MDA TEST 2

patient record

A compilation of a patient's health information. (A permanent document)

What information should the dental team have before starting treatment?

- PT registration form

- Medical/dental health history form

- medical alert information form

- consent forms

written privacy policy

- informs a pt that an office will not use or disclose protected health information for any purpose other than treatment, diagnosis, and billing

- mandated by HIPAA

Quality Assurance

Primary source of information used by the dental team to determine the overall quality of care the pt has received

Patient registration

Patient information

- Full name, DOB, residence, phone #, employment, spouses information

Insurance information

- Employee's name and DOB, employers name, address, and phone #, name of insurance carrier and policy number

Responsible Party

- Person responsible for payment of the account

Signature and Date

- Verifies the accuracy of the information

The dental assistant should offer to help the pt to complete the medical/dental history form because....

There maybe a language barrier or because the pt may not understand the terminology used

medical alert

Medical alerts and other precautions should be affixing an "alert" sticker to the inside cover of the pt record

How often should a pt's medical history be updated

every visit

clinical examination form

Provides dental team with past, present, and future examination, analysis, and charting needs of the patient.

informed consent form

form related to a specific treatment or procedure, provides the patient with the expected outcomes of treatment and describes any possible complications that might occur

progress notes

Treatment is recorded in this section of the pt record

- ALWAYS INCLUDE: date, tooth number, completed treatment, signature

Vital signs consist of

temperature, pulse, respiration, blood pressure

Factors that affect vital signs

Emotional factors:

- Stress

- Fear

Physical Factors:

- Illness

- Drinking or eating

- Exercise

Temperature

the degree of hotness or coldness of a body's internal enviorment

What is the average range of the body's oral resting temp?

97.6-99F

Metabolism

The process of physical and chemical changes that take place in the production of the bodys heat

Types of thermometers

digital, tympanic, glass

digital thermometer

Hand-held, battery-operated device that registers temperature and displays reading as numbers

tympanic thermometer

An infrared signal is bounced off the eardrum, and an accurate reading is provided within 2 seconds

glass thermometer

Many states have banned the use of mercury thermometers because of health hazards

pulse

The rhythmic expansion and recoil of arteries resulting from heart contraction; can be felt from the outside of the body.

Where can the pulse be felt?

- Radial Artery (Most Common): Inner surface of the wrist

- Brachial Artery: Inner fold of the upper arm

- Carotid Artery: alongside the larynx (neck)

Pulse characteristics

rate, rhythm, volume

rate of pulse

number of beats per minute

Rhythm of pulse

pattern of beats

volume of pulse

The force of the beat, such as a strong or a weak beat

Normal Pulse rate in resting

Adults: 60 to 100 BPM

Children: 70 to 120 BPM

Respiration

the process of inhaling and exhaling, or breathing

Respiration characteristics

rate, rhythm, depth

rate of respiration

number of breaths per minute

rhythm of respiration

breathing pattern

Depth of respiration

amount of air inhaled and exhaled

respiration readings

Adult 10-20 breaths per minute

Children 18-30 breaths per minute

blood pressure

the pressure that is exerted by the blood against the walls of blood vessels

systolic pressure

The amount of pressure it takes for the left ventricle of the heart to compress or push oxygenated blood out into the blood vessels

- "The sharp tapping sound"

diastolic pressure

The heart muscle at rest when it is allowing the heart to take in the blood to be oxygenated before the next contraction

arrhythmia

Abnormal heart rhythm

Blood Pressure classification for adults

Normal - less than 120 over less than 80

sphygmomanometer

blood pressure cuff

stethoscope

a medical instrument for listening to the sounds generated inside the body

- used to amplify Korotkoff sounds

Korotkoff sounds

series of sounds produced by the blood rushing back into the brachial artery, which has been collapsed by the pressure of the blood pressure cuff

- 5 phases

Why to pt's seek dental care?

- New pt seeking dental care

- Emergency pt

- Consultation with a specialist

- Returning pt for continued care

Dental assistant duties

- Assist the patient with forms

- Take and record vital signs

- Chart and record the dentist's findings during the EOE & IOE

- Expose radiographs

- Take preliminary impressions and fabricate diagnostic models

- Take extraoral and intraoral photographs

- Organize the patient record

- Prepare for the case presentation

Visual evaluation

- Face

- Lymph nodes

- Lips

- Soft tissue within the mouth

- Tongue

- Tooth structure

- Restorations

- Missing teeth

Palpation

to examine by touch

- Feeling for texture, size, and consistency

a mouth mirror is used for?

indirect vision, light reflection, retraction, tissue protection

a explorer is used for?

Asses tooth mobility caries and fractured

teeth

a periodontal probe is used for?

Checking the gum pockets for bone loss

Anatomic tooth diagram

Illustrations resemble the actual crown and root of the tooth

Geometric tooth diagram

A circle represents each tooth

Universal tooth numbering system

Numbering system for permanent teeth by using numerals #1 through #32 and for primary teeth by using capital letters A through T

International standards organization system (ISO)

Assigns a two-digit number to each tooth

Palmer Notation System

Uses a bracket to designate the four quadrants of the mouth

What does charting in black or blue represent?

Finished dental work

What does charting in red represent?

treatment that needs to be done

Soft tissue examination

examination of the cheeks, mucosa, lips, lingual and facial alveolar bone, palate, tonsil area, tongue, and floor of the mouth

Furcation

Area between two or more root branches

Types of treatment plans

Level I: Emergency Care

Level II: Standard Care

Level III: Optimum Care

Four-handed dentistry

System in which the dentist and dental assistant work together at the dental chair

supline position

laying flat on your back

Positioning/Sitting as the dental assistant

- Seated back on the stool

- Feet on the base or foot ring of the stool

- Positioned as close as possible to the dental chair

- Legs parallel to the pt's chair

- Eye level 4 to 6 inches above the operator

Classification of motions

The five categories that describe the extent of movement by the clinical assistant when assisting

- Class I: Movement of fingers only

- Class II: Movement of fingers and wrist

- Class III: Movement of fingers, wrist, and elbow

- Class IV: Use of the entire arm and shoulder

- Class V: Use of the entire upper torso

What are the dental operating zones

Operators, transfer, assistants, static

Operating zones for a right-handed operator

Operator's Zone : 7-12 o'clock

Transfer Zone: 4-7 o'clock

Assistant's Zone: 2-4 o'clock

Static Zone : 12-2 o'clock

Operating zones for a left handed operator

Operator's zone -12-5 o'clock

-Transfer zone -5-8 o'clock

-Assistant's zone -8-10 o'clock

-Static zone -10-12 o'clock

Three basic instrument grasps

- Pen Grasp: Instruments are held in the same manner as a pen

- Palm Grasp: instrument is held securely int he palm of the hand

- Palm-Thumb grasp: instrument is held in the palm of the hand and the thumb is used to stabilize the guide of the instrument

Expanded functions dental assistant

Can perform more duties than CDA

Direct supervision

oversight of clinical procedures or treatment by a qualified professional present in the exam or treatment room with the student

Indirect supervision

Overseeing an assistant's work by working in the immediate area

Instrument Design

handle- where operator holds the instrument

shank- attaches the working end to the handle

working end- has a specific function depending on its need

Examination instruments

Mouth Mirror, Explorer, Cotton Pliers, Periodontal Probe

Hand cutting instruments

excavator, hoe, chisel, hatchet, gingival margin trimmer

Restorative instruments

amalgam Carrier, condenser, burnisher, carvers, excavator, Woodson

Accessory instruments

spatulas, scissors , amalgam well, howe pliers, articulating paper holder

Explorer ends

Pig tail

Shepherds hook

Orban

Small & large spoon excavator

Excavate decay

Dental Chisel

Straight angled shank and a single beveled cutting edge. Breaks down enamel margin to form sharp lines and point angles/places retention grooves

- EX. Straight, bid-angle, wedelstaedt

Dental Hatchet

used to cut enamel and to smooth the walls and floors of the tooth preparation

Gingival Margin Trimmer

used to cut enamel and to place bevels along the gingival enamel margins of the preparation

Amalgam Carrier

To carry and dispense amalgam for cavity preparation

Condensers/Pluggers

Used to condense (pack down) freshly placed amalgam into the preparation.

Burnishers

used to smooth restorative material and move material towards prep walls/margins

Dental carvers

Contain sharp working end to remove excess material

Low speed handpiece

10,000-30,000 rpm, can move both forward and backwards

- Straight angle attatchment: does not go in pt's mouth, "lab work done chairside"

- Contra angle: does go in pt's mouth, uses latch type burs, polishes restorative work

- Prophy angle

High speed handpiece

450,000 RPM. Removes bulk of tooth structure during restorative procedures uses friction grip burs

Has a water cooling system

Sections of the high speed

- Working end: Where the attachments are held

- Shank: Handle (Body)

- Connective end: where the handpiece connects to the power source

ultrasonic handpiece

high speed vibration scaling tips used for scaling and curettage purposes; sometimes called ultrasonic scaler

laser handpiece

Uses a beam of light to cauterize soft tissue or to vaporize decayed tooth structure

CAN NOT BE USED ON AN EXISTING RESTORATION

Air abrasion handpiece

Small version of a sandblaster

Designed to remove stains and tooth decay

High-pressure delivery of aluminum oxide particles through a small probe

Removes enamel, dentin, and restorative materials without compromising healthy tooth structure

The parts of a rotary instrument are the:

shank, neck, head

Diamond burs

crown prep

What burs are used for initial entry?

Round and Pear

What types of burs are used for forming the walls of the restoration

Straight fissure plain and cross cut, Tapered fissure plain and cross cut, Inverted cone

Saliva ejector

A low-volume suction device that removes saliva and fluids from the patient's mouth

HVE (high volume evacuator)

A high suction device that removes fluids and debris from the patients mouth

Grasping the evacuator

Thumb-to-nose grasp or pen grasp

Limited area rinsing

Performed frequently throughout a procedure- accomplished quickly and efficiently

Full mouth rinse

-freshens entire mouth

-at the end of procedure

Air water syringe

A device used to spray air or water into the oral cavity

Cotton roll isolation

Use of cotton rolls positioned near salivary ducts to absorb saliva