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Dental Tech Final!

Primary Prevention Measures carried out so that disease does not occur and is truely prevented Ex-fluoride to prevent carries/ cleaning
Secondary prevention Treatment of early disease to prevent further progression of conditions ex-scaling/orthodontics/fillings
Tertiary prevention Uses methods to replace loss tissues and to rehabilitate the patient to a functioning normal level Ex-bridge/implants
Subjective Assessment Observation and interaction with patient,chief complaint, "my gums bleed when i brush"
Objective Assessment measurable comprehensive physical and oral assessment, actual probe depths
5 Phases of the process of detal Hygiene Care 1.Assessment 2.Diagnosis-identifies patients cond. 3.Planning-priorities, set goals, informed concent 4.Implementation-care plan is put into action 5.Evaluation-compare health to baseline data
Where can dental hygienist work? general practice, armed services, research, forensics, educaion, public health, school, industrial, hospitals, institutions(prisions),sales, consulting
Basic Personal barrier protection Face mask, goggles, gloves
Latex Allergy - Type 1 (immediate response) hives, rash, itching, sneezing, itchy watery eyes, itchy runny nose, coughing, wheezing, drop in BP, anaphylaxsis
Type 2 latex allergy (delayed) develops 6-72 hours later
Managment of Latex sensitivity medical history, document-make everyone aware, appointment planning-early appointments
Latex producs in the office rubber dams, nitrous oxide nose piece/tubing, oringg on ultrasonic, rubber polishing cup, lead apron cover, stopper in anesthesia carpule, orthodontic elastics, bite block, mixing bowls, stethoscope, bp cuff, suckion adaptor
ergonomics study of human performance and work place design in order to maximize health, comfort, and efficiency
How to avoid repetitive strain injuries eliminate stretching for light/bracket tray, reduce twisting, keep instruments sharp, use straight hose,use indirect vision, stretching exercises, schedule to reduce fatigue, wear fitted gloves, avoid cold temp, wash hands in warm water, neutral postion
Signs/symptoms of RSI pain in hand/wrist/lowerback, nocturnal pain, pain while working, stiff/numb/ tingling, weakened grasp, coldness in hands or fingers
Supine Position patient flat with head and feet on the same level, most ideal position for clinician
Trendelenburg Position Used in medical emergencies, head lowered 35-45 degress from supine, feet slightly elevated, head lower then heart
Contrainindications for supine position psychological, menieres disease, asthma, bronchitis, cold, sinusitis, emphysema, congestive heart failure, cerebrovascular insufficency, pregnancy, back problems
Maxillary illumination light directed from in front of patient, angle light toward mouth above chest
mand illumination light is directed above patients head
Sterillization proces by which all forms of life are destroyed
Moist heat(autoclave) sterillization time:15-30min temp: 250F 121C Pressure:15psi
Time for chemical sterilization 10 hours
Chemical Indicators stripes that change color during the sterilization prcess that indicates that the designated temp had been reached, not a true sterilization test
Biological monitoring use of selected test microorganisms that are put through a regular cycle of sterilization and then are cultured, weekly tesing recommended, ex-bacillus stearothermo, and bacillus subtilis
Chemical disinfectants surface -counters, immersion disinfectants-tongs, immersion sterilants- 10 hours in gluteraldehyde, hand antimicrobials
how to manage unit water lines flush water lines at least 1 min and 30 seconds between patients
Disinfectant Biocidal activity, the ability of the chemical disinfectant to destroy or inactivate living organisms
Primary reason for polishing to remove extrinsic stains that cannot be removed during normal tooth brushing
Contraindications for polishing no unslightly stain, patients at risk for dental caries, patients with respiratory problems, tooth sensitivity, restorations, newly erupted teeth
Abrasive a material compose of particles of sufficient hardness and sharpness to cut or scratch a softer material when drawn across the surface
Abrasion the wearing away of surface material by friction
Hazards of polishing removal of tooth structure,removal of fluoride rich surface, heat production, abrade gingiva, increased roughness
Abrasive agents thats used on gold Silex-gold inlays and crowns Calcium carbonate-high luster
Ways to reduce frictional heat use wet agents, slow speed, light quick intermittent touch
ingredient in prophy paste Abrasives - 50-60% :pumice or silicon dioxide
primary use for disclosing agents color plaque an calculus, aid in profys, patiets instruction and education
most effective method for prevention of dental caries fluoride
systemic fluoride injested ad circulation and is incorporated into developing teeth. low conc long duration. ex - flouridated water, supplements, foods, tooth paste
topical fluoride directly applied to exposed to erupted teeth. high conc short exposure. ex - trays, varnish, rinses, garmer isolation method
optimal fluoride level in drinking water 1ppm or .7-1.2ppm
%reduction in tooth decay when there has been continuous fluoride 40-65%
how is water absorbed or excreted in the body absorbed - gi tract/blood stream excretion - kidneys
dental fluorsis a form of hypomineralization that results from long term ingestion of fluoride amounts that exceed the approved theraputic amounts. happens during mineralization stage
Why not chose APF fluoride? not on composites or porcelins or sealemts
What do you use neurtal fluoride? 7 ph
acute fluoride toxicity rapid intake of excess dose over a short period of time, 30min to 24 hours, nausea vomiting diarrhea salivation thirst, induce vomiting or use ipecac syrup to cure.
chronic flouride toxicity long term injestion, skeletal, dental, or mild
whats the best method for obtaining health history combination of interview and questionaire
HIPAA health insurance portability and acountability act of 1996
how to make a correction in a patients chart cross out with a single line and then date and initial
High risk for premeditation prosthetic cardiac valves, infective endocarditis, congenital heart disease, pulmonart shunts, cardiac transplant
Moderate risk for premedication congenital malformations, heart disease, fever, mitral valve with regurgitation, hypertrophic cardiomyopathy
Negligible risk coronary artery bypass, mitral valve without regurgitation, previous fever, pacemaker
What dental procedures need premedication? extractions, periodontal pro, dental implants, root canals, inital placement of ortho bands, prophies, subgingival placement of fibers, intraligamentary local injections
What dental procedures dont need premedication? restorative dentistry, local injections, suture removal, rubber dams, impressions, fluoride, xrays,removable appliances
adult phrophy regimen for cardiac conditions amoxicillin - 2.0g clindamycin - 600mg cephalexin - 2.0g azithromycin - 500mg
adult phrophy regimen for orth patients amoxicillin or cephalexin - 2.0g clindamycin - 600mg
Purpose of taking medical histories can be a life or dealth situation,find causes for oral cond, when u need premedication, aid in referrals, gain insight into prognosis, insight into emotional/psych factors, legal matters, comparisions
HIPAA officer at ACOM Blank
6 features of disease transmission infectious agent, reservoir, port of exit, mode of transmission, port of entry, susceptible host
whats disease is of most concern to a DH hepatitis B
Tuberculosis - mycobacterium tuberculosis is responsible mode of transmission - inhalation, drug to treat - isoniazaid INH, test to diagnose - chest xray and mantoux tuberculin skin test
Hepatitis is inflamation of what? Common sign of Hepatitis? liver jaundice
Hepatitis A infectious hepatitis, fecal oral unwashed hands,
Hepatitis B serum hepatitis, blood and body fluids
If you have HBsAg your a carrier of Hep. B
Presence of anti-HBS person has had a previous exposure to Hep. B and is immune
whats heptavax plasma derived HB vaccine, original
whats recombivax synthetic, most popular
vaccines for Hep. B 3 doses: first then a month later then 6 months later. 7 year booster
Hepatitis C contaminated needles
Hepatitis D Delta hep or piggyback hep - cannot cause infection except in the presence of hep B. transmission - multiple exposures of hep B, blood
Hepatitis E non A non B transmitted by contaminated water fecal oral route
Varicella zoster chicken pox / shingles
Epstein barr infectious mononucleosis
HSV-1 herpes in the mouth - trigeminal nerve
HSV-2 herpes in the genitals - thoracis, lumbar
where does the herpes virus remain dormant sensory nerve ganglion
most common drug for HSV? acyclovir
herpetic whitlow? herpes simplex infection of the fingers that results from the virus entering through minor skin abrasions, results from contact with saliva
ocular Herpes transmission from splashing saliva or fluid into unprotected eye, can cause blindness
herpes libialis? cold ssores, fever blisters, usually triggered by stress sunlight illness trauma, prodrome - burning/stinging sensation, vesicles to crust
HIV stands for? AIDS stands for? Human immunodeficiency virus Acquired immunodeficiency syndrome
Enzyme responsible for replication of virus reverse transcriptase
Primary target cell for HIV infection CD4+ receptors of Helper T lymphocytes
Most common drug used to treat HIV AZT-zidovudine, retrovir
HIV is a retrovirus RNA is core genetic material
CDC defines AIDS as... a CD4+ count below 200 and at least 1 opportunistic infection
Common opportunistic infections with AIDS apthous ulcers, herpes labialis, hairy leukoplakia, candidiasis, wasting syndrome, encephalopathy, kaposis sarcoma, non hodgkins lymphoma, ANUG
Soft deposit Acquired pellicle, dental biofilm, material alba, food debris
hard deposit calculus
Acquired pellicle supra-from saliva sub-from gingival sulcus fluid
Biofilm begins with gram positive cocci and by day 7 its gram negative
plaques causes two things caries and gingival inflammation
gingivitis vs periodontitis reversible vs non reversible but treatable
most common area for plaque gingival third and interproximals
three things necessary for caries process susceptible host, microorganisms that produce acid, a diet for microorganisms
demineralization occurs at what ph 4.5-5.5 ph
carbs and caries alot of carbs in one sitting is better then less carbs in more sittings
bacteria for caries streptococcus mutans and streptococcus sobrinus
bacteria for periodontal infections actinobacillus actinomycetemcomitans, porphyromonas gingivalis, bacteroides forsythus
most common areas for supra gingival calculus lingual of mand anteriors, buccal of max 1st and 2nd molars
most common areas for subgingival calculus proximal surfaces
whats calculus mineralized plaque
how does calculus look like dried chalky white
Average number of days it takes for calculus to form 12 days
whats calculus composed of hydroxyapatite
Extrinsic stain occurs on the outside of the tooth ex-yellow, green, black line, tobacco, brown, orange, metallic
Intrinsic stain occurs within the tooth, cannot be removed
Exogenous stain develops from sources outside the tooth ex - restorative material (silver amalgam), silver nitrate, iodine, silver point seals, stannous fluoride
endogenous stain develops from within the body ex-pulpless teeth, tetra stain, amelogenesis imperfecta, dentinogenesis imperfecta, hypoplasia, dental fluorsis
what stain is found in clean mouths black stain
tetracycline stain can occur when a mother takes it during the 3rd trimester or during early childhood
the primary instrument for removing plaque toothbrushing
what groups of ppl would benefit form an electric toothbrush ortho, prosthedontics, implants, aggressive brushers, limited dexterity, caregivers
whats the most chronic gingival alterations from toothbrushing? rolled margins, mcCalls festoon, gingival clefts, recesssions
toothbrush abrasion wedge shaped indentations with smooth surfaces, mechanical wear, occurs on the facials of canines and premolers and first molars, cervical areas
Charters method brush is held horizontally, half on the teeth half on the gingiva toward the occlusal surface at a 45 degree angle, moves in a circular motion and massages tissues
Modified Stillman method sides of the brush are placed on the gingiva facing the apex at a 45 degree angle. then is is pressed and vibrated and rolled slowly over the crown.
Bass method makes a 45degree angle to the tooth and facing the apex, direct the filament tips into the sulcus. vibrate brush back and forth
Collis Method three sided brush used for caregivers on retarded people.
Fones Method teeth are closed, use fast wide circular motion with light pressure, usually for small children
when should you replace a tooth brush? every 2-3 months
how do you floss wrap around middle and ring finger and hold between thumb and pointer finger. saw through contact area then make a C shape around each tooth going up and down. move to a new piece b/w each tooth
who would use a bridge/floss threader lingual bars, bridges
who would use a proxybrush, end tuft brush b/w ortho appliances, open embrassures, fixes prostodontics,implants, splints, space maintainers, desensitizing agents, fluoride
who would use a rubber tip stimulator to improve gums, shrink swelling, helps perio disease
wooden/ interdental stimulators to clean interproximals for ppl who dont like floss
who uses a floss holder for the disabled and caregivers
normal blood pressure 120/80
normal respiratios 14-20
normal pulse 60-100
forms of tobacco cigaretts, cigars, pipes, snuff, chewing
hygienist responsibilities with regards to tobaccos counseling educate patients about the risks, assist patient in quiting, document all findings
Components of tobacco nicotine, pesticides, aldehydes, ketons, amines
metabolism of nicotine absorbtion -luns, skin, oral and nasal mucosa elimination - liver metabolizes it and the kidneys escrete it
systemic effects of tobacco uuse cancer, respiratory disease, cardiovascular disease, facial wrinkling, reproductive problems, impotence, ulcers, osteoporosis, addiction, alzheimers, halitosis, discoloration of hair/finger nails
oral effects of tobacco oral cancer, abrasion, attrition, calculus, perio, black hairy tongue, dry socket, delayed wound healing, xxerostomia, tooth loss, stains, leukoplakia, impaired taste and smell
nicotine addiction psychoactive agent - produces feelings of pleasure and well being, then leads to tolerance and dependency, and then addiction -withdraw, greater amounts, cant quit, giving up social stuff, knows medical problems it causes
reasons and benefits of quiting -health, effect on family, pregnancy, cost -bp decreases,temp increase, pulse dec, oxygen increases, chance of heart attack dec, nerve endings regrow, circulation inc, walking is easier,sinus stuff decreases
stages of readiness to change precontemplation - no thought of quiting contemplation - thinking about quiting preparation - sets a quit date makes small changes action - activly changes behavior maintenance- has stopped using tobacco relapse-using tobacco after quiting
5 A's to approach Ask, Advise, Assess, Assist, Arrange follow up
withdraw symptoms of tobacco depression, insomnia, anxiety, cant concentration, decreased heart rate, weight gain, cravings, stomach problems
NRT's pharmcotherapys partial replacement of nicotine to make it easier to abstain, reduces withdraw symptoms
NRT's nicotine gum(nicorette), nicotine patch(nicoderm),nicotine inhaler, nicotine nasal spray, nicotine lozenge
nicotine free therapy bupropion, chantix, zyban
local cessation program allegany county health department, western md health system wellness center, ACM Respiratory therapy program
Created by: samfuller10