Dhy 215 Test 1

Front 1

____ is the anatomic or physiologic age of a person as determined by changes in organismic structure & function; this takes into account posture, skin texture, strength, speed, & sensory activity

Back 1

Biologic Age: determined by changes in organismic structure and function

Front 2

___ is the actual measure of time elapsed since a person's birth

Back 2

Chronologic age
- the actual measure of time elapsed since birth

Front 3

Aging population may be recognized as the ....
Older population= __ & over
Elderly= __ & over
Aged= __ & older
Very old= __ & older

Back 3

Older population= 55+
Elderly= 65+
Aged= 75+
Very old= 85+

Front 4

ADL levels
level __: can perform task with partial assistance
Level __: Can perform the task with assistance; may need a device or mechanical aid but is still independent

Back 4

ADL levels
Level 2
--can perform task with partial assistance
Level 1
--Can perform the task with assistance; may need a device or mechanical aid but is still independent

Front 5

ADL levels....
Level___: Able to perform the task without assistance
Level___: pt requires full assistance

Back 5

ADL
level 0 - able to perform without assistance
level 3- Requires full assistance

Front 6

ASA classifications
__: pt has incapacitating disease that is a constant threat to life
__: pt is not expected to survive
__: pt has mild systemic diseaseor extreme dental anxiety (ex. diabetes controlled w/ medicine)

Back 6

ASA classifications
ASA 4 - pt has incapacitating disease that is a constant threat to life
ASA 5- pt is not expected to survive
ASA 2- pt has mild systemic diseaseor extreme dental anxiety (ex. diabetes controlled w/ medicine)

Front 7

ASA classifications
__: pt is without systemic disease
__: systemic disease that limits activity but is not incapacitating. (Insulin controlled diabetic)

Back 7

ASA 1
--pt is without systemic disease
ASA 3
-- Systemic disease that limits activity but is not incapacitation (insulin controlled diabetes)

Front 8

___ Aging: influence of the passage of time on a person, independent of extrinsic influences or disabilities including stress, trauma, or disease

Back 8

Primary Aging
--influence of passage of time on person, independent of extrinsic influences or disabilities including stress, trauma, disease

Front 9

___ Aging: growing old in the presence of external influences, with disabilities related to trauma and chronic diseases.

Back 9

Secondary Aging
--Growing old in presence of external influences, with disabilities related to trauma & chronic disease

Front 10

What are some of the changes that occur with Aging?? (10)

Back 10

Changes w/ Aging
- increased susceptibility to infection
- lowered immunity
- altered skin, mucosal barriers& flora
-nutritional factors,underlying chronic conditions
- decreased immunologic functioning
- Response to disease
- Course & Severity
- Pain sensitivity
- Temperature Response
- Healing

Front 11

What are some of the factors that influence disease in an older person?

Back 11

Factors that influence disease
**Biologic **Environmental**
**psychosocial**
**Lifestyle factors influence longevity **genetics**
**Diet& exercise** Smoking**Alcohol**Obesity*
**Lower education& socioeconomics backgrounds

Front 12

An elderly person responds differently than younger people to diseases characteristics of elderly include...
Course and severity: ___
Pain sensitivity: ____
Temp. Response: ____
Healing: ___

Back 12

Charactistics of elderly response to disease....
**Course & Severity: disease occurs w/ greater severity & have longer course w/ slower recovery
**Pain Sensitivity: may be lessened
**Temperature Response: pt may be very ill w/o expected increase in body temp
** Healing: decreased healing capacity& moreprone to secondary infection

Front 13

The most common chronic conditions associated with the elderly include ____? (5)

Back 13

Most common Chronic conditions
1. Arthritis
2. Hypertension
3/4. Visual & Hearing impairments
5. Cardiovascular diseases

Front 14

___ is a bone disease involving loss of mineral content and bone mass. **common in individuals older than age 60& incidence increases w/ age.
**most prominent in postmenopausal women may occur at all ages& in men

Back 14

Osteoporosis
--bone disease involving loss of mineral content and bone mass.**common in individuals older than age 60& incidence increases w/ age.
**most prominent in postmenopausal women may occur at all ages& in men

Front 15

What are the 2 causes of Osteoporosis??

Back 15

Causes of Osteoporosis
1. Endocrine: hormonal disturbances; depletion os estrogen after meopause
2. Calcium deficiency or defective absorption of Calcium

Front 16

Prevention is 1st line of defense against osteoporosis what are 3 ways to prevent this condition?

Back 16

Ways to prevent osteoporosis
1. Adequate Calcium intake during adolescence& elderly adulthood
2. The minimum requirements for both Ca & Vitamin D increase with age
3. Performing load bearing exercise

Front 17

What are the risk factors associated with Osteoporosis?

Back 17

Risk factors for Osteoporosis
-female gender: (+) fam history
- Caucasian or Asian ethnicity
- Low Ca & Vitamin D intake
- Early menopause or early surgical removal of ovaries; use of corticosteroids; eating disorders
-Sedentary lifestyle:lack of exercise
- alcohol&tobacco use or high caffeine intake

Front 18

What is the relationship between perio disease & osteoporosis?

Back 18

relationship between perio and osteoporosis....
** osteoporotic bone is less dense& more readily absorbed; periodontal pathogenic microorganisms can provide toxic products for increased periodontal breakdown

Front 19

What are some of the Symptoms of Osteoporosis?

Back 19

Symptoms of Osteoporosis
-Backache: stooping of posture
- Fractures: hip, compression fractures of spine, ends of long bones
- Evidence of bone changes in mandible; residual ridge resorption

Front 20

What is forms of treatment for osteoporosis?

Back 20

Osteoporosis Treatment...
-Medication
- Activity
- Behavioral : avoidance of smoking and excessive alcohol

Front 21

What are some of the Symptoms of Alzheimer's disease??

Back 21

Symptoms of Alzheimers
>Box 49-3 pg. 823
> forgetfulness, disorientation, personal hygiene neglect, disorientation.....

Front 22

Appointment considerations w/ Alzheimer's disease... when should a pt w/ this disease be seen for an appointment if he/she is in the Early stages...
Late stages....

Back 22

Apt consideration
>Early stages: provide routine care w/ initiation of aggressice preventive regimen. 3 month intervals, topical fluoride/ fluoride varnish recommended & OHI w/ caregiver & pt
> Late Stages- routine intra exams to assess lesions, sedation may be required, may need mouth prop or restraint, power toothbrush may improve biofilm retention, caregiver given OHI

Front 23

What are some of the oral findings in aging that are associated with the LIPS??

Back 23

Oral Findings in Aging: LIPS
- tissue change: dry, purse string results from dehydration & loss of elasticity
- Angular Cheilitis due to candidiasis & vitamin B deficiency it appears as skin folds fissuring @ angles of mouth

Front 24

What are some of the oral findings in aging that are associated with the ORAL MUCOSA??

Back 24

Oral Findings in Aging: ORAL MUCOSA
--Atrophic Changes- tissue becomes thinner& less vascular w/ loss of elasticity. Smooth/Shiny appearance associated w/ thinning
--Hyperkeratosis- white, patchy areas develop as result of irritation from sharp edhes or broken teeth,restorations, dentures, or use of tobacco
--Capillary Fragility- Facial bruises & petechiae of the mucosa are uncommon

Front 25

What are some of the oral findings in aging that are associated with the TONGUE??

Back 25

Oral Findings w/ Aging: TONGUE
--Atrophic Glossitis(burning tongue) appears smooth,shiny, bald w/ papillae
condition related to anemia
--Taste Sensations-perception of salt decreases w/ age. Olfactory sense declines more than taste. Sweet&Sour does not decline w/ age
--Sublingual Varicosities- deep,red or blue nodular dilated vessels on either side of midline on ventral of tongue

Front 26

What are some of the oral findings in aging that are associated with XEROSTOMIA??

Back 26

Oral Findings in Aging: XEROSTOMIA
--Not consequence of aging but is caused by medications, Autoimmune Diseases (Sjogren's syndrome)& other systemic diseases, and Radiation Therapy

Front 27

What are some of the oral findings in aging that are associated with Oral Candidiasis??

Back 27

Oral Findings w/ Aging:
ORAL CANDIDIASIS
--most common infection of oral mucosal tissue
--Denture stomatitis & angular cheilitis represent 2 most common forms
-- Associated w/ use of antibiotics, head&neck radiation therapy, chemo, steroids& other immunosuppressive drugs
--medical condition that alter immune system (HIV)
--pt w/ xerosotmia

Front 28

How do the teeth appear in someone who is older than they do in a younger individual?

Back 28

the teeth appear darker and yellowing as result of changes in the underlying dentin. Color change are from long use of tobacco& beverages (tea,coffee). Also dark intrinsic stains from restorations may be evident

Front 29

___ changes occur with aging this develops as reactions to wear, dental caries, restorations, bruxism, and other assaults during elder person's life.

Back 29

Pulpal changes - these include >the pulp and root canals narrow
> progressive deposition of calcified mass
> number of blood vessels entering the tooth declines
> there is an increased deposition of secondary & tertiary dentin

Front 30

THe teeth of elderly perople frequently show signs of ___, which may be a long term effect of diet, occupational factors, or bruxism. This may be accompanied by chipping and teeth may be more brittle

Back 30

Wear / Attrition

Front 31

___ at the cervical third of a tooth may be the result of extended use of a hard toothbrush in a horizontal direction with an abrasive dentifrice.

Back 31

Abrasion

Front 32

Root Caries: Older adults have more root caries than any other age group. Risk factors, not age, are responsible for # of root surface caries. What are the risk factors to root caries?? (>5 )

Back 32

Risk Factors for Root Caries
>Exposed root surface due to: perio infection, horizontal toothbrush technique
> Biofilm retention due to inadequate toothbrush
-cognititive & physical disabilities
- inadequate oral care received by institutional care
- faulty restoarations & partial dentures
>Xerostomia
>HIgh carbohydrate diet
>combo of all these factors

Front 33

tissue changes in the periodontium occur due to relation to aging. What are the related tissue changes that occur to the Bone...Cementum...and Gingiva?

Back 33

Tissue changed w/ Aging
>Bone- osteoporosis may be present, bone may have depressed vascularity,and reduction in healing may affect bone
> Cementum- incresed thickness demonstrated w/ aging
> Gingiva- most changes due to effect of infection or anatomic factors. There is an increased density of blood vessel; blood vessels with active flow is decreased. Predisposing factors may be a lack of suffient attached gingiva or malposition of teeth

Front 34

What are the clinical findings associated with patient w/ healthy periodontium, pt w/ perio infection, the treated patient??

Back 34

Clinical findings found in....
>Healthy periodontium=little bone recession, gigiva is firm, minimal sulcus depth w/ no bleeding & nonmobile
>pt w/ perio infection= tissue destruction goes into bone, perio ligament & cementum, loss of attachment, deep pockets,& tooth mobility
>Treated patient= pt may have scar tissue, areas of recession w/ exposed cementum, teeth nonmobile

Front 35

What are some of the reasons for a patient to need antibiotic premedication??

Back 35

-Prosthetic heart valves
-Individual w/ uncontrolled diabetes
-pt who is receiving chemo or steroid treatment
- previous endocarditis
-pt with prosthetic (hip/knee replacement)

Front 36

What are some of the factors that contribute to the accumulation of biofilm w/ the elderly??

Back 36

Factors contributing to accumulation of Biofilm....
- gingival recession with wide embrasures
- Exposed cementum w/ areas of abrasion or dental caries at the cervical 3rd
- decreased saliva production

Front 37

What are some of the dietary need of the aged?

Back 37

Dietary needs of the Aged...
-the # of calories need to be reduced due to decreased energy needs
- protein, vitamins,minerals, and water are important for body function repair and resistance to disease
- Increased need for CA, vitamin D, and folate
- A neccessary objective in geriatric nutrition is to retard the progression of diet-induced chronic diseases.
- Fluoride intake over the years is beneficial in the prevention of osteoporosis & fractures of bones,and water fluoridation is beneficial for direct application to teeth

Front 38

___ dentures : a removal dental prosthesis that replaces the entire dentition and associated structures of the maxilla or the mandible & rests on the denture foundation area, the mucosal covered ridge.

Back 38

Tissue- Supported Complete Denture
- replaces the entire dentition and associated structures of the maxilla or the mandible & rests on the denture foundation area, the mucosal covered ridge.

Front 39

___ denture - a complete dental prosthesis that is support in part or whole by onr or more dental implants

Back 39

Implant denture- a denture supported in part or whole by one or more implants

Front 40

___- a removable prothesis that rest on one or more remaining natural teeth, tooth roots, and/or dental implants.

Back 40

Overdenture
- rest on one or more remaining natural teeth, tooth roots, and/or dental implants

Front 41

__ - A removable dental prothesis designed to enhance esthetics, stabilization, and/or function for a limited period of time, after which it is to be replaced by a definitive prosthesis.

Back 41

Interim Denture Prosthesis
- designed to enhance esthetics, stabilization, and/or function for a limited period of time, after which it is to be replaced by a definitive prosthesis.

Front 42

__ is a denture that is fabricated for placement immediately following the removal of a natural tooth or teeth.

Back 42

Immediate Denture
- a denture fabricated for placement immediately following the removal of a natural tooth or teeth

Front 43

After the teeth are removed the ___ enters into a continuing process of remodeling. The alveolar bone undergoes resoprtion. This bone remodelings & soft tissue healing makes it necessary to have dentures rebased, relined, ,or remade at intervals.

Back 43

RESIDUAL RIDGES
-after teeth are removed the residual ridges enter into a continuing process of remodeling.

Front 44

___ interfere with the fabrication & wearing of dentures. Because of the size, shape, or location, "excess bone".
___ is bone enlargement over the midline of the palate.
___ is bony mass lcoated on the lingual in region of the premolars.
___ bony protruberance located on the buccal aspects of maxilla and/or mandible.

Back 44

TORI -excess bone, must be removed before dentures are fabricated.
TORUS PALATINUS- bone enlargement over midline of palate
TORUS MANDIBULARIS- bony mass located on lingual in region of premolars
EXOSTOSIS- located on buccal aspects of maxilla and/or mandible

Front 45

Oral Mucosa is composed of (3)
___ covers endentulous ridges & hard palate. Made up of 2 layers the lamina propria & surface stratified squamous epithelium which is keratinized in healthy mouth.
___ mucosa covers floor of mouth, vestibules, and cheeks.
___ mucosa covers the dorsal surface of the tongue.

Back 45

Mucosa composed of Masticatory, lining, and specialized mucosa.
~Masticatory mucosa covers edentulous ridges & hard palate.
~ Lining mucosa- covers floor of mouth,vestibules, and cheeks
~ Specialized mucosa covers the dorsal surface of the tongue

Front 46

__ mucosa is underneath the mucous membrane is the submucosa, which is attached to the underlying bone. Composed of connective tissue with vessels, nerves, adipose tissue, and glands.

Back 46

SUBMUCOSA
-underneath the mucous membrane is the submucosa, which is attached to the underlying bone. Composed of connective tissue with vessels, nerves, adipose tissue, and glands. the support & cushioning effect for dentures fepends on makeup of submucosa.

Front 47

___ test examines the edentulous mouth by retracting the lips and cheeks.

Back 47

Tension test
- a line of demarcation similar to the MGJ should be apparent
- frenal attachment can be observed

Front 48

____ begins well in advance to the day of delivery. Anticipatory guidance should be given so pt knows what to expect.Patient satisfaction has much to do with the emotional preparation prior to procedure/placement. Printed materials should be on a 5th grade level.

Back 48

Patient Counseling

Front 49

___ Care includes apt to adjust the prosthesis, teach denture hygiene, and arrange for continuing maintenance apt.
__ are placed immediate after teeth removal pt is instructed to leave denture in for 24-48 hrs after tooth removal to aid in control of bleeding & swelling.
___ - 1st apt is made within 24-48 hours of time of insertion. Additional apt are made.

Back 49

Postinsertion care- includes apt to adjust the prosthesis, teach denture hygiene, and arrange for continuing maintenance apt.
IMMEDIATE DENTURES- leave in 24-48 hours after tooth removal
NEW DENTURES OVER HEALED RIDGES- 1st apt within 24-48hrs at time of insertion

Front 50

Bone changes,,,
the alveolar ridge remodeling made lead too ___(5)

Back 50

Alveolar Ridge Remodeling may lead too:
~ loss of denture support
~ loss of facial height & lip support
~ Increased prominence of the chin
~ TMJ manifestations
~Occlusal disharmony

Front 51

Oral Mucosa Changes...
- 1 mouth may have thinning of mucosa, submucosa,the epithelium absent of kertatinization, and another may have normal mucosal.
~WHat are some Factors that influence the mucosa...... (6)

Back 51

Factors that influence the Mucosa
~ systemic sonditions that alter host response
~Aging, mucosa tends to become thinner
~ denture & tissue hygien
~ wearing the denture constantly
~ Xerostomia
~ Fit & Occlusion of the denture itself

Front 52

XEROSTOMIA can influence denture retention & tissue lubrication as well as reduce the resistance of oral mucosa to trauma and infection.
___ : the oral mucosa needs saliva for protection against fractional irritation by the denture
___: the film of saliva between the denture and mucosa contributes to retention and suction of the denture.

Back 52

Effects of Xerosotomia
LUBRICATION- the oral mucosa needs saliva to lubricate for protection against fractional irritation by the denture
RETENTION- the film of saliva between the denture and mucosa contributes to retention and suction of the denture.

Front 53

Sensory Changes: With a denture a pt may have change in ___ sense & __. The denture in place, sensitivity may be diminished to sm objects in mouth. Proprioception that signals how hard to chew & when to stop biting is lost from absence of PDL.

Back 53

Tactile sense & taste changes
-Dentures may develop thick odoriferous biofilm which can alter food flavor if not kept clean but denture itself does not affect the taste buds on tongue.
Proprioception that signals how hard to chew & when to stop biting is lost from absence of PDL.

Front 54

What are the 3 principle causes of lesions under dentures?

Back 54

Principle Causes of lesions under dentures:
~ ill fitting dentures
~ Inadequate oral hygiene
~ Continuous Wear

Front 55

What are some of the contributing factors to inflammatory lesions under dentures?

Back 55

Contributing factors to inflammatory Lesions
~ denture trauma from fit, occlusion, parafunctional habits
~inadequate denture hygiene & care of mucosa
~ chemotoxic effect from residual cleansing paste or solution not throughly rinsed from denture
~ allergy to denture base
~ continuouse denture wearing w/o relief for tissues
~ pt self treatment w/ over the counter products for relining

Front 56

Localized inflammation (sore spots) appear as isolated red, inflamed areas sometimes ulcerated. What are the contributing factors to these sore spots??

Back 56

Contributing factors to localized inflammation (sore spots)
~ trauma from an ill-fitting denture, a rough spot on a denture, a tongue bite, or foreign object under denture

Front 57

Generalized inflammation, Candida albican infection...
Oral Candidiasis in the form of ___ is a reoccurring disease common to denture wearers & may be characterized by...
~ generalized redness, inflamed mucosa of tissue that support the denture
~ burning sensation
~discomfort
~unpleasant taste

Back 57

DENTURE STOMATITIS
reoccurring disease common to denture wearers & may be characterized by...
~ generalized redness, inflamed mucosa of tissue that support the denture
~ burning sensation
~discomfort
~unpleasant taste

Front 58

What are some etiology factors of Candida albicans (generalized inflammation) infection? (5)

Back 58

Etiology factors for candida albicans (generalized inflammation)
~ trauma from ill fitting, usually maxillary dentures
~ continous denture wearing
~ reduced salivary flow
~ lack of denture cleanliness
~ Aging dentures have surface texture favorable to attachment to biofilm

Front 59

Patients that have a depressed immune system, history of head & neck radiation therapy, and antibiotic use are more prone too ____

Back 59

Candida albicans

Front 60

___ is located on the palate and appear as a group of closely arrange, pebble shaped, red, edematous projections. Contributing factors for this are associated with poor denture hygiene, ill fitting dentures, and possibly candida albicans infection

Back 60

Papillary hyperplasia
-located on the palate and appear as a group of closely arrange, pebble shaped, red, edematous projections. Contributing factors for this are associated with poor denture hygiene, ill fitting dentures, and possibly candida albicans infection

Front 61

___ is long standing chronic inflammatory tissue that appears in single or multiple elongated folds related to the border of an ill- fitting denture.

Back 61

Denture irritation Hyperplasia (Epulis Fissuratum)
-long standing chronic inflammatory tissue that appears in single or multiple elongated folds related to the border of an ill- fitting denture.

Front 62

__ appears as fissuring at the angles of the mouth w/ cracks, ulcerations, and erythema. Contributing factors includelack of support of commissure bc of overclosure from loss of vertical dimesnsion of occlusion & by moistness from drooling or a riboflavin deficiency

Back 62

Angular Cheilitis
- appears as fissuring at the angles of the mouth w/ cracks, ulcerations, and erythema.

Front 63

Prevention for denture induce oral lesions include (6)

Back 63

Prevention for denture induce oral lesion include...
~ proper denture hygien
~ rest for the tissues
~ proper diet & nutrition
~ Relief from xerostomia
~ dental caries control for overdenture wearers

Front 64

frequency of maintance appointments for denture wearers is determined by individual needs & risk factors.
Low risk pt = ___ months
Moderate risk= __ months
high risk= ___ months

Back 64

Low risk = 6-12 months
Moderate risk= 6 months
High risk = 3-6 months

Front 65

Classification of clefts:
__ cleft on the tip of uvula
__cleft of the uvula (bifid uvula)
__ cleft of soft palate
__ cleft of soft & hard palate
__ cleft of soft & hard palates that continues through alveolar ridge on one sideof premaxilla
__ cleft of soft & hard palate that continues through alveolar ridge on both sides leaving a free premaxilla
__ submucous cleft in which the muscle union is imperfect across the soft palate.

Back 65

Classification of clefts:
CLASS 1 cleft on the tip of uvula
CLASS 2 cleft of the uvula (bifid uvula)
CLASS 3 cleft of soft palate
CLASS 4 cleft of soft & hard palate
CLASS 5 cleft of soft & hard palates that continues through alveolar ridge on one sideof premaxilla
CLASS 6 cleft of soft & hard palate that continues through alveolar ridge on both sides leaving a free premaxilla
CLASS 7submucous cleft in which the muscle union is imperfect across the soft palate.

Front 66

___ happens when there is a failure of normal fusion of the embryonic processes during development.
~ this occurs during 1st trimester

Back 66

Cleft lip & palate
- happens when there is a failure of normal fusion of the embryonic processes during development.
~ this occurs during 1st trimester

Front 67

Formation of the lip occurs _ to __ week.
~ Cleft lip is evident by the end of the 2nd month in utero
Development of the palate occurs __ to __ week.
- cleft lip or palates occur in somewhere between 1-600 and 1-800 births.

Back 67

Formation of the lip occurs _4 to __7 week.
~ Cleft lip is evident by the end of the 2nd month in utero
Development of the palate occurs 8 to 12 week.

Front 68

__ is the result of the failure of the globular process and the maxillary process. Can be bilateral or unilateral. It is usually later to the midline. Can extend into one nostril or both.

Back 68

CLEFT LIP
the result of the failure of the globular process and the maxillary process.

Front 69

___ is caused by the failure of the palatal shelves to fuse. This may extend to connect w/ unilated or bilateral cleft lip. Congenital fissure in the palate.

Back 69

CLEFT PALATE
- caused by the failure of the palatal shelves to fuse

Front 70

What are some of the risk factors for cleft lip or palate?
(6)
early in 1st trimester is the significant time for influence due to the environmental factors

Back 70

Risk factors:
~ Genetic
~ Environmental....
-use of tobacco
- alcohol consumption
- teratogenic agents: vitamin A, phenytoin, steroids, drug abuse
- Inadequate diet: vitamins especially folic acid deficiency
- lact of prenatal care

Front 71

What are some of the Oral characteristics associated w/ cleft lip & palate?

Back 71

oral characteristics associated w/ cleft lip & palate
~ tooth development- missing teeth
~ malocclusion- require ortho care
~ Open palate- provides direct communicate w/ nasal cavity, cleft lip make difficult for child to suck, may cause formula/ milk to pass into nasal cavity
~ Muscle coordination is lacking of the lips, tongue, cheeks, floor of mouth, and throat may exist
~ Periodontal tissue- biofilm accumulation is greater esp around cleft area& loss of bone & attachment at cleft site is common
~ Dental Caries- @ higher risk

Front 72

What are some of the general physical characteristics of cleft lip and palate? (6)

Back 72

General physical characteristics cleft lip/palate:
1. Other congenital anomalies
2. Facial deformities
3. infections- predisposition to upper respiratory & middle ear infections.
4. Airway & breathing
5. Speech difficulties
6. Hearing loss common

Front 73

What are (2) personal factors that tend to affect a child/ person with cleft lip or palate

Back 73

Personal factors
~ pt tends to be more self consciousness
~ pt has feelings of inferiority

Front 74

What is the purpose for early treatment with the cleft lip?

Back 74

Purpose for early tx w/ cleft lip:
~ Aid in feeding
~ Encourage development of the premaxilla
~ Help partial closure of the palatal cleft
~ Lessen concern of family about appearance of their infant

Front 75

Primary surgery to close the palate of a pt w/ cleft palate should occur by __ months or earlier when possible.

Back 75

Primary surgery for cleft palate should take place by 18 months

Front 76

What are the goals for treatment of the cleft palate? (5)

Back 76

Goals for treatment Cleft palate
~ produce anatomic closure
~ maximize maxillary growth & development
~ achieve normal function, particularly normal speech
~relieve problems of airway & breathing
~ Establish good dental esthetics & functional occlusion

Front 77

Surgical procedures for cleft palate:
-Secondary procedures may involve lip,nose,palate,jaws
- Bone grafting is used to repair residual alveolar& hard palate clefts. Sources for autogenous bone for graft include __, __, __

Back 77

Sources for autogenous bone for graft: Rib, iliac crest, skull, or mandible
~Osseointegrant implant are used to replace missing teeth or to support prosthetics

Front 78

Types of prosthodontic appliances used in cleft pt:
~ ___ is a removable prosthesis that may be designed to provide closure of the palatal opening
~___ a removable appliance to complete the palatopharyngeal valving required for speech

Back 78

OBTURATOR a removable prosthesis that may be designed to provide closure of the palatal opening
SPEECH AID PROSTHESIS a removable appliance to complete the palatopharyngeal valving required for speech

Front 79

What are the purposes and functions of a prosthesis for pt w/ a cleft lip or palate? (6)

Back 79

Purpose/ functions prosthesis used for cleft lip/ palate
~ closure of palate
~ replacement of missing teeth
~ scaffolding to fill out the upper lip
~ masticatory function
~ restore vertical dimension
~ postorthodontic retainer

Front 80

___ is a physical or mental impairment that substantially limits one or more major life activities (Americans w/ disabilities Act)

Back 80

DISABILITY
a physical or mental impairment that substantially limits one or more major life activities (Americans w/ disabilities Act)

Front 81

___ is abnormality of structure or function of a limb or organ
___ is a disadvantage or limitation of an individual compared to others at similar station in his/her life

Back 81

IMPAIRMENT is abnormality of structure or function of a limb or organ
HANDICAP is a disadvantage or limitation of an individual compared to others at similar station in his/her life

Front 82

~ 1 in 5 people are affected by a disability
~ Medicine has increased life span
~ the older we become, the more likely that we will develop some type of disability
**What are the 7 classifications of disabilities??

Back 82

Classifications of Disabilities
1. Developmental (mental retardation, CP, Epilepsy, Autism)
2. Sensory impairment
3. Orthopedic Disorders
4. Medical disabilities
5. Cognitive Impairments/ Mental illness
6. Degenerative Nervous System Disorders
7. Communication disorders

Front 83

___ is popular rehabilitation trend and is returning patient home & community as quickly as possible after treatment rather than housing them permanently or for long periods in custodial institutions; the elimination of mental health institutions

Back 83

Deinstitutionalization
~ popular rehabilitation trend and is returning patient home & community as quickly as possible after treatment rather than housing them permanently or for long periods in custodial institutions; the elimination of mental health institutions

Front 84

__ is popular rehabilitation trend is it integration of people w/ disabilities into their community through programs of rehabilitation; process by which persons w/ special needs (educational, physical, psychologic) are included within the mainstream of society rather than segregated

Back 84

MAINSTREAMING
~ integration of people w/ disabilities into their community through programs of rehabilitation; process by which persons w/ special needs (educational, physical, psychologic) are included within the mainstream of society rather than segregated

Front 85

A person with disabilities may reveive __ & __ counseling, medical and dental services, and work placement. Specially staffed community housing for group living is available.

Back 85

A person with disabilities may reveive __Vocational & __Educational counseling, medical and dental services, and work placement. Specially staffed community housing for group living is available.

Front 86

ADL functional levels
~ level 1 =
~ level 2=
~ level 3=
~ level 4=

Back 86

ADL LEVELS
~ Level 1 = near normal function
~ level 2= stimulation of normal function w/ equipment, meds or methods
~ level 3= stimulation w/ normal function w/ aid of 3rd party
~ level 4= stimulation of normal function not possible

Front 87

What is the objectives for dental and dental hygiene care w/ a pt with a disability?

Back 87

Objectives for dental & hygiene care:
- motivate pt and caregiver
- contribute to pt general health through oral health
- prevention
- improve appearance through care
- make appointments comfortable experiences

Front 88

Oral manifestation associated w/ disabilities?? (5)

Back 88

Oral Manifestations associated w/ disabilities
~ congenital malformations- cleft lip or palate,malformed jaws or malposed teeth
~ Oral injuries: attrition, trauma from accidents
~ facial weakness or paralysis-a pt w/ this bilaterl mastication may not be possible biofilm collects heavier
~ Malocclusion
~Drug therapy related to oral findings
- a pt could have drug induced gingival overgrowth due to drugs like dilantin, ect
- Chemotherapy
- radiation therapy xerostomia may result
- other medications that can have side effect to alter oral cavity

Front 89

In order to creat a dental hygiene care plan you must know the pt functioning levels...
High= ___
Moderate= ___
Low= ___

Back 89

Functioning levels
High= capable of self care
Moderate= capable of partial care w/ assistance
Low= not capable of self care

Front 90

What are the causes of spinal cord dysfunction? (6 )

Back 90

Causes for spinal cord dysfunction:
~Trauma
~Neoplasm
~Viral or bacterial infections
~Progressive degenerative disorders
~Vascular accidents
~compression from arthritic spur
~Congenital anomalies or deformities

Front 91

At least one half of the trauma cases result from ___ other causes are falls, diving accidents, and violence…the majority of patients are teenage or young adult men.

Back 91

At least one half of the trauma cases result from ~ Motor vehicle accidents~ other causes are falls, diving accidents, and violence…the majority of patients are teenage or young adult men.

Front 92

The patient with a spinal cord injury will have total or partial loss of __, __, __ below the level of injury.

Back 92

The patient with a spinal cord injury will have total or partial loss of **sensory, motor, and autonomic function below the level of injury.

Front 93

There are 17 Cervical Vertebra (C) __ Thoracic
__ Lumbar

Back 93

There are 7 Cervical Vertebra (C) 12 Thoracic
5 Lumbar

Front 94

Spinal Cord Injury
~ C 2-3 injury is usually __
~ Involvement above C-4: usually has ___ and __
~ C-5 partial function of __ & __
~ C-6 partial function of the __,___,__
~ C-7 function of __,__, __
~ C-8 Normal arm function, and ___ weakness

Back 94

Spinal Cord Injury
~ C 2-3 injury is usually rapidly fatal
~ Involvement above C-4: respiratory difficulty and paralysis of all 4 extremities
~C-5 partial function of shoulder and elbow
~ C-6 partial function of the shoulder, elbow, and wrist.
~ C-7 function of shoulder elbow and wrist, and partial function of hand
~ C-8 Normal arm function, hand weakness

Front 95

Spinal Cord Injury:
___ Wheelchair; walk with braces
___ and below Wheelchair not essential
A ____ lesion – a complete transection or compression of the spinal cord leaves no sensation or motor function below the level of the lesion
An ____ lesion may leave some evidence of sensation or motor function below the level of the lesion.

Back 95

Spinal Cord Injury
~ T-1-T-10 Wheelchair; walk with braces
~ T-11 and below Wheelchair not essential
~A “complete” lesion – a complete transection or compression of the spinal cord leaves no sensation or motor function below the level of the lesion
~An “incomplete” lesion may leave some evidence of sensation or motor function below the level of the lesion.