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31 Cards in this Set
- Front
- Back
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Define the following term:
Bacteremia - |
- the presence of bacteria in the circulation, which can be transferred to distant sites within the body
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Define the following term:
Immunosuppression – |
- a reduced immune response resulting in reduced healing and increased risk of infection
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Define the following term:
Innocuous - |
- harmless
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Explain the reason for placing safety glasses on clients during treatment.
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● Safety glasses are used to protect the eyes from aerosols and spatter during oral procedures.
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Describe the recommended regimen for antibiotic prophylaxis prior to dental treatment for the client who is 18 months post hip joint replacement.
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● According to the ADA and AAOS guidelines, there is no scientific evidence to support the routine use of antibiotic premedication in patients with prosthetic knee implants. Therefore, prophylactic antibiotics are not recommended for this patient.
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List the characteristics for diagnosis of ARONJ.
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● The characteristics to be diagnosed with ARONJ include:
○ the client is currently receiving or has received BIS in the past ○ exposed bone that has persisted for more than 8 weeks is present ○ and there is no history of radiation therapy to the jaws |
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Define the following term:
Anaphylactic shock – |
- a severe and sometimes fatal allergic reaction characterized by respiratory distress and cardiovascular collapse
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Define the following term:
Hypersensitivity reaction – |
- an abnormal condition characterized by an excessive reaction to a particular stimulus such as allergy.
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Define the following term:
Sensitization – |
- an acquired reaction in which specific antibodies develop in response to an antigen.
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List the signs of a mild allergic reaction and the signs of a severe allergic reaction.
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● Signs of a mild allergy include skin rash, erythema, hives, and urticarial.
● Signs of a severe allergic reaction include bronchiolar constriction, asphyxiation, reduction of blood pressure, and cardiovascular collapse. |
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If a client reports that she is allergic to local anesthesia, what follow-up questions should YOU ask?
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● Follow-up questions should include "Which LA caused your reaction? What were your symptoms?"
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Identify at least five items of the dental armamentarium that can cause a latex allergy.
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● Items in the dental office chat can cause a latex allergy include:
○ rubber tubing ○ stethoscope ○ blood pressure cuff ○ gloves ○ latex barriers ○ elastic on face masks ○ rubber polishing cups ○ and rubber dam material. |
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Case Study A:
Mr. Gibson, a 60-year-old client in good health, presents for a routine oral prophylaxis. He reports that 3 months ago he underwent a right knee total joint replacement (TJR). The client states that he is feel ing terrific and is able to resume golfing and walking activities. His vital signs are pulse 74 bpm, respiration 16 breaths/min, blood pressure 120/70 mm Hg, right arm, sit ting. Is the client considered at risk for infection during oral health care? |
● The client is not considered to be at risk for infection. According to the ADA/AAOS, there is no scientific evidence that indicates this patient is at an increased risk of PJI.
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Case Study A:
Mr. Gibson, a 60-year-old client in good health, presents for a routine oral prophylaxis. He reports that 3 months ago he underwent a right knee total joint replacement (TJR). The client states that he is feel ing terrific and is able to resume golfing and walking activities. His vital signs are pulse 74 bpm, respiration 16 breaths/min, blood pressure 120/70 mm Hg, right arm, sit ting. Is prophylactic antibiotic therapy recommended for this client? |
● The client is not considered to be at risk for infection. According to the ADA/AAOS, there is no scientific evidence that indicates this patient is at an increased risk of PJI.
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Case Study A:
Mr. Gibson, a 60-year-old client in good health, presents for a routine oral prophylaxis. He reports that 3 months ago he underwent a right knee total joint replacement (TJR). The client states that he is feel ing terrific and is able to resume golfing and walking activities. His vital signs are pulse 74 bpm, respiration 16 breaths/min, blood pressure 120/70 mm Hg, right arm, sit ting. If the client had a history of hemophilia, would antibiotic prophylaxis be indicated? If so, |
● Consult with orthopedic surgeon and share new guidelines; discuss benefits and risks of prophylactic antibiotics; record recommendation of the orthopedic surgeon in the client's chart; discuss with client recommendation and inform client of scientific evidence; reach final decision and note it in client's chart.
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Case Study A:
Mr. Gibson, a 60-year-old client in good health, presents for a routine oral prophylaxis. He reports that 3 months ago he underwent a right knee total joint replacement (TJR). The client states that he is feel ing terrific and is able to resume golfing and walking activities. His vital signs are pulse 74 bpm, respiration 16 breaths/min, blood pressure 120/70 mm Hg, right arm, sit ting. If Mr. Gibson stated that his orthopedic surgeon recommended he have antibiotic premedication prior to dental or dental hygiene treatment, what steps would you take to address his concern? |
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Case Study B:
Olivia Rosenfeld presents for a dental examination. She is a 59-year-old client who has a medical history of osteoporosis. Treatment for this condition has consisted of weekly oral doses of Fosamax over a 3-year period of time. Her yearly dexa scan has shown improvement with her status changing from profound osteoporosis to osteopenia. Mrs. Rosenfeld has no oral complaints or other significant health concerns. Her vital signs are pulse 80 bpm, respiration 18 breaths/min, and blood pressure 110/60 mm Hg, right arm, sitting. 1. What other aspect of the medical history would you review to determine other risk factors for ONJ? |
● A history of corticosteroid therapy, chemotherapy, diabetes mellitus, smoking, alcohol, and poor oral hygiene are other risk factors that may be associated with ONJ.
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Case Study B:
Olivia Rosenfeld presents for a dental examination. She is a 59-year-old client who has a medical history of osteoporosis. Treatment for this condition has consisted of weekly oral doses of Fosamax over a 3-year period of time. Her yearly dexa scan has shown improvement with her status changing from profound osteoporosis to osteopenia. Mrs. Rosenfeld has no oral complaints or other significant health concerns. Her vital signs are pulse 80 bpm, respiration 18 breaths/min, and blood pressure 110/60 mm Hg, right arm, sitting. pon examination, the dentist recommends that the client have an erupted wisdom tooth extracted. Should treatment be delayed? |
● There is no evidence that delaying therapy will reduce the risk of ARONJ.
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Case Study B:
Olivia Rosenfeld presents for a dental examination. She is a 59-year-old client who has a medical history of osteoporosis. Treatment for this condition has consisted of weekly oral doses of Fosamax over a 3-year period of time. Her yearly dexa scan has shown improvement with her status changing from profound osteoporosis to osteopenia. Mrs. Rosenfeld has no oral complaints or other significant health concerns. Her vital signs are pulse 80 bpm, respiration 18 breaths/min, and blood pressure 110/60 mm Hg, right arm, sitting. If this client did develop ARONJ, what treatment options are available? |
● Recommend the client co maintain meticulous oral health and have regular oral examinations to identify any disease early. The goal is to avoid the need for surgery.
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Case Study C:
A female child, 9 years of age, presented for dental treatment. The chief complaint was "my back tooth hurts." The child had never been to a dentist. Medical history was noncontributory except for allergy to tomatoes, strawberries, seafood, and erythromycin antibiotics. When asked whether the child had received any local anesthetic (LA) drugs, the mother said the child had never had a dental anesthetic before. Oral examination revealed a large carious lesion in tooth number 30; radiographs revealed no evidence of loss of tooth vitality. To be safe the dentist selected lidocaine for local anesthesia. Within minutes after the injection, the dental assistant noticed erythema on one side of the child's face, and the child seemed anxious and reported difficulty breathing. It was clear that immediate medical intervention was necessary. 1. What was the most likely source for the child's symptoms? |
● The child appears to be allergic to lidocaine
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Case Study C:
A female child, 9 years of age, presented for dental treatment. The chief complaint was "my back tooth hurts." The child had never been to a dentist. Medical history was noncontributory except for allergy to tomatoes, strawberries, seafood, and erythromycin antibiotics. When asked whether the child had received any local anesthetic (LA) drugs, the mother said the child had never had a dental anesthetic before. Oral examination revealed a large carious lesion in tooth number 30; radiographs revealed no evidence of loss of tooth vitality. To be safe the dentist selected lidocaine for local anesthesia. Within minutes after the injection, the dental assistant noticed erythema on one side of the child's face, and the child seemed anxious and reported difficulty breathing. It was clear that immediate medical intervention was necessary. What type of allergic reaction does this case represent? |
● This allergic reaction represents a type I reaction.
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Case Study C:
A female child, 9 years of age, presented for dental treatment. The chief complaint was "my back tooth hurts." The child had never been to a dentist. Medical history was noncontributory except for allergy to tomatoes, strawberries, seafood, and erythromycin antibiotics. When asked whether the child had received any local anesthetic (LA) drugs, the mother said the child had never had a dental anesthetic before. Oral examination revealed a large carious lesion in tooth number 30; radiographs revealed no evidence of loss of tooth vitality. To be safe the dentist selected lidocaine for local anesthesia. Within minutes after the injection, the dental assistant noticed erythema on one side of the child's face, and the child seemed anxious and reported difficulty breathing. It was clear that immediate medical intervention was necessary. What management strategies should be used to treat this adverse reaction? |
● The dentist should inject epinephrine sublingually while the dental assistant activates 9 11 office emergency protocol.
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Case Study C:
A female child, 9 years of age, presented for dental treatment. The chief complaint was "my back tooth hurts." The child had never been to a dentist. Medical history was noncontributory except for allergy to tomatoes, strawberries, seafood, and erythromycin antibiotics. When asked whether the child had received any local anesthetic (LA) drugs, the mother said the child had never had a dental anesthetic before. Oral examination revealed a large carious lesion in tooth number 30; radiographs revealed no evidence of loss of tooth vitality. To be safe the dentist selected lidocaine for local anesthesia. Within minutes after the injection, the dental assistant noticed erythema on one side of the child's face, and the child seemed anxious and reported difficulty breathing. It was clear that immediate medical intervention was necessary. What management strategies should be used to prevent this allergic reaction from recurring in the dental office setting? |
● Record the event in the clinical record, place information regarding possible lidocaine allergy on the front of the health history, and avoid using lidocaine at future appointments. As there is no cross-sensitivity among the amide group of LA, the child should be sent for immunologic evaluation to determine whether one of the ocher LA in the amide group can be used.
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Case Study C:
A female child, 9 years of age, presented for dental treatment. The chief complaint was "my back tooth hurts." The child had never been to a dentist. Medical history was noncontributory except for allergy to tomatoes, strawberries, seafood, and erythromycin antibiotics. When asked whether the child had received any local anesthetic (LA) drugs, the mother said the child had never had a dental anesthetic before. Oral examination revealed a large carious lesion in tooth number 30; radiographs revealed no evidence of loss of tooth vitality. To be safe the dentist selected lidocaine for local anesthesia. Within minutes after the injection, the dental assistant noticed erythema on one side of the child's face, and the child seemed anxious and reported difficulty breathing. It was clear that immediate medical intervention was necessary. If the client reported that she felt sick to her stomach, should this be considered part of an allergic reaction? |
● Nausea is typically NOT a sign of an allergic reaction. It is usually a side effect of medication. In this case, it may also be related to anxiety.
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Case Study D:
A 49-year-old woman presents for a dental hygiene continuing care appointment. The client relates a chief complaint of recent onset of soreness and ulceration of her mouth. Examination reveals multiple small ulcers of the buccal mucosa and a sloughing of the gingiva. The dental hygienist questioned the client regarding changes in oral products used, and the client indicated that she recently switched toothpastes to a new tartar control brand. 1. What is the name for the oral condition described in the examination? |
● The name of this condition is contact stomatitis.
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Case Study D:
A 49-year-old woman presents for a dental hygiene continuing care appointment. The client relates a chief complaint of recent onset of soreness and ulceration of her mouth. Examination reveals multiple small ulcers of the buccal mucosa and a sloughing of the gingiva. The dental hygienist questioned the client regarding changes in oral products used, and the client indicated that she recently switched toothpastes to a new tartar control brand. What is the most likely cause of this condition? |
● The most likely cause of this contact stomatitis is use of the new toothpaste.
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Case Study D:
A 49-year-old woman presents for a dental hygiene continuing care appointment. The client relates a chief complaint of recent onset of soreness and ulceration of her mouth. Examination reveals multiple small ulcers of the buccal mucosa and a sloughing of the gingiva. The dental hygienist questioned the client regarding changes in oral products used, and the client indicated that she recently switched toothpastes to a new tartar control brand. What management strategies would be recommended for this client? |
● Discontinue the use of the new toothpaste product and record findings in the dental record for future reference.
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Case Study E:
Mr. Saxton, a 65-year-old client in good health, presents for a routine oral prophylaxis. He reports that 3 months ago he underwent a right knee TJR. The client states that he is feeling terrific and is able to resume golfing and walking activities. His vital signals are pulse 74 bpm, respiration 16 breaths/min, blood pressure 120/70 mm Hg, right arm, sitting. 1. Is the client considered a risk for infection during oral healthcare? |
● Given the time frame of the TJR, the client is at increased risk of hematogeneous joint infection.
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Case Study E:
Mr. Saxton, a 65-year-old client in good health, presents for a routine oral prophylaxis. He reports that 3 months ago he underwent a right knee TJR. The client states that he is feeling terrific and is able to resume golfing and walking activities. His vital signals are pulse 74 bpm, respiration 16 breaths/min, blood pressure 120/70 mm Hg, right arm, sitting. Is prophylactic antibiotic therapy recommended for this client? |
● Prophylactic antibiotic therapy is recommended for this client.
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Case Study E:
Mr. Saxton, a 65-year-old client in good health, presents for a routine oral prophylaxis. He reports that 3 months ago he underwent a right knee TJR. The client states that he is feeling terrific and is able to resume golfing and walking activities. His vital signals are pulse 74 bpm, respiration 16 breaths/min, blood pressure 120/70 mm Hg, right arm, sitting. If the client is not allergic to penicillin, what regimen would you recommend before proceeding with oral healthcare? |
● Cephalexin, cephradine, or amoxicillin 2g orally 1 hour before the oral healthcare procedure is recommended.
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Case Study E:
Mr. Saxton, a 65-year-old client in good health, presents for a routine oral prophylaxis. He reports that 3 months ago he underwent a right knee TJR. The client states that he is feeling terrific and is able to resume golfing and walking activities. His vital signals are pulse 74 bpm, respiration 16 breaths/min, blood pressure 120/70 mm Hg, right arm, sitting. If the client had a history of hemophilia, why would antibiotic prophylaxis be indicated? |
● Antibiotic prophylaxis is recommended in the client with hemophilia to prevent bacteremia from entering the join space and causing infection.
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