Module 1

What three things does the pre-anesthetic assessment evaluation include?

1. complete medical and dental history

2. physical examination

3. psychological examination

What five things should the complete medical or dental history include?

1. current conditions

2. past conditions

3. OTC drugs and supplements

4. adverse reactions to meds

5. problems with dental treatment

What can alter the efficacy and safety of L.A.s ?

concomitant of meds: 2+ meds taken on the same day

The physical examination includes what four things?

1. visual exam

2. BP

3. pulse and rr

4. weigth

What is the visual exam?

observe the patient posture, movement, speech, skin ect.

How do L.A.s affect BP?

increase BP

What BP would you consider N2O for stress reduction?

140-159/ 90-94

What BP would you retake and refer to a med consult before treatment?

160-199/95-114

What BP would you retake and refer for a immediate med consult?

>200/ >115

How does stress affect pulse and RR?

increases both

What is a acceptable HR for adult, child, and toddler?

adult: 60- 100

child: 75-100

Toddler: 120-160

What is a acceptable RR for adult, child, and toddler?

adult: 12-20

Child: 18-30

toddler: 25-32

What is the weight of the patient used to determine?

maximum recommended dose

How is the MRD affected for overweight children?

decreased

What exam does dental phobia fall under?

psychological exam

what are some clinical signs of moderate anxiety?

stiff posture

nervous "play"

"white knuckle" syndrome

sweating

too cooperative

nervous conversation

quick answers

What are the 3 steps in stress reduction protocol?

1. adequate pain control

2. decrease pain of injection

3. select LA of appropriate duration

How does stress affect the pain reaction threshold?

decreases the pain reaction threshold

What four things does the risk assessment evaluate?

1. safety of dental treatment

2. modifications of dental treatment

3. need for local anesthesia

4. selection of specific L.A.- if needed

What does the acronym ABCDE stand for in the risk assesment?

A- antibiotics, anxiety, allergy

B - bleeding

C - chair positioning

D - drugs, devices

E - equipment, emergencies

What is the definition of fear?

an unpleasant often strong emotion caused by anticipation or awareness of danger

What percent of the U.S. avoids dental care because of fear?

between 6 and 14%

What is the difference between fear and anxiety?

fear tends to be short lived , disappearing when the threat or danger passes

anxiety is not eliminated as easily and tends to be a learned response from a personal experience or from the experience of others

In reference tp the dental office what is the difference between fear and anxiety?

anxiety is from anticipation of or the thought of dentistry

fear refers to the reaction occuring in the dental office