interventions specific to our clients needs

the _____ portion must be resolved by the _______

evidence, client goal

the _____portion must be resolved by our ntervention

etiology

our DH ______ will help resolve the etiology

interventions

what does idiopathic mean?

relating to a disease that arises spontaneously or the cause is unknown

What part of ADPIE is the care plan?

D+P

Hypertension: Have they taken their ______ today?

medication

Hypertension: do they monitor their ________ _______ at home?

blood pressure

Hypertension: do they know what their blood pressure is _______?

normally

Hypertension: what is required at every appt?

monitor vitals

At what bp does someone with hypertension need medical clearance?

160/100 mm Hg

Diabetes: type ___ or type ____?

1 or 2

Diabetes: _____ were they diagnosed?

whrn

Diabetes; fasting blood glucose: how often is it ______?

monitored

What is the blood glucose range for diabetes?

3.9-11.2 mmol/L

When is fasting blood glucose usually monitored?

evening and morning

Diabetes: what is their _____?

A1C

What should someones A1C be?

< 7%

When can we no longer do dental hygiene treatment, blood glucose is _______

higher than 11

Diabetes: did the client ____ and take their medication today?

eat

Asthma: when was their last _______. Frequency?

attack

Asthma: do they have a ______? Do they carry it?

inhaler

Asthma: have they ever been?

hospitalized

What should asthma patients have with them every appt?

inhaler

Heart Attack/Stroke: _____ of event?

date

Heart Attack/Stroke: last follow up with _______?

medical dr

Heart Attack/Stroke: if taking a __________ or __________ INR is needed

Direct Oral Anti-coagulant (DOAC) or Warfarin

heart attack: requires _____ days for recovery

30s

stroke: requires _____ months for recovery

6

Stent Placement: ___ weeks for non coated stent; _____ year for drug coated stent.

6; 1

What’s a macule?

Is hypertension a risk or alert?

RISK

is diabetes a risk or alert?

RISK

is a stroke a risk or alert?

ALERT

is a heart attack a risk or alert?

ALERT

is asthma a risk or alert?

RISK

is a heart attack a risk or alert?

ALERT

When the client comes in for a continued care appointment and a referral for blood pressure has been taken, the expectation is that ________________________ Multiple readings are done at the first appointment according to the CDHO fact sheet

BP only needs to be taken once as long as it is under 160/100 mm/Hg.

Medications and conditions they are taken for  must be listed in the progress note at every ________ appointment

continued care

UHN statement for medical conditions for _____ patients only

risk

What’s the radiograph interval for a low risk 6+ years?

24-36 months

What’s the recall interval for 6+ years?

6-12 months

What’s the fl recommendation for low risk 6+ years?

fl toothpaste, varnish for root exposure/sensitivity

What’s the X-ray interval for moderate risk 6+ years?

18-24 months

What’s the recall interval for moderate risk 6+ years?

4-6 months

What’s the fl recommendation for moderate risk 6+ years?

0.05 NaF rinse daily and varnish

What’s the fl recommendation for high risk 6+ years?

1.1% NaF toothpaste 2 x day, NaF rinse 2x day and varnish

what’s the recall interval for high risk 6+ years?

3-4 months

What’s the x ray interval for high risk 6+ years?

6-18 months

What’s the extreme risk x ray interval for 6+ years?

6 months until no caries detected

what’s the recall interval extreme risk 6+ years?

3 months

What’s the extreme risk fl recommendation for 6+ years?

1.1% NaF TP 2xday, 0.05%                                                                       NaF rinse when mouth feels dry and after eating, varnish

What are two other aids to recommend to high and extreme risk patients?

Chlorexidine 10 mL rinse for 1 minute daily for one week each month

Xylitol(6-10 g/day) gum or candies; two tablets of gum or two candies four to five times daily

Macule

An area that is usually distinguished by a color different from that of the surrounding tissue. It is flat and does not protrude above the surface of the normal tissue. A freckle is an example of a macule 

Papule

 A small, circumscribed lesion usually less than 10 mm in diameter. It is elevated or protrudes above the surface of normal surrounding tissue

Pustules

Variously sized circumscribed elevations containing pus 

Vesicle

A small, elevated lesion less than 10 mm in diameter that contains serous fluid

Pedunculated

Attached by a stemlike or stalk like base similar to that of a mushroom

Nodule

 A palpable solid lesion up to 10mm in diameter found in soft tissue. Can occur above, level with, or beneath the skin surface 

Erythema

a abnormal redness of the mucosa or gingiva

 Erythroplakia

clinical term used to describe an oral lesion that appears as a smooth red patch or granular red and velvety patch. Less common than leukoplakia 

Pallor

paleness of the skin or mucosal tissues

 Leukoplakia

A clinical term for a white, plaque like lesion on the oral mucosa that cannot be rubbed off or diagnosed as a specific disease (often premalignant)

corrugated

wrinkled

Fissure

 A cleft or groove, normal or otherwise, showing prominent depth

Papillary

Resembling small, nipple-shaped projections or elevations found in clusters

Coalescence

The process by which parts of a whole join together, or fuse, to make one larger lesions. Ex. Herpes 

Fordyce Granules: (variation of normal)

Clusters of ectopic sebaceous glands 

Appear as yellow lobules in clusters 

Commonly observed on vermilion border of lips and buccal mucosa 

No treatment 

White Hairy Tongue (variant of normal)

Elongated filiform papillae are white. Result of either an increase in keratin production or a decrease in normal desquamation 

Black Hairy Tongue (variant of normal)

Papillae are brown-to-black because of chromogenic bacteria

Erythema Migrans:

 Term used to describe “geographic tongue” found on mucosal surfaces other than tongue

What’s Geographic Tongue?

Erythematous patches surrounded by a white or yellow border. Diffuse areas devoid of filiform papillae. Distinct presence of fungiform papillae 

What are the 4 different characteristics of Gingival Indices

colour, contour, texture and consistency

What is the CAL?

CEJ to JE

what is Protection from Health Risks (PHR)?

the need to avoid medical contraindications related to dental hygiene care

What is Freedom From Fear and Stress (FFS)

the need to feel safe and be free from fear and anxiety

What’s the Freedom From Pain (FFP)?

free from head and neck pain

What’s Wholesome Facial Image (WFI)?

client satisfaction with oral facial features and breath

What’s Skin and Mucous Membrane Integrity of the Head and Neck (SMMIHN)?

the need for intact coverings of the head and neck region, PERIO!

What’s Biologically Sound and Functioning Dentition (BSFD)?

the need for intact and functional teeth and restorations

What’s Conceptualization and Understanding (CU)?

conceptualization and problem solving is the need to understand and make sound judgements about ones oral health

What’s Responsibility for Oral Health (ROH)?

refers to the need to be accountable for ones own oral health

What UHN is angular chelates?

SMMIHN

What UHN is a missing 2.6?

BSFD

What UHN is hasn’t had a dental visit in 10 years?

ROH

What UHN is heavy supra gingival calculus?

ROH

What UHN is smokes a pack a day?

PHR

What UHN is thinks that flossing is not necessary?

CU

What UHN is played rugby without a mouthguard?

PHR

What UHN is heavy extrinsic stain?

ROH

What UHN is worried about halitosis?

WFI

what UHN is class 2 mobility on 2.1?

BSFD

What UHN is the Last dental hygienist really ‘hurt’ them

FFS

What UHN is clinical attachment loss?

SMMIHN

what UHN is scared of dentists

FFS