DEN 104 Final Exam Study Material

Define patients with special needs

a patient with a physical or mental impairment that substantially limits one or more major life activities

What may providing dental care to patients with disabilities require?

modifications to the traditional treatment plan

What do dental health professionals need to be prepared to accommodate?

patients with special needs, regardless of the type of disability

What is one of the most serious threats to the health of an individual?

heart disease

What is the leading cause of death in the U.S. and among men over the age of 40 and among women over the age of 65?

heart disease

HTN

hypertension

HBP

high blood pressure

What is hypertension/high blood pressure?

the result of the heart having to work harder as it pumps against resistance such as that provided by a blocked artery

Neurologic Disorders

diseases of the brain, spine, and the nerves that connect them

List some examples of neurological disorders

• alzheimers disease

• seizures

• multiple sclerosis

• cerebrovascular accident (stroke)

Autism

• developmental disorders

• affects how information is processed in the brain

• characterized by an inability to get along with people, poor social skills, lack of interpersonal relationships, and repetitive behaviors

Seizures

• symptom of brain damage that causes an abnormal electrical brain activity, which can manifest in several ways

• patients who have a seizure disorder may be receiving anti-epileptic medications such as Dilantin (phenytoin)

Dilantin Side Effects

• increased bleeding tendencies

• drowsiness

• lack of coordination

• drug-induced gingival overgrowth

• xerostomia

Behavioral and Psychiatric Disorders

• bipolar disorder

• posttraumatic stress disorder (PTSD)

• schizophrenia

Bipolar Disorder

extreme elation followed by depression

Posttraumatic Stress Disorder (PTSD)

“re-experiencing” a traumatic event

Schizophrenia

psychotic disorder characterized by varying degrees of personality disorganization

What may result from the psychoactive drugs prescribed?

xerostomia

Endocrine Disorders

Hyperthyroidism

What regulates metabolism in body cells?

thyroid gland

What is Hyperthyroidism?

a patient with an overactive thyroid gland has graves disease and is highly sensitive to epinephrine

Pulmonary Disorders

disorders that affect the lungs and are characterized by airway obstruction

(patients can be diagnosed with a pulmonary disorder with symptoms from several disease categories)

Chronic Obstructive Pulmonary Disease (COPD)

• Chronic bronchitis

What is Chronic Bronchitis?

a disorder that results in irreversible narrowing of the bronchial airways caused by chronic inflammation, increased production of mucus, edema of the bronchial mucosa

Alzheimer’s Disease

disorder that begins in middle age and is marked by deterioration of mental capacity (dementia)

Stages of Aging

refers to the irreversible and inevitable changes that occur with time

Stages of the older population

frail older adults are beginning to have multiple health problems, and more of the have fixed and removable prostheses

Oral Health Conditions of the aging population

• xerostomia

• periodontal disease

• slower healing tissues

• increased tooth decay (coronal/root caries and recurrent decay around defective restorations)

• dark and brittle teeth

• bone resorption (loss of alveolar ridge)

What causes dark and brittle teeth in older patients?

deposits of secondary dentin that have gradually reduced the size of the pulp chamber

Stroke

cerebrovascular accident

Angina

• a type of chest pain that is usually sharp, caused by reduced blood flow to the heart

• sign that patient is at risk for a heart attack

Myocardial Infarction

heart attack

Endocarditis

• severe infection of the cardiac valves and supporting structures

• caused when bacteria or other germs from another part of your body, such as your mouth, spread through your bloodstream and attach to damaged areas in your heart

• prevention: premed antibiotics

Diabetes Mellitus

• disease in which your blood glucose, or blood sugar, levels are too high

• absence or insufficient production of insulin

• an inability of the body to properly use insulin is a result of this

Blood Disorders

hemophilia

What is Hemophilia?

excessive bleeding caused by a congenital lack of a protein substance necessary for blood clotting

Category 1 Patient

healthy patients

Category 2 Patient

medical conditions requiring scheduling changes or shorter appointments

Category 3 Patient

medical conditions requiring significant modifications in dental treatment planning

Category 4 Patient

medical conditions requiring major modifications including dental treatment within the operating room

Category 5

serious medical conditions and only limited care

What is the most cost effective means of reducing caries?

community water fluoridation

Lethal Dose Range of Sodium Fluoride

for an adult 5-10 grams

Recommended ppm of fluoride in water

0.7 to 1.2 ppm

Topical Fluorides

applied directly to and absorbed by the surface of the teeth

Examples of Topical Fluorides

• APF

• Fluoride varnish

• Stannous Fluoride

• Sodium Fluoride

Where are topical fluorides found?

• toothpaste

• mouthwash

What has been the most effective method for prevention of dental caries?

the introduction of fluorides

What causes dental fluorosis?

prolonged exposure to high fluoride concentrations

Primary mineral associated with remineralization?

• calcium (redeposits)

• fluoride enhances/speeds up the process

Most common age for a child to begin using foam/gel fluoride instead of varnish

age 6

APF

• acidulated phosphate fluoride

• used twice yearly, has a sore taste and not recommended for crowns and bridges

Goal of preventive dentistry

• help people of all ages obtain optimal oral health throughout their lives

To prevent dental disease…

a partnership must be formed between the patient and the dental healthcare team (dentist, hygienist, assistant)

Age-Related Dental Changes

• enamel becomes darker in color and develops numerous surface cracks

• pulpal blood supply decreases

• abrasion and attrition occur in the crowns of the teeth

• increase of gingival recession

Xylitol

• artificial sweetener that prevents caries (anticariogenic)

• found in chewing gum, antibacterial mouth rinse and mints

Plaque Control Program

goal is to remove plaque at least once daily

Once plaque is removed how long does it take to reform?

24 hours

Recommended Toothbrush

soft-bristled nylon brush

(replace every 8-12 weeks or when they begin to show signs of wear/bristles splay outward)

Should you floss before or after brushing?

before you brush so that the fluoride from your toothpaste is able to reach the proximal surfaces for prevention of dental caries

Can oral irragation devices remove plaque?

no

Fones Brushing Method

usually for children or older adults with dexterity issues

Bass Method Technique

• patients with periodontitis

• most common technique

• 45 degree angleplace toothbrush against your teeth with some of the bristles right at the sulcus of your gums

• move brush back and forth in short circular strokes

Stillman Technique

• patients with gingivitis

• 45 degree angle place half of the toothbrush bristles covering the gums, and the other half of the bristles on the tooth surface

• making short and light horizontal/circular movements