3 - Tx Prognosis Flashcards
(38 cards)
Except for emergencies, no dental treatment should be initiated until when?
A treatment plan has been established and accepted by the patient
When can a treatment and sequence of treatment be planned?
After a diagnosis and prognosis have been determined.
What is the Urgent Phase?
- It begins with a thorough review of the pt’s medical condition and history. This initial emergency appointment is to establish pt’s comfort and may include:
- Eliminate pain and or abscess
- Address emergency concern
What is the Control Phase?
- Control active pathological lesions
- Control general caries
- Control plaque and initial perio therapy
- Initiation of endo treatment
- Provisional restoration for esthetic and or functional reason
- Establish required VDO
- Initiation of ortho stabilization
- Initial tooth prep and provisional for diagnosis purposes
- Oral surgery procedures
- Establishing design for fixed/removable pros
What phase of treatment is to determine the response to our initial therapy before our definitive phase begins?
Re-Evaluation Phase
What’s the Definitive Phase?
- After re-assessing initial treatment, includes all therapies that restore function after pt’s disease has been controlled
- Fixed/removable pros
- Implant restoration
- Ortho
What’s the initial therapy for Gingivitis?
- Medical consult (if indicated)
- OHI
- Full-mouth scale and polish
- Re-eval 4-6 weeks
- Prophy every 6 months if resolved
What is the initial therapy for mild chronic periodontitis?
- Medical consult (if indicated)
- OHI
- Quadrant or half mouth SRP w/ anesthesia
- 2-4 appts
- Re-eval 4-6 weeks
- 3-4 month maintenance
What’s the initial therapy for moderate chronic periodontitis?
- Medical consult (if indicated)
- OHI
- Quadrant SRP w/ anesthesia
- 2-4 appts, re-eval 4-6 weeks
- Local antimicrobials in 5-6 mm pockets
- Refer to periodontist
What is the initial therapy for advanced chronic periodontitis?
- Medical consult (if indicated)
- OHI
- Quadrant SRP w/ anesthesia
- 2-4 appts, 4-6 Re-eval
- Local antimicrobials in 5-6 pockets
- Refer to periodontist
What is the sequence of thoughts when determining prognosis?
- Diagnostic prognosis
- Therapeutic prognosis
- Prosthetic prognosis
- Provisional prognosis
How is prognosis divided?
Into:
- Overall prognosis
- Individual tooth
What is the single most important risk factor for overall prognosis/systemic background?
SMOKING
Cigarette smokers are _____ times more likely than non-smokers to develop severe periodontitis?
5-8 times
What are the negatives for smoking relating to periodontitis?
- Inhibits wound healing, following therapy
- Alters quality of microbiota in pockets
- Decreases nuetrophils, chemotaxis, phagocytosis and oxidative bursts
- Increases collagenase production
- Decreases GCF flow
- Vaso-constrictor
What are the positive benefits related to smoking cessation at 20 min?
- BP drops to normal
- Pulse rate drops to normal
- Peripheral body temp increases to normal
What are the positive benefits related to smoking cessation at 8 hours?
- CO in blood drops to normal
What are the positive benefits related to smoking cessation at 24 hours?
- Chance of heart attack decreases
What are the positive benefits related to smoking cessation at 2 weeks - 3 months?
- Circulation improves
- Lung function increases up to 30%
What are the positive benefits related to smoking cessation at 1 -9 months?
- Coughing, sinus congestion, shortness of breath decreases
- Cilia re-grow in lungs thereby enhancing host defense against respiratory infections
What are the positive benefits related to smoking cessation at 1 year?
- Risk of coronary heart disease is 50% less
What are the positive benefits related to smoking cessation at 5 years?
- Lung cancer death rate for avg smoker decreases by almost 50%
- Stroke risk is reduced to that of non-smoker in 5-15 year quit range
- Risk of oral, pharynx and esophageal cancer is 50% less than that of a smoker’s
What are the positive benefits related to smoking cessation at 10-15 years?
- Lung cancer death similar to non-smoker
- Risk coronary heart disease is that of non smokers
What effects does diabetes have on patients concerning perio?
- Altered oral microbial flora
- Altered host defence mechanism
- Vascular changes
- Increased thickness of basement membrane and vessel wall
- Collagen breakdown
