Normal Blood Pressure
less than 120/80
Elevated Blood Pressure
120-129/<80
Stage 1 Hypertension
130-139/80-89
Stage 11
... [Show More] Hypertension
140+/90+
Hypertensive Crisis
180+/120+
Normal HbA1c
Lower than 5.7% (4%-5.6%)
Hyperglycemia
Blood sugar higher than 130 mg/dl fasting or higher than 180 mg/dl after a meal.
Hypoglycemia
Blood sugar lower than 70 mg/dl
What is insulin shock?
Extreme hypoglycemia
What appointment modification can be made for diabetics?
Schedule AM appointments after the patient has had a meal.
What are signs of hypoglycemia?
Mild-moderate: dizziness, moodiness, headaches, hunger, shakiness, sweating, confusion, rapid heartbeat.
Extreme: fainting, unconsciousness, seizures, coma.
Caused by skipping meals, use of insulin or diabetes medication, unusual physical activity, or excessive alcohol consumption.
Management of hypoglycemia
Glucose tablet, juice, candy or food with sugar.
What are signs of hyperglycemia?
Nausea, confusion, thirst, shortness of breath, fruity (ketone) breath, fatigue, frequent urination.
Management of hyperglycemia
Remind patient to take medication
What is a normal body temperature?
Adult: 97-99 degrees (ideal is 98.6 degrees)
What is a normal pulse rate?
Adult: 60-100 BPM
Child: 80-100 BPM
Infant: 100-160 BPM
*Taken at lateral or ventral aspect of the wrist or brachial Avery (depression at the bend/antecubital fossa) at the elbow
Normal Respiration Rates
Adults: 12-20 BPM
Child: 18-22 BPM
*Allow patient to rest 5 minutes before recording
What is Bradypnea?
Slow respiratory rate
What is Tachypnea?
Rapid respiratory rate.
What is Oraquix?
An Amide made of Lidocaine & Prilocaine. Applied in the sulcus and takes approx 30 second to take effect. 15-20 Duration. Maximum of 5 carpules.
Basic Life Support
Always check vitals before emergency call
-No Response: call emergency and get AED
-No Breath: tilt head, 10-12 rescue breaths per min.
-No Pulse: Compressions+breaths. 100-120 compressions per minute 2 inches deep.
Mild Allergy Management
-Administer Benadryl (aka diphenhydramine-antibistanine)
-Keep supine
-Oxygen as needed
Anaphylaxis Management
-Epinephrine: .2-.5 for adults, .01 for kids
2-3 times as needed @ 10-15 minute intervals
-Call emergency is recovery isn't quick
-Supplemental oxygen
What are signs of an allergic reaction?
Hives, hypotension/dilated blood vessels, swelling, and shock in severe cases.
What drugs cause prolonged gingival bleeding?
Warfarin, Plavix, Coumadin, Clopidogrel, NSAIDS
What is COPD?
A lung disease that blocks airflow. Patients may have candidiasis & xerostomia from inhaler (recommended that they rinse with water after use).
Contraindications: Ultrasonic or air polishers. No nitrous. Do not sit supine (pt may need oxygen supplement).
What are 3 common drugs that cause gingival enlargement?
-Cyclosporine (sandimmune-anti organ rejection)
-Calcium Channel Blockers including Nifedipine-procardia or Amlodipine (anti-hypertensives)
-Phenytoin or Dilantin (anti-seizure)
What are the most common Asthma drugs?
-Albuterol (inhaled corticosteroids)
-Singulair (leyukotrine modifier)
-Prednisone (systemic corticosteroids)
-Mast cell stabilizers (Intal)
What is Asthma?
A chronic respiratory disease that causes constricting of the airway due to inflammation and muscular contraction of the bronchioles, and production of extra mucous. Also called Reactive Airway Disease
Management of Asthma
-Place patient in a seated position
-give inhaler
-Oxygen given in acute conditions
What are the most common pre-med antibiotics & doses?
*Amoxicillin 2g is most common
-Clydamycin 600 mg is given if there is an allergy to penicillin.
-Azithromycin 500 mg
-Clarithromycin 500 mg
What conditions DO NOT require premeds?
-Valvle prolapse w/NO regurgitation
-Rheumatic heart disease w/NO dysfunction
-Bicuspid valve disease
-Calcified aortic stenosis
-Congenital heart conditions
-pacemaker (older than 6 months)
What conditions require premedication?
-Cardiac Transplant
-Unrepaired cyanotic congenital heart disease (conduit & palliative shunts)
-Defects with prosthetics (only for the 1st 6 months)
-Partial unrepaired defects
-Artificial heart valves
-History of endocarditis
Common drugs for Diabetes
Biquanide
Xerostomia Drugs
-Anti-histamines (Benadryl)
-Anti-Depressants (Prozac, Fluoxetine)
-Anti-Psychotic (Clozapine-Cloxaril)
-Anti-Anxiety (diazepam-Valium)
-Anti-Emetric (Alka Seltzer)
-Anti-Parkinsons (Levodopa)
-Anti-Allergic (Loratadine-Clariton)
-Anti-Hypertensive (Hydrochlorothiazide)
-Anti-Cholinergic
DOES NOT CAUSE XEROSTOMIA: Antitussives
Anti Hypertensive
-olol: Beta Blocker (dd)
-pine: Calcium channel blocker (CAL PINES)
-ide: Diuretic (ide='die'/diuretic)
-pril: Ace inhibitor ('April')
-tan: ARB (like 'tan arm'...tan=arb)
ASA Classifications
Class 1-Healthy
Class 2-Mild systemic disease (including pregnancy, obesity, smoking, or allergies)
Class 3-Severe systemic disease (chronic heart failure, COPD, uncontrolled hypertension, stable angina, congestive heart failure)
Class 4-Systemic disease that is a constant threat to life
Class 5-Patient not likely to survive 24 hours
Class 6-Dead
Millers Classification Mobility
Class 1: <1mm horizontal movement
Class 11: 1-2mm movement
Class 111: >2mm and/or presence of vertical depression.
*Fremitus=palpable or visible movement while in function.
GV Black Classification of Caries
Class 1: Occlusal of molars, premolars, facial/lingual surfaces of molars and lingual of maxillary incisors
Class 11: Proximal surfaces of molars and premolars
Class 111: Proximal of incisors & canines not involving the incised edge
Class 1V: Proximal of incisors & canines involving incisor edge/or angle.
Class V: Cervical third of facial or lingual
Class V1: Incisal edge of anterior teeth and cusp on posterior
What are common risk factors for periodontitis?
-Tobacco, genetics, socioeconomic status, parafunctional habits (clenching/grinding), mouth breathing, occlusal trauma, furcations, nutrition, obesity, stress, systemic disease, hormones.
What antibiotic causes GI upset and pseudomonas colitis?
Clindamycin (Concentrates in the bone)
What antibiotics are most likely to cause a superinfection?
Broad Spectrum Antibiotics
What antibiotic is associated with aplastic anemia?
Chloramphenicol
What antibiotic is associated with liver damage?
Tetracycline (this can't be taken with milk or antacids and concentrates well in GCF)
What antibiotic is associated with allergic cholestatic hepatitis?
Erythromycin
What is the first choice of antibiotic for Prosthetic Joints?
Keflex 2g [Show Less]