CTP Flashcards by Anitra Davis

SRP if

CAL is 5 or more, or if its 4 with BOP

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RPD

What teeth will be replaced and where rest will be

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RPD distal extension

put rest on mesial

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Perio prognosis good

health or slight CAL, no mobility, no furcation, and control of etiological factors

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perio prognosis fair

Moderate CAL, class 1 mobility, class 1 furcation

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perio prognosis poor

severe cal, class 2 or 3 furcation, class 2 or 3 mobility

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perio prognosis hopeless

therapy is unlikely to improve situation

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what you must say with restorations

tooth, surface, indirect or direct

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specialist referrals

must include diagnosis and proposed tx plan

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rheumatic fever

Ask if the patient has a history of endocarditits, has ever had a heart valve replacement, or have any other heart conditions.

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heart mumor

physcians consult

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heart surgery

abx prophylaxis

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valve replacement

abx

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pacemaker

dont use cavitron or elecrosurge

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stroke

check for blood thinners, dont treat if stroke was less than six months

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HBP

Reduce stress
Do not treat when patient is over 160/100
Medical consult may be wanted – refer to physician as needed
limit anesthetic to .04 mg epi?

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bleeding disorder

Check INR (ok to treat <3)
Medical consult on how to control bleeding if dental procedure will cause bleeding.

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dont treat if active

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asthma

Determine last asthma attack (hospitalized?)
Determine medications that are being taken for control – use prophylactically
Determine triggers for asthma

Administer O2 or Nitrous Oxide
Have fast acting bronchodilator on hand in case of emergency (not steroid – takes too long to act)

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COPD

dont use nitrous

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diabetes

Check HBA1C - > 10 treat with caution
Check fasting blood glucose - <160
Make sure patient ate prior to apt if Type I
-Normal HbA1c <6.5 (for diabetics, goal is <7)

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kidney failure

reduce amount of LA used, treat on non dialysis days

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hepatitis

Check liver function
Limit acetaminophen and LA amount with decreased liver function
Use univerisal precautions
DONT PRSCRIBE NORCO-> ibuprofen

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HIV

Use universal precaustions
Check statuse of HIV virus
Check white blood cell count – if low may require antibiotics for treatments.

epilepsy/seizure

med consult

joint replacement

abx if orthopedic presccribes and recommend or history

cancer

Chemotherapy --> pre-medicate, wait 7 days following chemotherapy, avoid extractions

ulcerative colitis

avoid clindamycin

depression/anxiety

monitor for xerostomia

schizphrenia

med consult, early morning appointments if patient is taking antipsychotics

pregnancy

do not do elective treatment in 1 or 3 trimester, avoid nitrous, limit LA

hyperthyroidism/graves

Take caution with using epinephrine. May cause hypertensive crisis if patient has a heigtened sympathetic nervous system. (HR, anxiety, sweating, palpatations – fight or flight)

hypertenisve crisis

risk for stroke or heart attack

addisons disease

Give them a boost of corticosteroid prior to treatment – to avoid an adrenal crisis

cushings disease

Med consult – no speciific treatment modifications

chronic steroid treatment

act’s like Addison’s Disease - natural ability to produce corticosteroid is decreased) Give them a boost of corticosteroid prior to treatment – to avoid an adrenal crisis.

propranalol and lidocaine

LA last longer bc propranalol slows heart

bisphosphonatees -aldronate

IV (history) – refer patient to oral surgeon Oral – 6 months wait period prior to extensive treatment Wait 6 months before and 6 months after treatment IV Bisphosphonates: Refer to oral surgeon, avoid surgeries at all cost Breast and Prostate Cancer – will typically take for inhibition of metastasis to bone (high risk) Oral Bisphosphonates: 6 months delay for treatment Taken less than 3 years – not high risk More than 3 years – high risk If patient has been taking bisphosphonates for 10 years refer to primary care physician – patient really shouldn’t be taking it for that long. Emergent treatment  educate patient of risk of oral bisphosphonates

blood thinners

``` Coumadin (Warfarin) -- INR below 3 Avoid erythromycin and ketoconazole Plavix – affects platelets Dabigatran (Blocks Thrombin) -- Pr Eliquis (Block Factor Xa) – get supplemental factor Xa from physician Chronic Ibuprofen ```

Amoxicillin premed

2 g | 4 x 500mg tabs

amoxi course

500 mg 30 tabs | Sig: Take 2 tabs stat, 1 tab QID until gone

clinda premed

600 mg | 4 x 150mg tabs

clinda course

300 mg 21 tabs | Sig: Take 1 tab TID 7 days

azithromycin permed

500 mg | (2 x 250 mg tabs

axithro course

500 mg 3-6 tabs | Sig: Take 1 tab 1x a day for 3-5 days

premedicate

``` Heart valve replacement History of endocarditis Heart transplant Congenital heart defects cyonotic Not repaired Repaired - first 6 months Repaired with continued defects ```

anesthetic adult

lidocaine 4.4 mg/kg

premed child

50 mg/kg  Amoxicillin 20 mg/kg  Clindamycin 15 mg/kg  Azithromycin

pedo abx course

-Amoxicillin 20-40 mg/kg/day In 3 divided doses -Clindamycin 8-20 mg/kg/day In 3-4 divided doses

pedo anesthetic

1 kg=2.2 lbs 1 carpule per 25 lbs lido 4.4mg/kg arti 7 mg/kg

norco

norco 5/325 8 tablets take 1-2 every 4-6 hrs prn

metabolism of nsaids

all in liver except ibuprofen-> kidney

allergic to cephalosporins

dont do penicillins or cephalosporins

sulfa allergy

dont give sulfonamides (articaine)

sulfites/bisulfites allergy

avoid LA with epi

anesthetic amounts in carpule

lido 36 mg per carpule | arti 72 mg per carp

children anelgesics

ibuprofen 8 mg/kg/dose every 8 hours

ibuprofen max

800 mg 3 times a day (give this to liver issue patients)

abx pill sizes

amoxi - 500 mg clinda - 150 mg azithro- 250 mg