Pediatric Dentistry SAS 9-13

Antimicrobials

Antimicrobials

substances that kill or suppress the growth or multiplication of microorganisms used to inhibit bacteria and sometimes protozoa.

Narrow-spectrum antibiotics

Active against single or limited group of microorganisms

Extended-spectrum antibiotics

Effective against gram positive organisms and a signifanct number of gram negative microorganisms.

Broad-spectrum antibiotics

Acts against a wide variety of species

Bacteriostatic drugs

Limit the spread of infection by halting bacterial growth and replication.

Bactericidal drugs

Act independently of host immune defenses to cause cell death.

Prophylactic

Use of antimicrobials to prevent an infection

Empiric

Initial use of broad-spectrum antibiotic especially if px is seriously ill

Definitive

Following culture and susceptibility tests. Narrow in spectrum agent to target specific pathogen

Penicillin

inhibition of cell wall synthesis

Clindamycin

Inhibition of protein synthesis

Penicillin

The drug of choice assuming px does not have allergies. The standard antibiotic

Natural, semi-synthetic, B- lactamase inhibitors

Penicillin classification

Penicillin G

Discovered by Alexander Fleming

Penicillin V

Has a chemical structure that enhances stability in acidic environments. Administered orally

Amoxicillin

Replaced penicillin VK as the drug of choice for prevention of infective endocarditis. Produces higher and longer sustained blood levels

Co-amoxiclav

combination of amoxicillin and clavulanate

Clindamycin

Both bacteriostatic and bactericidal

Metronidazole

Inhibits acetaldehyde enzymes

Metronidazole

active against anaerobic bacteria

Fluroquinalones

bactericidal antibiotics with broad-spectrum activity

Nystatine

topical antifungal

Ampothericine B

Antifungal medication given if px if infected systematically

Acyclovir

10 times more potent against herpes virus

Valacyclovir

FDA approved for children 12 years and older for tx of herpes labialis and 2 years and older for chickenpox.

RX

latin for recipe

Subscription

instructions given to the pharmacist

Transcription

Instruction to px

Superscription

Contains name of the dentist, address and contact number

Gram staining

Test whether gram is positive or negative

Positive: Blue

Thick cell wall

Negative: Pink

Thin cell wall

Crystal Violet

V

Iodine

I

Ethyl Alcohol

A

Safranin

S

Morbidity

A diseased state, disability or poor health due to any cause

Mortality

Emergencies that may threaten the px’s life or state of being subject to death

Oxygen

Primary emergency drug in the dental office

Hypoxemia

low oxygen content in the arterial blood

Albuterol

Tx of bronchospasm in either asthma attack or allercgic reaction

Aspirin

Tx for suspected acute coronary syndrome (heart attack)

Diphenhydramine

Tx for allergic reactions

Epinephrine

Tx for anaphylaxis, severe persistent asthma and bronchospasm

Glucose(oral)

Tx for hypoglycemia

Midazolam

Anticonvulsant for status epilepticus

Naloxone

reverses opioid medications

Nitroglycerine

Tx for chest pain as a result of angina pectoris

Flumazenil

Reverses oversedation

Position

Circulation

Airway

Breathing

Definitive Treatment

Five basic steps for management of medical emergencies

2-2.4

Compression depth in adults

2

compression depth in children

1.5

compression depth in infants

30:2

compression to ventilation ratio for adults

15:2

compression to ventilation ratio for children

Tongue

Most common cause of airway obstruction

Glossoptosis

tongue is relaxed causing airway obstruction

Penicillin and latex

primary agents that provoke allergic reactionsw

Allergy

hypersensitivity response by the immune system to antigens that are recognized as foreign

Asthma

aka Acute Bronchospasms

IgE

immunoglobulin responsible for allergies

Intrinsic Asthma

asthma caused by stress

Extrinsic Asthma

Asthma triggered by outside causes like dust and pollen

Hyperventilation

A maladaptive anxiety reaction that occurs in apprehensive pxs who attempt to hide their anxiety

Syncope

Most common medical emergency in the dental office

Vasopressor syncope / Simple faint

most common type of syncope

Dental Caries

Most prevalent chronic disease

White spot lesion

Earliest sign of dental caries

Saliva

Acts as a buffer for caries

White spot lesion

Found on the enamel smooth surfaces. best seen after tooth surface is cleaned and air dryed

Streptococcus Mutans

contribute to dental caries because of their ability to adhere, produce and survive.

S. Mutans

most common in man with over 98% of adults harboring this bacterium

Sucrose

factor affecting dental caries prevalence and progression

Frequency of sugar consumption

Intensity of caries in children may be due to

pH below 5.5

an environment for bacterial growth

Fluoridation

Placement of fluoride in the water

Fluoridization

Placement of fluoride done by the dentist

Disclosing tablet or solution

helps the child and parent evaluate the thoroughness of the cleaning

Children under 3 years old

should brush with a smear of fluoride toothpaste to prevent fluorosis

Children over 3 years old

should brush with a pea sized amount to prevent fluorosis

Prevent decay on intact dental surfaces

Arrest active decay

Remineralize decalcified tooth surfaces

Goals of fluoride administration

Fluoride

Inhibits demineralization and promotes remineralization

Silver diamine fluoride

A topical fluoride that contains 5% fluoride, 24-27% silver

0.7-1.2 ppm

Normal fluoride

Period of ovum

Fertilization to implantation, 10-14 days

Period of embryo

Cell differentiation, major organs appear. 2-8 weeks

Period of fetus

maturation of newly formed organs 8-40 weeks

50%, 200%

most children undergo _ increase in length and _ increase in weight

Gorss motor skills

By age 2 a child has _ to run, climb walk up and down stairs

8th week

Palatal fusion occurs at

9th week

Cleft palate occurs at

Osteoblasts

Bone forming cells

Osteoclasts

Bone destroying cells

Fontanels

Bones that compose the cranium are not fused and are separated by gaps called

2 years

gaps close by ossification within _ after birth

Ectoderm and Mesoderm

Germ layers

Ectoderm

responsible for future enamel

Mesoderm

responsible for future pulp and dentin

Dental organ

formative tissue of enamel

Dental papilla

formative tissue of dentin and pulp