Dental Tech Final!
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| Primary Prevention | Measures carried out so that disease does not occur and is truely prevented
Ex-fluoride to prevent carries/ cleaning
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| Secondary prevention | Treatment of early disease to prevent further progression of conditions
ex-scaling/orthodontics/fillings
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| Tertiary prevention | Uses methods to replace loss tissues and to rehabilitate the patient to a functioning normal level
Ex-bridge/implants
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| Subjective Assessment | Observation and interaction with patient,chief complaint, "my gums bleed when i brush"
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| Objective Assessment | measurable comprehensive physical and oral assessment, actual probe depths
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| 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
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| Where can dental hygienist work? | general practice, armed services, research, forensics, educaion, public health, school, industrial, hospitals, institutions(prisions),sales, consulting
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| Basic Personal barrier protection | Face mask, goggles, gloves
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| Latex Allergy - Type 1 (immediate response) | hives, rash, itching, sneezing, itchy watery eyes, itchy runny nose, coughing, wheezing, drop in BP, anaphylaxsis
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| Type 2 latex allergy (delayed) | develops 6-72 hours later
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| Managment of Latex sensitivity | medical history, document-make everyone aware, appointment planning-early appointments
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| 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
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| ergonomics | study of human performance and work place design in order to maximize health, comfort, and efficiency
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| 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
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| Signs/symptoms of RSI | pain in hand/wrist/lowerback, nocturnal pain, pain while working, stiff/numb/ tingling, weakened grasp, coldness in hands or fingers
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| Supine Position | patient flat with head and feet on the same level, most ideal position for clinician
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| Trendelenburg Position | Used in medical emergencies, head lowered 35-45 degress from supine, feet slightly elevated, head lower then heart
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| Contrainindications for supine position | psychological, menieres disease, asthma, bronchitis, cold, sinusitis, emphysema, congestive heart failure, cerebrovascular insufficency, pregnancy, back problems
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| Maxillary illumination | light directed from in front of patient, angle light toward mouth above chest
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| mand illumination | light is directed above patients head
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| Sterillization | proces by which all forms of life are destroyed
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| Moist heat(autoclave) sterillization | time:15-30min temp: 250F 121C Pressure:15psi
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| Time for chemical sterilization | 10 hours
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| Chemical Indicators | stripes that change color during the sterilization prcess that indicates that the designated temp had been reached, not a true sterilization test
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| 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
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| Chemical disinfectants | surface -counters, immersion disinfectants-tongs, immersion sterilants- 10 hours in gluteraldehyde, hand antimicrobials
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| how to manage unit water lines | flush water lines at least 1 min and 30 seconds between patients
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| Disinfectant | Biocidal activity, the ability of the chemical disinfectant to destroy or inactivate living organisms
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| Primary reason for polishing | to remove extrinsic stains that cannot be removed during normal tooth brushing
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| Contraindications for polishing | no unslightly stain, patients at risk for dental caries, patients with respiratory problems, tooth sensitivity, restorations, newly erupted teeth
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| Abrasive | a material compose of particles of sufficient hardness and sharpness to cut or scratch a softer material when drawn across the surface
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| Abrasion | the wearing away of surface material by friction
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| Hazards of polishing | removal of tooth structure,removal of fluoride rich surface, heat production, abrade gingiva, increased roughness
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| Abrasive agents thats used on gold | Silex-gold inlays and crowns
Calcium carbonate-high luster
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| Ways to reduce frictional heat | use wet agents, slow speed, light quick intermittent touch
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| ingredient in prophy paste | Abrasives - 50-60% :pumice or silicon dioxide
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| primary use for disclosing agents | color plaque an calculus, aid in profys, patiets instruction and education
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| most effective method for prevention of dental caries | fluoride
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| systemic fluoride | injested ad circulation and is incorporated into developing teeth. low conc long duration. ex - flouridated water, supplements, foods, tooth paste
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| topical fluoride | directly applied to exposed to erupted teeth. high conc short exposure. ex - trays, varnish, rinses, garmer isolation method
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| optimal fluoride level in drinking water | 1ppm or .7-1.2ppm
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| %reduction in tooth decay when there has been continuous fluoride | 40-65%
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| how is water absorbed or excreted in the body | absorbed - gi tract/blood stream
excretion - kidneys
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| 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
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| Why not chose APF fluoride? | not on composites or porcelins or sealemts
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| What do you use neurtal fluoride? | 7 ph
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| 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.
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| chronic flouride toxicity | long term injestion, skeletal, dental, or mild
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| whats the best method for obtaining health history | combination of interview and questionaire
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| HIPAA | health insurance portability and acountability act of 1996
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| how to make a correction in a patients chart | cross out with a single line and then date and initial
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| High risk for premeditation | prosthetic cardiac valves, infective endocarditis, congenital heart disease, pulmonart shunts, cardiac transplant
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| Moderate risk for premedication | congenital malformations, heart disease, fever, mitral valve with regurgitation, hypertrophic cardiomyopathy
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| Negligible risk | coronary artery bypass, mitral valve without regurgitation, previous fever, pacemaker
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| 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
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| What dental procedures dont need premedication? | restorative dentistry, local injections, suture removal, rubber dams, impressions, fluoride, xrays,removable appliances
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| adult phrophy regimen for cardiac conditions | amoxicillin - 2.0g
clindamycin - 600mg
cephalexin - 2.0g
azithromycin - 500mg
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| adult phrophy regimen for orth patients | amoxicillin or cephalexin - 2.0g
clindamycin - 600mg
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| 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
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| HIPAA officer at ACOM | Blank
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| 6 features of disease transmission | infectious agent, reservoir, port of exit, mode of transmission, port of entry, susceptible host
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| whats disease is of most concern to a DH | hepatitis B
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| Tuberculosis - mycobacterium tuberculosis is responsible | mode of transmission - inhalation, drug to treat - isoniazaid INH, test to diagnose - chest xray and mantoux tuberculin skin test
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| Hepatitis is inflamation of what? Common sign of Hepatitis? | liver
jaundice
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| Hepatitis A | infectious hepatitis, fecal oral unwashed hands,
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| Hepatitis B | serum hepatitis, blood and body fluids
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| If you have HBsAg | your a carrier of Hep. B
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| Presence of anti-HBS | person has had a previous exposure to Hep. B and is immune
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| whats heptavax | plasma derived HB vaccine, original
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| whats recombivax | synthetic, most popular
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| vaccines for Hep. B | 3 doses: first then a month later then 6 months later. 7 year booster
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| Hepatitis C | contaminated needles
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| Hepatitis D | Delta hep or piggyback hep - cannot cause infection except in the presence of hep B. transmission - multiple exposures of hep B, blood
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| Hepatitis E | non A non B transmitted by contaminated water fecal oral route
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| Varicella zoster | chicken pox / shingles
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| Epstein barr | infectious mononucleosis
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| HSV-1 | herpes in the mouth - trigeminal nerve
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| HSV-2 | herpes in the genitals - thoracis, lumbar
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| where does the herpes virus remain dormant | sensory nerve ganglion
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| most common drug for HSV? | acyclovir
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| herpetic whitlow? | herpes simplex infection of the fingers that results from the virus entering through minor skin abrasions, results from contact with saliva
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| ocular Herpes | transmission from splashing saliva or fluid into unprotected eye, can cause blindness
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| herpes libialis? | cold ssores, fever blisters, usually triggered by stress sunlight illness trauma, prodrome - burning/stinging sensation, vesicles to crust
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| HIV stands for? AIDS stands for? | Human immunodeficiency virus
Acquired immunodeficiency syndrome
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| Enzyme responsible for replication of virus | reverse transcriptase
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| Primary target cell for HIV infection | CD4+ receptors of Helper T lymphocytes
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| Most common drug used to treat HIV | AZT-zidovudine, retrovir
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| HIV is a retrovirus | RNA is core genetic material
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| CDC defines AIDS as... | a CD4+ count below 200 and at least 1 opportunistic infection
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| Common opportunistic infections with AIDS | apthous ulcers, herpes labialis, hairy leukoplakia, candidiasis, wasting syndrome, encephalopathy, kaposis sarcoma, non hodgkins lymphoma, ANUG
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| Soft deposit | Acquired pellicle, dental biofilm, material alba, food debris
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| hard deposit | calculus
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| Acquired pellicle | supra-from saliva
sub-from gingival sulcus fluid
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| Biofilm | begins with gram positive cocci and by day 7 its gram negative
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| plaques causes two things | caries and gingival inflammation
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| gingivitis vs periodontitis | reversible vs non reversible but treatable
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| most common area for plaque | gingival third and interproximals
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| three things necessary for caries process | susceptible host, microorganisms that produce acid, a diet for microorganisms
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| demineralization occurs at what ph | 4.5-5.5 ph
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| carbs and caries | alot of carbs in one sitting is better then less carbs in more sittings
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| bacteria for caries | streptococcus mutans and streptococcus sobrinus
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| bacteria for periodontal infections | actinobacillus actinomycetemcomitans, porphyromonas gingivalis, bacteroides forsythus
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| most common areas for supra gingival calculus | lingual of mand anteriors, buccal of max 1st and 2nd molars
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| most common areas for subgingival calculus | proximal surfaces
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| whats calculus | mineralized plaque
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| how does calculus look like dried | chalky white
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| Average number of days it takes for calculus to form | 12 days
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| whats calculus composed of | hydroxyapatite
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| Extrinsic stain | occurs on the outside of the tooth
ex-yellow, green, black line, tobacco, brown, orange, metallic
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| Intrinsic stain | occurs within the tooth, cannot be removed
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| Exogenous stain | develops from sources outside the tooth
ex - restorative material (silver amalgam), silver nitrate, iodine, silver point seals, stannous fluoride
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| endogenous stain | develops from within the body
ex-pulpless teeth, tetra stain, amelogenesis imperfecta, dentinogenesis imperfecta, hypoplasia, dental fluorsis
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| what stain is found in clean mouths | black stain
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| tetracycline stain | can occur when a mother takes it during the 3rd trimester or during early childhood
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| the primary instrument for removing plaque | toothbrushing
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| what groups of ppl would benefit form an electric toothbrush | ortho, prosthedontics, implants, aggressive brushers, limited dexterity, caregivers
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| whats the most chronic gingival alterations from toothbrushing? | rolled margins, mcCalls festoon, gingival clefts, recesssions
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| toothbrush abrasion | wedge shaped indentations with smooth surfaces, mechanical wear, occurs on the facials of canines and premolers and first molars, cervical areas
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| 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
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| 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.
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| 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
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| Collis Method | three sided brush used for caregivers on retarded people.
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| Fones Method | teeth are closed, use fast wide circular motion with light pressure, usually for small children
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| when should you replace a tooth brush? | every 2-3 months
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| 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
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| who would use a bridge/floss threader | lingual bars, bridges
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| who would use a proxybrush, end tuft brush | b/w ortho appliances, open embrassures, fixes prostodontics,implants, splints, space maintainers, desensitizing agents, fluoride
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| who would use a rubber tip stimulator | to improve gums, shrink swelling, helps perio disease
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| wooden/ interdental stimulators | to clean interproximals for ppl who dont like floss
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| who uses a floss holder | for the disabled and caregivers
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| normal blood pressure | 120/80
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| normal respiratios | 14-20
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| normal pulse | 60-100
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| forms of tobacco | cigaretts, cigars, pipes, snuff, chewing
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| hygienist responsibilities with regards to tobaccos counseling | educate patients about the risks, assist patient in quiting, document all findings
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| Components of tobacco | nicotine, pesticides, aldehydes, ketons, amines
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| metabolism of nicotine | absorbtion -luns, skin, oral and nasal mucosa
elimination - liver metabolizes it and the kidneys escrete it
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| 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
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| 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
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| 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
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| 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
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| 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
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| 5 A's to approach | Ask, Advise, Assess, Assist, Arrange follow up
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| withdraw symptoms of tobacco | depression, insomnia, anxiety, cant concentration, decreased heart rate, weight gain, cravings, stomach problems
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| NRT's pharmcotherapys | partial replacement of nicotine to make it easier to abstain, reduces withdraw symptoms
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| NRT's | nicotine gum(nicorette), nicotine patch(nicoderm),nicotine inhaler, nicotine nasal spray, nicotine lozenge
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| nicotine free therapy | bupropion, chantix, zyban
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| local cessation program | allegany county health department, western md health system wellness center, ACM Respiratory therapy program
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