What conditions require a Pre- medication? - ANSWER-1. Previous IE
2. Joint Replacement
3. Valve Replacement
4. Unrepaired congenital or developmental
... [Show More] cardiac defects
The dental evaluation should include - ANSWER-- Chief complaint
- Date of last visit (new clients)
- Areas of pain or discomfort
- Swelling/ bleeding
- Anxiety
- Previous treatments
- Oral habits
Know your vital signs
Normal body temp for adults and children - ANSWER-98.6
Know your vital signs
Normal pulse for adults - ANSWER-60 to 100 BPM
Know your vital signs
Normal pulse for children - ANSWER-80 to 120 BPM
Know your vital signs
Normal pulse for infants - ANSWER-100 to 160 BPM
Know your vital signs
Normal respiration for adults - ANSWER-14 to 20 breaths per minute
Know your vital signs
Normal respiration for children - ANSWER-20 breaths per minute
Know your vital signs
Normal Blood Pressure for adults and children - ANSWER-Below 120/80 is ideal
Know your vital signs
Prehypertension - ANSWER-130 to 139 / 85 to 89
Be cautious
Know your vital signs
Hypertension 1 - ANSWER-140 to 159 / 90 to 99
Need a consult
Know your vital signs
Hypertension 2 - ANSWER-160 to 179 / 100 to 109
Need a consult
Know your vital signs
Hypertensive crisis - ANSWER-180+ / 110+
Emergency situation
Know your ASA classifications
ASA I - ANSWER-Normal, healthy
Know your ASA classifications
ASA II - ANSWER-Mild systemic disease
controlled asthma, epilepsy, non-insulin dependent diabetes, cigarette smoking, BP between 140-159/90-94
Know your ASA classifications
ASA III - ANSWER-Severe systemic disease, limits activity
stable angina, CVA/myocardial infarction more than 6 months ago, Congestive Heart Failure, well controlled insulin dependent diabetes, CPOD, exercise induced asthma, BP between 160-199/95-114
This level patient needs a consult before procedure
Know your ASA classifications
ASA IV - ANSWER-Incapacitating systemic disease
unstable angina, myocardial infarction or CVA within 6 months, severe CHF or COPD, uncontrolled diabetes or diseases, BP 200 or higher over 115 or higher
You would not be treating this level patient
Know your ASA classifications
ASA V - ANSWER-Patient not expected to survive 24 hours.
You would not be treating this level patient.
Patients with heart conditions may require accommodations, what are they - ANSWER-Shortened appointments
Let them sit up for a bit before standing after being supine
They might need a premed, might have high BP, might need a consult
What is the standard premed regimen? - ANSWER-4 x 500 mg of Amoxicillin (2g) 30 minutes to 1 hour before treatment
What is the premed alternative if the patient is allergic to penicillin? - ANSWER-600 mg of Clindamycin one hour before treatment
A vitamin K deficiency results in what? - ANSWER-Prolonged clotting time
Anticoagulants are used to treat what? - ANSWER-- Pulmonary emboli
- Thrombophlebitis
- Myocardial infarction
Commonly used anticoagulants - ANSWER-Heparin and Coumadin
Be aware when these are on a medical history, increased bleeding is an issue.
Mydriasis - ANSWER-Dilated pupils
Can be caused by a CNS stimulant (like cocaine) or lack of oxygen to the brain
Miosis - ANSWER-Pinpoint Pupils
Can be caused by a CNS depressant (like heroin), narcotics, alcohol
Crepitus - ANSWER-Noise in the joint
Trismus - ANSWER-Difficulty opening the mouth
Be able to identify lymph nodes - ANSWER-- pre/ post auricular
- occipital
- anterior cervical
- posterior cervical
- submental
- submandibular
- tonsillar
- Superficial clavical
The Parotid gland is associated with which duct? - ANSWER-Stensons
The Submandibular gland is associated with which duct? - ANSWER-Whartons
The Sublingual gland is associated with which duct? - ANSWER-Bartholins
Know the types of palpation
Digital - ANSWER-Single finger
Used on the hard palate
Know the types of palpation
Bidigital - ANSWER-finger and thumb on the same hand
used on the lip, parotid, under the tongue
Know the types of palpation
Manual - ANSWER-One hand, all fingers
used on the lymph nodes and the larynx
Know the types of palpation
Bimanual - ANSWER-fingers from each hand applied simultaneously
used on the floor of the mouth, one on the inside, one on the outside
Bilateral - ANSWER-two hands at the same time
used on the TMJ, cervical lymph nodes
What is the palatine fovea? - ANSWER-the two dots between the hard and soft palate.
Characteristics of Filiform papilla - ANSWER-- Hairlike projections on the dorsum of the tongue
- Most numerous
- No taste buds
Characteristics of Fungiform papilla - ANSWER-- Mushroom shaped, among the filiform on the dorsum
- Has taste buds
Characteristics of Circumvallate papilla - ANSWER-- Large and circular
- Form a V on the back of the tongue
- Has taste buds
Characteristics of Foliate papilla - ANSWER-- On the side of the tongue
- Taste buds
T/F: Joint enlargement is typically a concern when assessing the TMJ - ANSWER-False.
enlargement is not a concern
crepitus, trismus, deviated opening.
Which teeth have multiple roots? - ANSWER-- Mandibular molars
- Maxillary molars
- Maxillary first premolars
If a tooth other than these has two roots, it is considered an anomoly
Characteristics of the area surrounding dental implants - ANSWER-- There is no PDL
- The gingival sulcus is replaced with a biologic seal
Why is titanium used for dental implants? - ANSWER-- It is biocompatible
- It is osseointegrated into alveolar bone
What type of instruments should be used around an implant? - ANSWER-Non- Metal only
Plastic or carbon
How do you assess bone loss around an implant? - ANSWER-RADS. Not a probe
What is the #1 sign of implant failure? - ANSWER-Mobility
T/F: Patient selection is critical for implant candidates - ANSWER-True. [Show Less]