Dental Health Chapter 1

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Questions and Answers

What is the state of having a disease or illness?

Morbidity

What does mortality mean?

Death

Which organ system should dental professionals pay attention to in older patients?

Respiratory system

Digestive system

Cardiovascular system (correct)

Musculoskeletal system

What is the leading cause of death in older patients 65 years and older?

Cardiovascular disease Signup and view all the answers

What does CHP stand for?

Complete Health Profile Signup and view all the answers

What information should be collected from a patient before initiating treatment?

Medical history and ASA Signup and view all the answers

Define Hematuria.

Presence of RBC in urine Signup and view all the answers

What is myocardial infarction?

Occurs when the flow of blood is reduced to the heart muscle Signup and view all the answers

What medication is an antibiotic for infection?

Metronidazole Signup and view all the answers

What medication is used for organ rejection?

Cyclosporine Signup and view all the answers

What does ASA II stand for?

Mild to moderate recheck before appointment Signup and view all the answers

What is the role of Team 1 during an emergency in a dental office?

Stay with the patient, provide BLS, call for help Signup and view all the answers

Where is the first aid kit stored in a typical dental office?

Sterilization Area Signup and view all the answers

What is the color of the oxygen/nitrous tank?

Green Signup and view all the answers

What is the acronym KISS used for?

Keep It Simple Stupid Signup and view all the answers

What injection site is used for intramuscular injections?

Vastus Lateralis Signup and view all the answers

What medication is used to treat anaphylactic shock?

Epinephrine Signup and view all the answers

What medication is used to dilate blood vessels and expand the lungs?

Albuterol Signup and view all the answers

What drug is often used during an emergency?

Epinephrine Signup and view all the answers

What is the name of the equipment that helps maintain the airway open to provide oxygen?

Magill Tube Signup and view all the answers

What is the name of an antidotal drug used for opioid overdoses?

Narcan Signup and view all the answers

What is the name of an antidotal drug used for benzodiazepine overdoses?

Benzodiazepine antagonist Signup and view all the answers

What is the name of the medication commonly known as Valium?

Diazepam Signup and view all the answers

What are the uses of Diazepam?

Treats anxiety, seizures Signup and view all the answers

What type of law deals with contractual agreements between a dentist and patient?

Contract law Signup and view all the answers

What type of law deals with fraud, misuse of narcotics?

Criminal law Signup and view all the answers

What type of law deals with breaching a duty to the disadvantage of another?

Tort law Signup and view all the answers

What type of law deals with failure to act reasonably?

Breach of duty Signup and view all the answers

The Good Samaritan law protects individuals who provide aid in emergencies, even if they are not medical professionals.

True Signup and view all the answers

What is the recommended position for a patient who is unconscious?

Supine position with feet elevated, airway, breathing and administering oxygen Signup and view all the answers

What are some factors that can cause psychogenic syncope?

Fright, anxiety, stress, sight of blood Signup and view all the answers

When is the CAB (Cardiopulmonary Cerebral Resuscitation) activated?

Cardiac Arrest Signup and view all the answers

How long does recovery typically last after syncope?

Up to 24 hours Signup and view all the answers

What triggers the release of epinephrine and norepinephrine during presyncope?

Fear or pain Signup and view all the answers

What are the characteristic signs of Addison's disease?

Confusion, weakness, extreme fatigue, hypotension (more common in females, 30-35 years) Signup and view all the answers

Where are adrenal glands located?

In the outer part of the adrenal gland, top of the kidney Signup and view all the answers

What is the primary function of the adrenal cortex?

Produce hormones that help regulate metabolism, immune system, blood pressure, response to stress and other essential functions Signup and view all the answers

What are the common signs of adrenal insufficiency?

Hypotension, altered mental status, anorexia, vomiting, weight-loss, fatigue, and recurrent abdominal pain Signup and view all the answers

What are the recommended steps for managing a conscious patient with adrenal insufficiency?

Stop dental treatment, position, ABC assessment, monitor vital signs, summon medical assistance, emergency kit & oxygen Signup and view all the answers

What is the definition of pallor?

Loss of skin pigmentation associated with clammy skin Signup and view all the answers

Tonic-clonic movements can occur during vasodepressor syncope.

True Signup and view all the answers

What is the medical condition associated with low levels of oxygen in the body?

Hypoxia Signup and view all the answers

What is the medical term for shortness of breath?

Dyspnea Signup and view all the answers

What is the absence of respiratory movement?

Apnea Signup and view all the answers

What instrument is used to remove foreign objects from the airway?

Magill Intubation Forceps Signup and view all the answers

How do you manage a patient who is hyperventilating?

Prioritize communication, listen to their concern and assure them you will be there the whole time. Signup and view all the answers

What is the primary issue affected by asthma?

Obstruction of the airway Signup and view all the answers

What age group is primarily affected by intrinsic asthma?

Older Adults 35 years Signup and view all the answers

What is considered the most severe form of asthma?

Status Epilepticus Signup and view all the answers

What are the primary goals of a physician when dealing with a patient experiencing an asthma attack?

To improve the patient's breathing and find out how severe the asthma attack is and to see whether the treatment is working. Signup and view all the answers

What are some common signs of an asthma attack?

Wheezing, difficulty speaking, fast heart rate, cough and chest pain Signup and view all the answers

What is bronchospasm?

When the muscles narrow and tighten Signup and view all the answers

What is hypercarbia?

High level of carbon dioxide in blood Signup and view all the answers

What are some common signs and symptoms of hypercarbia?

Fatigue, headache, flushed skin, shortness of breath, nausea, irritability Signup and view all the answers

What are some common symptoms of severe hypercarbia?

Confusion, depression or paranoia, anxiety, nausea and vomiting, seizure, fainting Signup and view all the answers

What percentage of Americans are estimated to have heart failure?

2-3% Signup and view all the answers

What are the main symptoms of left ventricular failure?

Chest pain, whole body weakness, fatigue, shortness of breath and excess urine Signup and view all the answers

What is the primary cause of right ventricular failure?

Left ventricular failure, causing low oxygen, weakness, fatigue, cyanosis, coolness of extremities Signup and view all the answers

What is the ASA classification for a normal healthy patient?

ASA 1 Signup and view all the answers

What is the ASA classification for a patient who can walk one flight of stairs or two city blocks without discomfort but must stop due to distress?

ASA 2 Signup and view all the answers

What is the ASA classification for a patient who can climb one flight of stairs or walk two city blocks but must stop and rest before completing the task?

ASA 3 Signup and view all the answers

What is the ASA classification for a patient who cannot negotiate a flight of stairs or walk two city blocks due to shortness of breath or fatigue?

ASA 4 Signup and view all the answers

What is acute pulmonary edema?

Fluid leaves the capillaries and infiltrates the alveolar sacs of the lungs. Signup and view all the answers

What are some common causes of acute pulmonary edema?

Stressful situation, too much salty meals Signup and view all the answers

What is the feeling of chest pain associated with hyperventilation?

Feeling of weight or pressure, shooting or stabbing sensation Signup and view all the answers

What is respiratory distress?

Occurs when the body needs more oxygen than it's receiving, leading to difficulty breathing or low oxygen in the blood Signup and view all the answers

What is the visual appearance of cyanosis?

Bluish discoloration of skin and mucous membranes Signup and view all the answers

What is altered consciousness?

Temporary change in a person's awareness Signup and view all the answers

What are some potential causes of altered consciousness?

Drug overdose, hyperthyroidism, hypothyroidism Signup and view all the answers

What are the primary characteristics of delirium?

Change of mental state, confusion, disorientation, difficulty talking and remembering Signup and view all the answers

How do you manage altered unconsciousness?

Ensuring basic life support (ABC'S) Signup and view all the answers

Which body system is affected in diabetes mellitus?

Endocrine system Signup and view all the answers

What is the purpose of a PPD TB test?

A small amount of tuberculin is injected into the arm and checked 24-72 hrs later. BUT TO CONFIRM THE TEST WE CAN TAKE CHEST X-RAY. Signup and view all the answers

What is hyperglycemia?

The body increased demand for insulin (usually a much longer process 48 hrs) Signup and view all the answers

What are the treatment considerations for a patient with ASA Class 2?

Follow usual ASA 2 considerations, plus the following: Eat a normal breakfast and take usual insulin dose in morning, if possible. Avoid missing meals before and after surgery, if possible. If missing meal is unavoidable, consult physician or decrease insulin dose by half. Signup and view all the answers

What is hypothyroidism?

Loss of consciousness, it may take a relatively mild form, inadequate supply of thyroid hormones, not eating for hours Signup and view all the answers

What is a TIA?

Transient ischemic attack AKA incipient stroke Signup and view all the answers

What is an embolic stroke?

May cause transient interference with blood flow Signup and view all the answers

What are the most dangerous types of seizures?

Tonic-clonic or grand mal seizures Signup and view all the answers

What is the prodromal phase of a seizure?

Several minutes to hours before seizure, changes in emotional reactivity Signup and view all the answers

What are the typical responses of dental staff to prodromal changes before seizures?

Not noticed by dental staff Signup and view all the answers

Who often notice prodromal changes before seizures?

Noticed by friends and family Signup and view all the answers

What are the recommendations if a patient is experiencing prodromal changes before seizures?

Should not sit for dental treatment, prepare for a seizure to occur Signup and view all the answers

How long do auras typically last before a seizure?

Lasts a few seconds Signup and view all the answers

What medication is used to manage seizures?

Diazepam (Valium) Signup and view all the answers

What is the maximum dosage of lidocaine for overdose?

1.5 mg/kg via IV Signup and view all the answers

What is the leading cause of fatal anaphylaxis?

Penicillin Signup and view all the answers

What are the leading causes of death related to allergies?

Peanuts and latex Signup and view all the answers

What medication is used to counteract allergic reactions to anesthetics?

Diphenhydramine (histamine blocker) Signup and view all the answers

Study Notes

Chapter 1

Morbidity is the state of having a disease.
Mortality is death.
Risk factors for older patients include cardiovascular and periodontal disease, with cardiovascular disease being the leading cause of death in those over 65.
To rule out a condition, understanding the patient's medical history and ASA (American Society of Anesthesiologists) score is crucial.
Hematuria is the presence of red blood cells in the urine.
Myocardial infarction occurs when blood flow to the heart muscle is reduced.
Metronidazole is an antibiotic.
Cyclosporine is used for organ rejection.
ASA scores are used to classify patient risk: ASA I (healthy), ASA II (mild to moderate, needing recheck before appointment), ASA III (severe), and ASA IV (not suitable for treatment).
Basic Life Support (BLS) protocol in a dental office involves a team approach:
Team 1 stays with the patient and performs BLS.
Team 2 brings the Automated External Defibrillator (AED) and ensures it's ready.
Team 3 acts as a circulating nurse, documenting medications and administering them as needed (often a dentist).
The sterilization area is where first aid kits are stored.

Chapter 2

Oxygen/nitrous tank is green.
KISS (Keep It Simple Stupid) is a guiding principle.
Intramuscular injections are given into the vastus lateralis muscle.
For anaphylaxis shock, epinephrine is used.
Vasodilator and lung expansion drugs include albuterol.
Magill tube maintains airway for oxygen delivery.
Opioid/Narcan and benzodiazepine antagonist are examples of antidotal drugs.
Diazepam (Valium) is used to treat anxiety and seizures.
Contract, criminal, and tort laws pertain to the duties of dentists.
Good Samaritan Law applies to healthcare professionals helping others.

Chapter 3

Factors for psychogenic syncope include stress, anxiety, and seeing blood. Non-psychogenic syncope can be caused by heat, position or exhaustion.
Cardiac arrest is diagnosed when CAB activation is needed.
Post-syncope recovery is typically rapid and lasts up to 24 hours.
Presyncope is a precursor to syncope which may be triggered by pain or emotional distress.
Understanding Addison Disease (Adrenal insufficiency) is important. Addison's disease is a potentially dangerous condition characterized by weakness, extreme fatigue and confusion, often seen in females between 30-35 years of age. It results from reduced adrenal cortex function, located in the adrenal glands. The adrenal glands sit on top of the kidneys and their function is crucial in regulating stress response, immune system, blood pressure and other vital functions.
Signs of adrenal insufficiency include hypotension (low blood pressure), altered mental status (confusion, difficulty concentrating), anorexia (decreased appetite), vomiting, weight loss, fatigue, and recurrent abdominal pain (reoccuring stomach pain).
Knowledge about how to manage patients with adrenal insufficiency is essential for dental practitioners.

Chapter 4

Unconscious patients should be positioned, ensuring their airway is clear.
Basic Life Support (BLS) steps should be performed.
Evaluate the patient's medical history.
Pallor is the loss of skin pigmentation, often accompanied by a clammy feeling, may be related to a syncope episode. Vasodepressor syncope involves movements during the episode.
Hypoxia (low O2 levels) can lead to dyspnea (shortness of breath).
Apnea is the absence of respiratory movement.
Proper instruments (e.g., Magill Intubation forceps) to clear airways are essential.

Chapter 5

Managing a hyperventilating patient involves prioritizing communication and reassurance.
Asthma primarily affects airway obstruction.
Intrinsic asthma is common among older adults. Extrinsic is common among younger adults.
A goal in treating asthma is to improve breathing and assess severity.
Signs of asthma include wheezing, difficulty speaking, rapid heart rate, persistent coughing, and chest pain.
Bronchospasm is the narrowing and tightening of the airways.
Symptoms of hypercarbia may include headache, flushed skin, shortness of breath, nausea, and irritability. Poor air exchange. High quantity of carbon dioxide in the blood are also common symptoms.

Chapter 6

Severe symptoms include confusion, depression, anxiety, nausea, vomiting, and seizures.
Heart failure can be broadly classified into left-sided and right-sided failure, with each causing different symptoms. Low oxygen levels, weakness and fatigue are among some of the symptoms of heart failure
ASA classifications (I to IV) for heart failure assess a patient's functional capacity.
Acute pulmonary edema is characterized by fluid accumulating in the lungs' air sacs (alveoli).
Chest pain may occur in patients with hyperventilation, often felt as a feeling of weight, pressure, shooting, or stabbing sensation.
Cyanosis is a bluish discoloration of the skin, indicating inadequate oxygenation.
Altered consciousness, such as delirium (confusion, disorientation, and impaired memory) can result from various factors, such as drug overdose, hyper/hypothyroidism, among others.

Chapter 7

Hyperglycemia (high blood sugar) and hypoglycemia (low blood sugar) present different kinds of issues. Hyperglycemia is the increased demand for insulin, occurring over 48 hours. Hypoglycemia is the decrease in the body's need for insulin.
Hemoglobin A1c levels are used to manage diabetes. Ranges from excellent to fair based on the value.
ASA classifications provide different levels of dental consideration for diabetics.

Chapter 8

Hypothyroidism involves an insufficient supply of thyroid hormones.
Hyperthyroidism involves excessive thyroid hormone production.
Transient ischemic attacks (TIAs), commonly known as mini-strokes, can be a precursor to more serious and lasting damage.
A cerebrovascular accident (CVA), also known as a stroke, is the third leading cause of death and a leading cause of adult disability.
An embolic stroke causes transient interference with blood flow.
Different types of seizures include tonic-clonic (grand mal), the most dangerous kind. Symptoms before the seizure (prodromal phase) may be subtle, or might last up to several minutes, or hours. Seizure symptoms include changes in emotional reactivity that may be noticed by friends and family but not clinical staff. These individuals who have a seizure may need to pre-emptively sit for treatment, and need warning signals to avoid injury. Preparation for a seizure is important for treatment. An aura is a pre-seizure signal. Patients may also have the same aura for each seizure. These can last for seconds at a time.

Chapter 9

Prevention of overdoses using lidocaine in specific doses is important.
Allergies to particular allergens are a concern, causing potentially fatal issues like anaphylaxis.
Allergens such as penicillin, peanuts and latex are common.
Misdiagnosis of allergies needs to be avoided, and proper procedures for administration of treatment is crucial. This could include using diphenhydramine if there is sensitivity to anesthetics.

Chapter 10

Angina is chest pain caused by reduced blood flow to the heart.
Stable angina is caused by physical activity or stress, while variant angina is caused by spasm in the coronary arteries.
Medications such as metoprolol, carvedilol, and amlodipine are used to treat angina and related conditions such as hypertension.
Myocardial infarction (MI), or heart attack, is the lack of blood flow to the heart muscle, with specific locations often affected.

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Description

Explore key concepts in dental health, including morbidity, mortality, and risk factors associated with older patients. This chapter covers important medical history aspects, as well as protocols like Basic Life Support in a dental setting.