ME DH107 Final
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| What is primary prevention? | measures carried out so that disease does not occur and is truly prevented
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| what is secondary prevention? | treatment of early disease to prevent further progression of potentially irreversible conditions
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| what is tertiary prevention? | using methods to replace lost tissue and to rehabilitate the patient to a level where function is near as normal as possible
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| fluoride application to prevent caries is an example of what prevention? | primary
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| scaling teeth to prevent progression of gum disease is what prevention? | secondary
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| a bridge to replace missing teeth is what prevention? | tertiary
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| what is the primary function of a dental hygienist? | educator. develops health promotion strategies.
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| what is subjective assessment? | observation and interaction with patient. chieft complaint, feelings, attitudes.
ex. "my gums bleed when i brush"
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| what is objective assessment? | measurable and includes both a comprehensive physical and oral assessment.
ex. actual recording of probing depths
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| what are the 5 phases of the process dental hygiene care? | Assess, diagnose, plan, implement, evaluate.
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| where else can a hygienist work besides dental offices? | Hospitals, institutions, forensics, research, armed services.
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| what is ergonomics? | the study of human performance and work place design in order to maximize health, comfort, and efficiency. (the "fit" between people and their work space)
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| what are some ways to avoid repetitive strain injuries (RSI) | avoid stretching/twisting for things, keep instruments sharp, use straight hose attachments, alternate instrument handle design, scheduling, stretch throughout day, wear properly fitting gloves, use indirect vision, maintain neutral position
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| what are signs and symptoms of RSI? | pain in hand, wrist, lower back. nocturnal pain in hands and forearms. pain while working. stiffness, numbness, tingling in hand, wrist, or back. weak grasp/loss of strength. coldness in hands or fingers.
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| What is the trendelenburg position? | head is lowered 35 to 45 degrees from supine with feet slightly elevated.
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| why is the trendelenburg position used? | used in medical emergencies. allows head to be lower than heart.
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| what are some contraindications for supine position? | psychological.
physical - meniere's disease, asthma, bronchitis, cold, sinusitis, emphysema, congestive heart failure, cerebrovascular insufficiency, pregnancy, back problems.
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| what are 3 components of basic personal barrier protection? | face mask, protective eyewear, gloves.
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| what are the symptoms of latex allergies? | urticaria (hives)
dermatitis (rash, itching)
nasal problems (sneezing, itchy/runny nose)
respitory reaction (difficulty breathing, coughing, wheezing)
watery/itchy eyes
drop in blood pressure
anaphylaxis
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| management of latex | medical history should reveal. document in chart, make staff aware. plan appointments for earlier in day before latex gloves contaiminate air. remove all latex for high risk patients.
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| some latex products found in an office besides gloves are? | rubber dam, NO2 nosepiece and tubing, O ring on ultrasonic insert, polishing cup, lead apron, stopper in anesthesia carpule, ortho elastics, bite block, mixing bowls, stethoscope, blood pressure cuff, suction adapter.
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| define sterilization | process by which all forms of life are destroyed, including spores.
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| what is the time, temperature, and pressure of moist heat (autoclave) sterilization? | time: 15-30 minutes
temp:250 F, 121 C
pressure: 15 psi
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| disinfecting vs sterilization | disinfecting eliminates harmful micro organisms but doesn't eliminate spores. sterilization eliminates all including spores.
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| Time requirements for chemical sterilization (immersion method) | 10 hours
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| what are chemical indicators? | indicates that the autoclave reached a temp required for penetration and contact time was adequate.
ex. stripes on autoclave tape
(not a true test for sterilization)
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| what is biological monitoring? | use of selected test microorganisms are put through a cycle of sterilization and then cultured. if no growth occurs the sterilizer is performing with max efficiency.
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| what are recommended disinfectants? | gluteraldehydes, chlorines, iodophors, phenolics.
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| how do you manage biofilm in the unit water lines? | at beginning of day flush for 1 minute, between patiens flush for 30 seconds.
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| what are the 6 essential features for disease transmission? | infectious agent, reservoir, port of exit, mode of transmission, port of entry, susceptible host
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| Which infectious disease is of most concern to DHCW’s? | Hepatitis B
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| the most common mode of transmission of tuberculosis is | inhalation
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| the most common drug used to treat TB is | isoniazid (INH)
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| the test used to diagnose TB is | mantoux tuberculin skin test
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| the bacteria responsible for TB is | mycobacterium tuberculosis
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| hepatitis is the inflammation of? | the liver
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| the most common clinical sign of hepatitis is | jaundice
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| hepatitis A | "infectious hepatitis"
modes of transmission is fecal-oral, waterborne, food-borne, and blood.
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| Hepatitiis B | "serum hepatitis"
transmits through blood, saliva, semen, and vaginal fluids. percutaneous and permucosal (needle sticks, IV's). perinatal exposure.
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| Hepatitis C | tramsmits through percutaneous (IV, needles), non-percutaneous (sexual), perinatal
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| Hepatitis D | "delta hepatitis" or "piggyback hepatitis"
transmission: transmits through blood, saliva, semen, and vaginal fluids. percutaneous and permucosal (needle sticks, IV's). perinatal exposure.
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| Hepatitis E | transmitted by contaiminated water, and fecal-oral
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| the presence of HBsAg means | carrier of Hepatitis B
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| the presence of anti-HBs means | person has had previous exposure to Hepatitis B and is now immune to it
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| the most common hep B vaccine is | recombivax
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| what is the vaccination protocol (schedule) for Recombivax, titers, booster | the vaccine is given in 3 doses: onset, 1 months, 6 months. Should have a titre taken, 7 year booster is suggested although may not be necessary
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| piggyback hepatitis means? | the hep D virus can only infect someone who already has hep B
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| What is varicella-zoster? | vericella (chickenpox) and herpes zoster (shingles)
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| What is Epstein-Barr? | infectious mononucleosis
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| Differentiate between (herpes simplex virus) HSV-1 and HSV-2. Can you tell the difference between the two clinically? | herpes type 1 - oral
herpes type 2 - genital
you can't tell the difference clinically
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| Where does the herpes virus remain dormant? | sensory nerve ganglion
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| the most common drug used to treat HSV is | acyclovir
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| herpetic whitlow is | herpes infection of the fingers
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| ocular herpes is | herpetic infection of the eye
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| herpes labialis is | herpetic infection of the mouth, cold sores and fever blisters.
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| HIV stands for? | Human Immunodeficiency virus
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| AIDS stands for? | acquired immunodeficiency syndrome
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| HIV is what kind of virus? | retrovirus
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| the enzyme responsible for replication of HIV is? | reverse transcriptase
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| the primary target cell for HIV infection is? | CD4+ receptors of T helper lymphocytes
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| the most common drug used to treat HIV is? | AZT-zidovudine
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| CDC defines full blown AIDS as ? | CD4+ count below 200 and at least 1 opportunistic infection
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| what are common opportunistic infections and oral manifestations associated with HIV/AIDS | tuberculosis, bacterial pneumonia and septicaemia,herpes simplex, herpes zoster.
oral: candiasis, hairy leukoplakia, kaposi's sarcoma, non-hodgkin's lymphoma, ANUG
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| the best method for obtaining a health history is? | a combination of interview and questionnaire
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| HIPPA stands for? | Health insurance portability and accountability act
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| the proper way to make a correction in a patient's chart is to? | draw one line through the mistake and initial it
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| High risk vs. moderate risk vs. negligible risk for antibiotic premedication | high risk must premed, moderate and negligible no longer require premed.
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| which dental procedures do and dont require premed? | any procedure that can cause bleeding requires premed.
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| adult prophylactic regimen | amoxicillin 2g 1 hour prior
or clindamycin 600 mg 1 hour prior
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| child prohylactic regimen | amoxicillin 50 mg 1 hour prior or clindamycin 20 mg 1 hour prior
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| what is the purpose of taking a medical history? | can help identify cause and diagnosis of oral conditions, reveal need for precautions or modifications, recognize undiagnosed conditions, general health and nutritional status (insight into prognosis), records for reference, evidence in legal matters.
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| what is the primary reason for polishing? | removal of extrinsic stains
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| what are the contraindications for polishing? | no stain, risk for dental caries, respiratory problems, sensitivity, restorations, newly erupted teeth
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| abrasive | material composed of particles of sufficient hardness and sharpness to cut or scratch a softer material when drawn across the surface
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| abrasion | wearing away of surface material by friction
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| how do you reduce frictional heat? | use wet agents, slow speed, quick light intermittent touch.
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| the main ingredient in polishing paste is? | abrasives
ex. pumice, silicon dioxide
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| what is the primary use for disclosing agents? | colors plque, calculus and materia alba.
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| the most effective method for preventing caries is? | fluoride
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| systemic fluoride is? | absorbed through the body and delivered to developing teeth
ex. drinking fluoridated water
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| topical fluoride is? | directly applied to teeth
ex. using fluoride rinses
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| what is the optimum fluoride level in fluoridated drinking water? | 1 ppm (part per million)
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| what is the percent reduction in tooth decay when there has been continuous use of fluoridated water from birth? | 40 - 65%
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| How is fluoride absorbed and excreted by the body? | it is absorbed by the GI tract or blood stream. and is excreted by the kidneys.
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| what is dental fluorosis and when does it occur? | its a form of hypomineralization resulting from ingestion of excess fluoride during tooth developement. occurs at mineralization stage.
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| signs of acute fluoride toxicity? | syptoms begin at 30 min last up to 24 hours. nausea, vomiting, diarrhea, abdominal pain, increased salivation, thirst
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| signs of chronic fluoride toxicity? | skeletal fluorosis, dental fluorosis, mild fluorosis
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| what are extrinsic stains? | Occur on outside of tooth; may be removed
ex. tobacco, tea, coffee
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| what are intrinsic stains? | Occurs within the tooth substance; may not be removed by scaling and/or polishing
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| what are exogenous stains? | Develop or originate from sources outside the tooth; may be intrinsic or extrinsic
ex. amalgam tattoo, stannous fluoride
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| wat are endogenous stains? | Develop from within the tooth; Are always intrinsic; usually are discolorations of the dentin reflected through the enamel
ex. tetracycline, enamel hypoplasia, fluorosis
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| what stain is frequently found in clean mouths? | black stain
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| tetracycline stain is? | occurs if mother takes tetracycline during 3rd trimester of pregnancy or during early childhood years when teeth are forming
is gray-brown, dark yellow, light green
generalized or localized depending on dosage, length of exposure, type of tetracycline.
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| soft deposits are | acquired pellicle, biofilm, maria alba, food debris
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| hard deposits are | calculus
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| acquired pellicle is derived... | supragingivally from saliva, subgingivally from gingival sulcus fluid
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| biofilm Begins primarily with ? | gram positive cocci and by day 7 is primarily gram negative spirochetes and vibrios
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| plaque causes what? | caries and gingival inflammation
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| is ginigivitis and periodontitis reversible? | Gingivitis is reversible; Periodontitis is not reversible (it is treatable but not reversible)
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| the most common areas for plaque are? | gingival 3rd and interproximal surfaces
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| the 3 things necessary for caries process are? | a susceptible host, mircoorganisms that produce acid, a diet for microorganisms (cariogenic food)
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| Demineralization begins to occur at what pH | 4.5 to 5.5
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| Is frequency or quantity of carbohydrate more important in caries formation | frequency
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| the primary bacteria responsible for dental caries is? | streptococcus mutans and streptococcus sobrinus
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| the primary bacteria responsible for periodontal infections is? | actinobacillus actinomycetemcomitans and porphyromonas gingivalis
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| Most common areas for supragingival calculus | lingual of mand. anterior and buccal of max 1st and 2nd molars
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| Most common areas for subgingival calculus | proximal surfaces
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| calculus is? | mineralized plaque
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| How does calculus appear clinically when dried with air. | chalky white
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| Average # of days it takes for undisturbed plaque to begin to mineralize into calculus. | 12 days
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| Calculus is primarily composed of ? | hydroxyapatite
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| Primary instrument for removing bacterial plaque? | toothbrush
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| what groups of people that would benefit from electric toothbrushes? | Ortho patients
Complex restorative and prosthodontic treatment
Implant patients
Aggressive brushers
Patients with limited dexterity
Parents or caregivers of people unable to brush themselves
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| what are the contributing factors and appearance of toothbrush abrasion? | Wedge shaped indentations with smooth, shiny surfaces, occurs from mechanical wear.
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| when should a toothbrush be replaced? | at least every 3-4 months
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| what is normal blood pressure? | systolic under 120, diastolic under 80. subtracted should be 40 and under.
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| what is normal pulse? | 60-100 beats per minute
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| what is normal respirations? | 14-20 respirations per minutes
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| forms of tobacco are? | Cigarettes
Cigars
Pipes
Snuff
Chewing Tobacco
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| Hygienist’s responsibilities with regards to tobacco counseling? | Educate patient’s about the risks associated with tobacco use.
Assist patient’s who want to quit using tobacco.
Document all relative findings
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| components of tobacco? | nicotine, Pesticides, Aldehydes, Ketones, amines
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| metabolism of nicotine? | Absorption
Lungs, skin, oral or nasal mucosa depending on type of tobacco used
Elimination
Liver metabolizes nicotine and excretes it through kidneys
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| smokeless tobacco | Absorption: Oral Cavity
Gingiva and oral mucosa
2 to 3 times the nicotine absorbed versus smoking
Absorption: Intestinal
Juice that is accidentally or intentionally swallowed is absorbed through small intestine
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| systemic effects of tobacco use | Cancer
Respiratory disease
Cardiovascular disease
Facial wrinkling; aging
Reproductive problems
Impotence
Ulcers
Osteoporosis
Nicotine addiction
Alzheimer’s
Halitosis
Discoloration of fingers and fingernails
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| oral effects of tobacco use | Oral cancer
Abrasion and attrition
Calculus buildup
Periodontal disease
Black hairy tongue
Dry socket
Delayed wound healing
Xerostomia
Tooth loss
Halitosis
Stains
Peri-implantitis
Leukoplakia
Impaired taste and smell
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| nicotine addiction | Psychoactive agent
Produces feelings of pleasure and well being
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| reasons to quit smoking | health, effect on family, Pregnancy, Cost
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| 20 minutes after quitting Blood pressure decreases, pulse rate drops, body temp. of hands and feet increases 8 Hours Carbon monoxide level in blood drops to normal, oxygen level in blood increases to normal 24 hours Chance of heart attack decreases |
2 weeks to 3 months
Circulation improves, walking becomes easier, lung function increases
1 to 9 months
Coughing, sinus congestion, fatigue, shortness of breath decrease
1 year
Excess risk of coronary artery disease is decreased to half that of a
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| Pre-contemplation No thought of quitting in next 6 months Contemplation Thinking about quitting in the next 6 months Preparation Willing to set a quit date and start making small changes Action Actively engaged in strategies to change behavior | Maintenance
Has stopped using tobacco for more than 6 months
Relapse
Using tobacco after quitting; will usually happen many times before successful quitting; set new quit date
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| 5 a's approach | ask
advise
assess
assist
arrange follow up
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| nicotine withdrawl symptoms | depresses mood, insomnia, restlessness, irritability, frustration, anger, anxiety, tension, difficulty concentrating, decreased heart rate, weight gain, cravings, stpmach problems
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| NRT's and nicotine free therapies | gum, patch, inhaler, nasal spray, lozenge.
Bupropion
chantix
zyban
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| local cessation programs | Allegany County Health Department
Western Maryland Health System Wellness Center
Allegany College of Maryland Respiratory Therapy Program
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