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DH 2 > Substance Abuse > Flashcards

Substance Abuse Flashcards

1
Q

What is tobacco?

A
  • Toxic to humans; nicotine naturally occurring
  • Depletes nutrients and absorbs chemicals from soil
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2
Q

What are some different forms of tobacco?

A
  • Smokeless tobacco
  • Electronic nicotine delivery systems (ENDS)
  • Waterpipes (hookah)
  • Dissolvable and gel tobacco forms
  • Not safe substitute
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3
Q

What is the risk for tobacco in the systemic health?

A

Causes cancer throughout the body

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4
Q

What are some oral manifestations of tobacco use

A

Pale pink, fibrotic gingiva
Halitosis
Leukoplakia
Stomatitis
Sialometaplasia
Periodontitis
Increased rate, severity, CAL,
bone loss, probing depths
Tooth loss
Delayed healing
Implant failure risk
Squamous cell carcinoma
Oral and pharyngeal cancer risk

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5
Q

Oral Manifestations of
Smokeless Tobacco Use

A

Leukoplakia
Nicotine stomatitis
Smoker’s melanosis
Hairy tongue
Periodontitis
Implant failure risk
Necrotizing gingivitis
halitosis

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6
Q

Medical Treatment Strategies

A

Self-help:Cold turkey, gradual decrease, ENDS substitute, OTC nicotine-replacement
Assisted interventions by HCP

FDA approved pharmacotherapies
Chantix, Wellbutrin

Counseling
Acupuncture, hypnotherapy
Nicotine replacement therapy

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7
Q

What are the dental management for

A

Review MH for tobacco
use history

Type of product? How
often used? How long?
Tried other forms?

Ask if interested in
quitting.
* If not, discontinue conversation
* Educate about oral effects
* You are a resource for
cessation services.

Conduct a thorough
IO/EO for signs of
tobacco use

Evaluate for increased
stain, calculus, caries,
inflammation, signs of
periodontal problems

NSPT: Jeopardizes
healing, lessened
outcomes of treatment,
cessation improves
results

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8
Q

What is the motivational interviewing ?

A
  • Resist
  • Understant
  • Listen
  • Empower
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9
Q

What are the 5A’s and R’s?

A

A- Ask, Advise, Asist, Assess, Arrange
R- Repition, Relevance, Risks, Rewards , Roadblocks

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10
Q

What are the causes of alcohol abuse?

A
  • Genetics: GABRA2 and CHRMS2 (genes)
  • Biopsychosocial: (children of alcohol dependednt parents)
  • Environmental
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11
Q

What are the signs of Alcohol abuse?

A

Craving
Loss of control
Tolerance
Physical dependence

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12
Q

What are stages of alcohol metabolism?

A
  • First: ingestion and absorption
  • Second: Liver metabolism
  • Third: Diffusion
    Metabolized more slowly than absorbed: Rate dependent on: age, gender, adipose (fatty) tissue, food ingestion
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13
Q

What are some health hazards

A

Wernicke-Korsakoff’s Syndrome
Brain disorder of cerebellum: thiamine deficienc

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14
Q

What are some medical management:

A
  • Abstinence
  • Detoxification management
  • Pharmacotherapy: anticonvulsant, alcohol-sensitizing agents, anticraving agents (naltrexone, acamprosate)
  • Rehabilitation
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15
Q

What is dental management for alcholol abuse?

A

Health history / Screening
Medications?
Other intervention or treatment program?
Referral

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16
Q

Oral Manifestations of Alcohol Use & Abuse

A

Breath and body odor of alcohol and of tobacco
Skin: Redness of forehead, cheeks, nose petechiae
Face color: Light yellowish brown → jaundice
Eyes: Red, baggy eyes or puffy facial features
Evidence of trauma
Angular cheilitis
Swollen parotid glands
Tremor of hands, tongue, eyelids

17
Q

What are some considerations for any drug use?

A

Drug use varies from recreational use to addiction
Daily drug use varies = questioning at each appointment
No classic cultural, socioeconomic, or educational profile for
a substance abuser
Chemical dependency = illness

18
Q

What is the clinical presentations for marijuana?

A

Clincial Presenstation

Altered sense of time and distance
perception; anxiety, paranoia, delusions

Dental Management
* ID signs and symptoms of use
* Postpone treatment if used by a patient
with ischemia or heart failure
* Refer to physician

19
Q

What are the clinical presentation opioids?

A

Euphoria, decreased pain perception, sedation,
orthostatic hypotension
* Overdose
* slow, shallow respirations, bradycardia, lowered
body temperature, unresponsiveness
* Withdrawal
* GI upset, muscle cramps, rhinorrhea, irritability

20
Q

What are the medical and dental management for opioids?

A

Administer Narcan to reverse effects of overdose
Dental: identify drug-seeking behavior

21
Q

What are the clinical presentation for cocaine?

A

Sense of well-being, heightened awareness, anorexia,
needing less sleep, restlessness, elation, agitation, panic,
paranoia, hallucinations and delusions, euphoria,
heightened sexual desire, tachycardia, arrhythmias, HBP,
chills, nausea, vomiting, visual needle tracks
*Overdose
*MI, arrhythmia, CVA, respiratory arrest, depression

22
Q

What are the Medical and Dental management for cocaine ?

A

Increased risk for Hep B, Hep C, HIV, if injected.

Dental Management
No anesthesia with epinephrine for at least 6 hrs. after use

23
Q

What are the clinical presentation Methamphetamines

A

Same as cocaine use; violent
behavior; hyperactivity, increased
physical endurance
* Cessation Symptoms
* Depression, sleepiness, or difficulty
sleeping

24
Q

what are the dental management about methamphetamines ?

A

No dental treatment for patients who
are high

25
Q

What are the clincial presentation during withdrawal of sedative hypnotics?

A

Nausea, vomiting, weakness,
tachycardia, sweating,
orthostatic hypotension, tremor,
loss of appetite, weight loss,
tinnitus, delirium, hallucinations

26
Q

What are the dental management sedative hypnotics ?

A

Do not treat if patient is not
awake asunable to provide
consent

27
Q

What are the dental management sedative hypnotics

A

Requires aggressive approach to
prevention and treatment of dental
disease
Diets include foods that increase risk
for dental disease

Considerations:
OHI
Timing of procedures
Positive communication
Appropriate pain control
Consult with physician regarding
management of condition

28
Q

What are extraoral presentations?

A

Eyes
Arms

29
Q

What are some Oral Manifestations

A

Caries
Recession
Xerostomia
Tongue coated;
glossitis
Heavy calculus
deposits
Moderate to severe
inflammation
Increased bleeding
Periodontal
infections
Chipped, fractured
teeth
Stained teeth
Attrition
Erosion

30
Q

What are the oral manifestation marijuana?

A
  • Pre-malignant lesions
  • Periodontal infection
  • Leukoplakia
31
Q

What are the oral manifestation Ecstasy?

A

Xerostomia
Attrition
TMJ pain
Rampant caries

32
Q

What are the oral manifestations of cocaine?

A

Perforation
Gingival recession
Erosive caries

33
Q

What are the oral manifestations for meth mouth?

A

Severe cervical
Caries
Rampant caries
Periodontal infection

DH 2 (21 decks)

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