M2 - ALL (combined)

endemic

• amount of a PARTICULAR DISEASE that is present in a community

• CONSTANT PRESENCE of a disease in a population

hyperendemic

PERSISTENT, HIGH LEVELS of disease occurrence

epidemic

an increase in the number of cases ABOVE WHAT IS NORMALLY EXPECTED

outbreak

• same as EPIDEMIC

• but is often used for MORE LIMITED GEOGRAPHIC AREA

cluster

grouped in place and time that are suspected to be greater than the number expected

cluster

AGGREGATION OF CASES

pandemic

an epidemic that has spread over several countries

pandemic

widespread

constant presence

in an endemic, there is a [?] of a disease in a population within a geographic area

persistent, high levels

in a hyperendemic, there is [?] and [?] of disease occurrence

increase

above what is normally expected

in an epidemic there is an [?] in the number of cases [?]

epidemic, limited geographic area

an outbreak is same as [?] but is often used for a more [?]

place and time
greater

cluster is grouped in [?] that are suspected to be [?] than the number expected

national institute for occupational safety and health

what is NIOSH

inhalation
alveoli
lungs

tuberculosis occurs through [?] then travels to the [?] of the [?]

mycobacterium tuberculosis

scientific name of tuberculosis

moderate

risk of infection of TB in dental healthcare

protocols
written infection control program

CDC recommends that dental health care personnel include [?] for TB infection control in their offices’ [?]

latent

a person with [?] tuberculosis is not infectious

airborne + standard precaution

precautions for active tb

standard precaution

precautions for latent tb

1	DIRECT CONTACT with blood, oral/body fluids
2	indirect contact with CONTAMINATED objects (instruments, equipment, environmental surfaces)
3	contact with eyes, nose, mouth or mucous membrane with droplets containing microorganisms
4	INHALATION of AIRBORNE MICROORGANISMS that can remain suspended in the air for long periods

routes of transmission of TB (dictate)

airborne
droplet nuclei

TB is transmitted through [?] particles known as [?]

pulmonary
laryngeal
sneeze, cough, speak, sing

TB Can be generated when people with [?] or [?] tuberculosis [?]

1 to 5 micrometers

size of the TB droplet

1	Limit treatment to URGENT OR EMERGENCY care
2	Delay elective procedures UNTIL LESIONS ARE HEALED
3	Provide treatment designed to REDUCE the time of healing
4	When aerosol producing equipment cant be avoided, use EXTREME CAUTION and EXTRA PPE then DISINFECT after use -        Should FULL COVER THE BODY -        Lab gown, goggles, face shield
5	Use a NIOSH N95 rated or higher mask if aerosol is present
6	Even if there is minimal aerosol danger, still wear extra PPE
7	Be aware of POTENTIAL reaction to pain, keep the hand that is not holding the instrument away of the “line of fire”
8	Provide EYE PROTECTION for the patient and recommend that the patient WASH HANDS AND FACE after treatment
9	CHANGE GLOVES FREQUENTLY if the procedure is lengthy -        Wash hands with soap and warm water every glove change
10	EDUCATE the patient on the nature of herpes labialis

dentistry infection control methods for TB (dictate)

extreme caution
extra ppe
disinfect

DENTISTRY INFECTION CONTROL METHODS FOR TB:

When aerosol producing equipment cant be avoided, use [?] and wear [?] then [?} after use

NIOSH
N95

DENTISTRY INFECTION CONTROL METHODS FOR TB:

use [?] [?] rated or higher face mask if aerosol is present

extra PPE

DENTISTRY INFECTION CONTROL METHODS FOR TB:

Even if there is minimal aerosol danger, still wear [?]

pain
away

DENTISTRY INFECTION CONTROL METHODS FOR TB:

Be aware of POTENTIAL reaction to [?}, keep the hand that is not holding the instrument [?] from the “line of fire”

eye
wash hands and face

DENTISTRY INFECTION CONTROL METHODS FOR TB:

Provide [?] PROTECTION for the patient and recommend that the patient [?] after treatment

gloves

DENTISTRY INFECTION CONTROL METHODS FOR TB:

CHANGE [?] FREQUENTLY if the procedure is lengthy

herpes labialis

DENTISTRY INFECTION CONTROL METHODS FOR TB:

EDUCATE the patient on the nature of [?]

urgent/emergency

DENTISTRY INFECTION CONTROL METHODS FOR TB:

Limit treatment to [?] care

reduce
healing

DENTISTRY INFECTION CONTROL METHODS FOR TB:

Provide treatment designed to [?] the time of [?]

lesions
healed

DENTISTRY INFECTION CONTROL METHODS FOR TB

Delay elective procedures UNTIL [?] ARE [?]

fluids, counters, dental charts, and handpieces

HSV can survive for hours in?

not
complete protection

gloves are [?] a [?] from HSV

1	emergency treatment for dental conditions
2	treatment of the lesions (no other treatment should be rendered)

treatments of HSV according to CDC

herpes simplex virus

can cause persistent infection and is shed in saliva

HSV - 1 and HSV - 2

types of HSV

oral to oral contact

way of spreading HSV 1

genital to genital contact

way of spreading HSV 2

HSV 1

asymptomatic type of HSV

blisters and open sores on lips

symptoms of HSV

cold sores

Lip sores are called?

1. oral to oral contact

2. oral to skin

3. genital

mode of transmissions of HSV

oral herpes
sores, saliva, and surfaces around the mouth

oral to oral contact can cause [?] via [?]

normal
no symptoms

oral to skin transmission of HSV leads to a disease that looks [?] and there are [?]

active sores

gives the greatest risk of HSV transmission

neonatal herpes

HSV transmitted during childbirth is called?

HAV, HBV, HCV

types of hepatitis

liver

hepatitis affects what organ?

none

is there a vaccine for HCV?

90%

current regimen cures more than [?] cases

2
3
6

there is an administration of [?] or [?] injections in the span of [?] months

perinatally, percutaneously, and sexual contact, open cuts and sores, sexual transmission, IV drug use

transmission of hepatitis

HAV

type of hepatitis that does not cause chronic infection

acute illness, does not cause chronic infection

describe HAV

HBV

hepatitis that can be either acute or chronic

• acute or chronic illness

• infects MAINLY THE LIVER but can also infect the kidneys and pancreas

• can be FATAL

describe HBV

liver
kidneys
pancreas

HBV infects MAINLY THE [?] but can also infect the [?] and [?]

human hepatocytes

HCV targets what?

70-85%

Prevalence of HCV becoming CHRONIC

liver cirrhosis, hepatocellular carcinoma, or death

HCV can lead to?

it progresses or left untreated

HIV becomes AIDS when?

death

AIDS eventually leads to?

very slowly
years

HIV and AIDS progresses [?] often takes [?] to exhibit signs and symptoms

1	Anal or vaginal sex
2	Blood transfusions
3	Organ/tissue transplants
4	Pregnancy, birth, or breastfeeding (rare)

mode of transmission of HIV/AIDS

oral manifestations

early and important clinical indicators of HIV infection

50%
80%

oral manifestations affects:

• [?] of HIV infected patients

• [?] of patients with AIDS

<200

people with aids CD4 T lymphocytes count

HIV

a RETROVIRUS, works by targeting the body’s immune system

CD4 t cells

HIV specifically targets what cells

Candida albicans

other name of oral candidiasis

oral thrush
erythematous candidiasis
angular cheilitis
periodontal disease

types of oral candidiasis

oral thrush

“creamy plaques”

hyphae, keratin waste, inflammatory cells, epithelial cells, bacteria, and fibrin

composition of oral thrush

CD4 T lymphocyte count, tobacco use, and wide spectrum antibiotic use or corticosteroids

risk factors of oral thrush

erythematous candidiasis

usually present as FLAT RED LESIONS

palate/dorsum of the tongue

location of erythematous candidiasis

symptomatic
oral burning
taste distortion

the lesions of erythematous candidiasis are [?] accompanied by an [?] sensation or [?]

angular cheilitis

appears as FISSURES OR LINEAR ULCERATIONS of the commissures

angular cheilitis

frequently associated with SMALL WHITE UNILATERAL OR BILATERAL PATCHES  or presence of INTRAORAL EDEMA

fissures, linear ulcerations

angular cheilitis appears as [?] or [?] of the commissures

white unilateral or bilateral patches
intraoral edema

angular cheilitis are frequently associated with small [?]/[?] or presence of [?]

candida spp and related to mixed C. albicans and Staphylococcus aureus infection

causes of the angular cheilitis

Candida spp.

20% of angular cheilitis are caused by?

Related to mixed C. albicans and Staphylococcus aureus infection

60% of angular cheilitis are?

27% up to 76%

prevalence of periodontal disease when the patient has AIDS

1	Linear gingival erythema
2	chronic periodontitis
3	necrotizing gingivitis (NG)
4	necrotizing ulcerative periodontitis (NP)
5	xerostomia
6	kaposi sarcoma
7	recurrent apthous ulcer
8	oral hairy leukoplakia
9	oral hyperpigmentation
10	oral herpes virus
11	caries

most relevant hiv/aids related periodontal diseases (x11)

highly active antiretroviral therapy (HAART)

reduces the viral load in a patient’s body, therefore reducing your chance of transmission to others

reduces
viral load
reducing
transmission

highly active antiretroviral therapy (HAART) [?] the [?] in a patient’s body, therefore [?] your chance of [?] to others

AVOIDING exposure to blood and bodily fluids

primary way to prevent transmission of HIV in dental healthcare settings

saliva
blood

during dental procedures, [?] tends to become contaminated with [?]

increases
standard precautions
all patients
barrier protection

contamination of saliva with blood [?] the risk of HIV transmission from saliva. With this, [?] should be followed for [?] and [?] should be worn

percutaneous injuries

an occupational source of the greatest risk of HIV transmission is [?]

standard precautions

 Dental personnel can REDUCE THE RISK of these percutaneous injuries by following [?]

engineering controls
work practice
safe injection

[?] and [?] controls for all sharps and following [?] practices is a must