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24 Cards in this Set
- Front
- Back
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Describe Five aspects that must be considered when treating an individual who abuses recreational drugs.
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● Aspects that must be considered when treating an individual who abuses recreational drugs include:
○ medical consultation ○ client instruction regarding refraining from use of drugs before dental or dental hygiene appointments ○ use of non-narcotic pain medications for postoperative pain management ○ monitoring of bleeding time during treatment ○ and management of increased dental caries. |
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Describe management considerations and recommendations for support for the client who asks for assistance in quitting smoking.
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● A smoking cessation protocol should include three steps:
○ Ask ○ Advise ○ and Refer. ● Recommending use of a tobacco quit-line and providing follow-up support is helpful for achieving success. |
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List three issues that must be considered when rendering treatment to an individual with alcohol abuse.
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● Issues related to treating individuals with a history of alcohol abuse vary and may include any of the following:
○ nutritional deficiency ○ increased oral disease ○ liver dysfunction ○ increased bleeding and liver disease ○ behavior management ○ oral manifestations of alcohol abuse ○ oral care product selection ○ and tobacco and alcohol use. |
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Define the following term:
Parturition - |
- the act of giving birth to a child.
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Define the following term:
Teratogen - |
- refers to any drug capable of causing a birth defect in the fetus.
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Define the following term:
Valvulopathy - |
- a disorder of valve function causing a variety of cardiac disorders.
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Identify four side effects of birth control and hormone replacement medications that are relevant for oral health care.
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● Side effects of birth control and hormone replacement therapy relevant for oral health care include increased blood pressure, nausea, increased bleeding, and increased incidence of dry socket.
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What procedure can be used during treatment to prevent syncope in the pregnant woman who is in her third trimester?
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To prevent syncope in the pregnant woman, place a pillow under the client's right hip to displace the weight of the fetus to the left and away from the vena cava vein.
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List the indications for which antibiotic prophylaxis is no longer indicated.
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● Antibiotic prophylaxis is no longer indicated in the following conditions:
○ cardiac-native heart valve disease ○ prosthetic heart valve and pacemakers ○ hip, knee, and shoulder prosthetic joints ○ renal dialysis shunts ○ cerebrospinal fluid shunts ○ vascular grafts ○ immunosuppression secondary to cancer and cancer chemotherapy ○ systemic lupus erythematosus ○ and type 1 diabetes mellitus. |
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List the indications for which antibiotic Prophylaxis is still indicated.
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Antibiotic Prophylaxis is still indicated for:
○ Prosthetic heart valve ○ previous IE ○ heart murmur or valvulopathy that develops in a transplanted heart ○ congenital heart disease: unrepaired congenital malformations ○ repaired congenital defects for 6 months following surgery ○ and repaired congenital defects with residual defects. |
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Case Study A:
Mason Briggs, a 23-year-old client, presents to the office for restorative dental care involving a crown preparation. His medical history is significant for previous infective endocarditis (IE) and use of recreational drugs including marijuana and cocaine. The client states that he used marijuana last evening, because he was anxious about having a crown preparation and wanted to be calm for this appointment. He has not used cocaine within the past week. The client reports that he took his prescription of amoxicillin 1 hour before the dental appointment. His vital signs are pulse 68 bpm, respiration 14 breaths/min, and blood pressure 110no mm Hg, right arm, sitting. Why did the client take amoxicillin for the dental appointment? What dosage should the client have taken for this appointment? |
● With a history of infective endocarditis (IE), the client should take amoxicillin as a preventive agent.
● The client should have taken 2 g of amoxicillin 1 hour before the appointment. |
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Case Study A:
Mason Briggs, a 23-year-old client, presents to the office for restorative dental care involving a crown preparation. His medical history is significant for previous infective endocarditis (IE) and use of recreational drugs including marijuana and cocaine. The client states that he used marijuana last evening, because he was anxious about having a crown preparation and wanted to be calm for this appointment. He has not used cocaine within the past week. The client reports that he took his prescription of amoxicillin 1 hour before the dental appointment. His vital signs are pulse 68 bpm, respiration 14 breaths/min, and blood pressure 110no mm Hg, right arm, sitting. What potential risks exist for the client during a crown preparation given that he has recently used marijuana? |
● During a crown preparation, gingivae in the area are likely to bleed.
● The dentist may need to use a gingival retraction cord with epinephrine to stop the bleeding and improve the impression for the crown. ● For clients who recently used marijuana, there is the risk that the epinephrine in the retraction cord may enhance tachycardia and cause increased blood pressure. |
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Case Study A:
Mason Briggs, a 23-year-old client, presents to the office for restorative dental care involving a crown preparation. His medical history is significant for previous infective endocarditis (IE) and use of recreational drugs including marijuana and cocaine. The client states that he used marijuana last evening, because he was anxious about having a crown preparation and wanted to be calm for this appointment. He has not used cocaine within the past week. The client reports that he took his prescription of amoxicillin 1 hour before the dental appointment. His vital signs are pulse 68 bpm, respiration 14 breaths/min, and blood pressure 110no mm Hg, right arm, sitting. Given the client's medical history, should the dentist proceed with treatment? Why or why not? |
● It is recommended that treatment be postponed for at least I week for this client because he used marijuana the evening before the appointment. An alternative suggestion is for the dentist to use products that do not contain epinephrine or other vasoconstrictors.
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Case Study A:
Mason Briggs, a 23-year-old client, presents to the office for restorative dental care involving a crown preparation. His medical history is significant for previous infective endocarditis (IE) and use of recreational drugs including marijuana and cocaine. The client states that he used marijuana last evening, because he was anxious about having a crown preparation and wanted to be calm for this appointment. He has not used cocaine within the past week. The client reports that he took his prescription of amoxicillin 1 hour before the dental appointment. His vital signs are pulse 68 bpm, respiration 14 breaths/min, and blood pressure 110no mm Hg, right arm, sitting. If the dentist decided to postpone treatment until next week, what recommendations should be made concerning preparation for treatment? |
● Advise the client to refrain from using any recreational drugs before the dental appointment because epinephrine will need to be used as part of treatment and can cause significant cardiovascular effects.
● Also, because the client took amoxicillin for the scheduled appointment, the dentist should prescribe a different antibiotic for the next appointment. |
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Case Study B:
Joseph Morton, Ill, a 35-year-old client, presents for a routine prophylaxis. On entering the dental office, he appears somewhat disoriented, is staggering, and has alcohol on his breath. The dental hygienist inquires about his use of alcohol, and the client responds that he regularly drinks at least four or five vodka martinis at lunch and immediately after work, followed by several bottles of beer at home. The client reports that he had several martinis at lunch and just finished two beers before arriving for his evening appointment. His vital signs are pulse 80 bpm, respiration 18 breaths/min, and blood pressure 130/80 mm Hg, right arm, sitting. The dental hygienist proceeds to perform an oral examination. What types of clinical findings should the hygienist be looking for as part of the oral examination? |
● Clinical findings may include periodontal disease, increased dental caries, increased bleeding, candidiasis, xerostomia, and evidence of squamous cell carcinoma
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Case Study B:
Joseph Morton, Ill, a 35-year-old client, presents for a routine prophylaxis. On entering the dental office, he appears somewhat disoriented, is staggering, and has alcohol on his breath. The dental hygienist inquires about his use of alcohol, and the client responds that he regularly drinks at least four or five vodka martinis at lunch and immediately after work, followed by several bottles of beer at home. The client reports that he had several martinis at lunch and just finished two beers before arriving for his evening appointment. His vital signs are pulse 80 bpm, respiration 18 breaths/min, and blood pressure 130/80 mm Hg, right arm, sitting. The dental hygienist proceeds to perform an oral examination. During the course of the oral examination, the client repeatedly becomes argumentative and verbally abusive. What would you recommend concerning treatment for this client? |
● Recommend treatment be postponed until the client is sober.
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Case Study B:
Joseph Morton, Ill, a 35-year-old client, presents for a routine prophylaxis. On entering the dental office, he appears somewhat disoriented, is staggering, and has alcohol on his breath. The dental hygienist inquires about his use of alcohol, and the client responds that he regularly drinks at least four or five vodka martinis at lunch and immediately after work, followed by several bottles of beer at home. The client reports that he had several martinis at lunch and just finished two beers before arriving for his evening appointment. His vital signs are pulse 80 bpm, respiration 18 breaths/min, and blood pressure 130/80 mm Hg, right arm, sitting. The dental hygienist proceeds to perform an oral examination. If the dental hygienist were to perform a debridement procedure and the client complained of post-treatment pain and requested pain medication, what type of analgesic medication would be appropriate? |
● Non-narcotic analgesics such as acetaminophen are preferred. Aspirin or nonsteroidal anti-inflammatory drugs may be recommended depending on whether or not the client has any GI bleeding or ulcers. Narcotic medications are contraindicated.
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Case Study B:
Joseph Morton, Ill, a 35-year-old client, presents for a routine prophylaxis. On entering the dental office, he appears somewhat disoriented, is staggering, and has alcohol on his breath. The dental hygienist inquires about his use of alcohol, and the client responds that he regularly drinks at least four or five vodka martinis at lunch and immediately after work, followed by several bottles of beer at home. The client reports that he had several martinis at lunch and just finished two beers before arriving for his evening appointment. His vital signs are pulse 80 bpm, respiration 18 breaths/min, and blood pressure 130/80 mm Hg, right arm, sitting. The dental hygienist proceeds to perform an oral examination. If the client presented with alcohol abuse and a GI condition, which analgesic and maximum dosage should be recommended? |
● Acetaminophen, 4 g/day.
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Case Study C:
Regina Bergen, a 28-year-old client, presents for an emergency appointment as a result of pain associated with tooth number 29. The client is 8 months pregnant and in good health. Oral examination reveals a large carious lesion on the occlusal surface of number 29. Restorative treatment is planned. Her vital signs are pulse 80 bpm, respiration 18 breaths/min, and blood pressure 110/60 mm Hg, right arm, sitting. Which local anesthetic agent is considered safe for use during pregnancy? |
● Lidocaine is considered safe for use with pregnant clients.
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Case Study C:
Regina Bergen, a 28-year-old client, presents for an emergency appointment as a result of pain associated with tooth number 29. The client is 8 months pregnant and in good health. Oral examination reveals a large carious lesion on the occlusal surface of number 29. Restorative treatment is planned. Her vital signs are pulse 80 bpm, respiration 18 breaths/min, and blood pressure 110/60 mm Hg, right arm, sitting. Why would an NSAID be contraindicated for treatment of postoperative pain in this client? |
● NSAIDs delay parturition
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Case Study C:
Regina Bergen, a 28-year-old client, presents for an emergency appointment as a result of pain associated with tooth number 29. The client is 8 months pregnant and in good health. Oral examination reveals a large carious lesion on the occlusal surface of number 29. Restorative treatment is planned. Her vital signs are pulse 80 bpm, respiration 18 breaths/min, and blood pressure 110/60 mm Hg, right arm, sitting. Can radiographs be performed on this client? |
● Radiographs can be performed for this client, but only if deemed necessary (to determine the extent of the decay); a protective lead apron is used, and only the minimum number of radiographs should be taken.
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The client returns 3 months later with facial swelling and continued pain associated with tooth number 29. She reports having delivered a healthy baby boy. Oral and radiographic examination of number 29 is performed, and the client is diagnosed with a periapical abscess. The dentist prescribes an oral antibiotic and refers the client to an endodontist for further evaluation. Medical history update reveals the client is taking an oral contraceptive.
What specific recommendation would you make concerning antibiotic coverage and use of oral contraceptives? |
● Recommend that the client take antibiotics as prescribed until completed and that the client use a backup non-hormonal contraceptive method while raking the antibiotics and for 1 week after antibiotic therapy is completed.
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Case Study D:
Marjorie Logan, a 55-year-old woman, presents for a routine dental examination. She reports a history of hypertension and a pacemaker placed 3 years ago. She also reports a recent history of osteoporosis and hyperparathyroidism, for which she is being treated with calcium and prescription vitamin D. The client notes that she takes atenolol for her hypertension and feels well. She indicates that she exercises daily and can climb stairs without incident. Her vital signs include pulse 82 bpm, respiration 16 breath/min, and blood pressure 138/86 mm Hg, right arm. What prophylactic antibiotic regimen is recommended for this client? |
● According to the 2007 AHA guideline for prevention of IE, prophylactic antibiotic coverage is not recommended, given this client's medical history
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Case Study D:
Marjorie Logan, a 55-year-old woman, presents for a routine dental examination. She reports a history of hypertension and a pacemaker placed 3 years ago. She also reports a recent history of osteoporosis and hyperparathyroidism, for which she is being treated with calcium and prescription vitamin D. The client notes that she takes atenolol for her hypertension and feels well. She indicates that she exercises daily and can climb stairs without incident. Her vital signs include pulse 82 bpm, respiration 16 breath/min, and blood pressure 138/86 mm Hg, right arm. What are the initial signs of osteoporosis? In most cases, osteoporosis is asymptomatic for years. |
● Low back pain and fractures develop later in the course of the disease.
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