Disease Prevention Flashcards
(207 cards)
1
Q
what is a care plan
A
blueprint or guide that coordinates all treatment
2
Q
what is the preliminary phase
A
emergency only review pg 1 still
3
Q
Steps in Learning-Ladder or Decision-Making Continuum
A
- Unawareness or Ignorance
- Awareness
- Self-Interest
- Involvement
- Action
6.Habit or commitment
4
Q
Learning-Ladder or Decision-Making Continuum:
1. Unawareness or Ignorance
A
client lacks information or has incorrect information about the problem
5
Q
Learning-Ladder or Decision-Making Continuum:
2. Awareness
A
Client knows a problem exists but does not act on this knowledge
6
Q
Learning-Ladder or Decision-Making Continuum:
3. Self- Interest
A
the client recognizes the problem and has an inclination towards change
7
Q
Learning-Ladder or Decision-Making Continuum:
4. Involvement
A
Client attitude and feelings are affected, desire for additional knowledge
8
Q
Learning-Ladder or Decision-Making Continuum:
5. Action
A
new behaviours directed toward solving the problem are instituted
9
Q
Learning-Ladder or Decision-Making Continuum:
6.Habit or Commitment
A
new behaviours are practiced over a period, become a lifestyle change
10
Q
Trans-theoretical model steps
A
- precontemplation
- contemplation
- preparation
- action
- maintenance
11
Q
Trans-theoretical model:
1. Precontemplation
A
client has no intention of making a change within the next 6 months
12
Q
Trans-theoretical model
2. Contemplation
A
client intends to make a change within the next 6 months
13
Q
Trans-theoretical model:
3.Preparation
A
client intends to make a change within the next 30 days and has taken some behavioural steps In this decision
14
Q
Trans-theoretical model:
4.Action
A
the client has practiced changed behaviours for less than 6 months
15
Q
Trans-theoretical model:
5. Maintenance
A
the client has practiced changed behaviours for more than 6 months
16
Q
learning domain: cognitive
A
concerned with the knowledge outcomes and the client’s intellectual abilities and skills
17
Q
learning domain: affectice
A
concerned with the clients attitudes, interests, appreciation and modes of interest
18
Q
learning domain: psychomotor
A
concerned with the client’s technical skills or motor skills
19
Q
Health belief model is based on
A
based on the concept that one’s beliefs direct behaviour. (what they believe happens)
20
Q
Health belief model: susceptibility
A
clients must believe they are susceptible to a particular disease/condition
21
Q
Health belief model: severity
A
clients must believe that if they get the particular disease/condition, consequences will be severe
22
Q
Health belief model: asymptomatic nature of disease
A
clients must believe that a disease may be present without their being fully aware of it
23
Q
Health belief model: benefit of behaviour change
A
clients must believe that the effective means of preventing or controlling problem exists
24
Q
agent-host-environment theory
A
theory that disease is a result of an imbalance in one or all three factors:
- agent
-host
-environment
25
Primary prevention
targets risk factors
involves techniques and agents to forestall onset and reverse the progress of the disease or
arrest the disease process before treatment becomes necessary
26
primary prevention intention is
to reduce or eliminate risk factors
27
primary prevention examples
plaque removal, use of fluoride, sugar discipline, sealants
28
secondary prevention
routine tx methods to prevent injury/disease once exposure to risk factors occurs. but still in early "preclinical" stage.
29
secondary prevention intention is
early identification [through screening and treatment]]
30
secondary prevention examples
screening and deep scaling, restorations, periodontal debridement, endodontics
31
teritiary prevention
involves using measures to replace lost tissues and rehabilitate patients so physical capabilities and/or mental attitudes are as near to normal as possible after secondary prevention has failed
32
tertiary prevention intention is
to prevent sequelae (after effect of disease)
33
tertiary prevention examples
prosthodontics, implants
34
primordial prevention
targets social and economic policies and factors that impact health
35
Maslow's hierarchy of needs theory
suggest that inner force drives a person to action. and only when a client's lower needs are met will the client become concerned about the higher-level needs
36
Maslow's hierarchy of needs classified
1. self actualization
2. esteem
3. love and belonging
4. safety needs
5. physiological needs
37
****Bass or Sulcular Method recommended for
also what about modified bass
periodontal patients
38
****Bass or Sulcular Method angulation
45 degree angle to the gingival 1/3 (margin)
39
***what does Bass or Sulcular Method do
disrupts biofilm, good gingival stimulation, effective control technique
40
*Stillman's method indicated for
gingival stimulation + recession
look at ur slides to add more tom
41
how to do stillman's method*
position bristles on attached gingiva, direct apically at 45 degree angle to the long axis
42
*how to roll method
roll or sweep bristles, often used in combination with bass, charters, or stillman's method
43
*how to charters method
position bristles toward occlusal surfaces, move in short strokes
44
*charters method is ideal for
orthodontics
45
leonard method*
throw off
46
fones methods*
circular brushing, children
47
power assisted toothbrushes are indicated for: (6)
-children
-physically and mentally challenged
-elderly
-arthritic patients
-poorly motivated individuals
-implant care
48
hard tissue variables are (4)
tooth position
root anatomy
status of restoration
prostheses
49
client variables
level manual dexterity
adherence
skill development
personal preference
50
TYPE 1 EMBRASURE
embrasures are occupied by interdental papillae
51
TYPE 2 EMBRASURE
embrasures have slight to moderate recession of interdental papillae
52
TYPE 3 EMBRASURE
embrasures have an extensive recession or complete loss of interdental papillae
53
dental floss effectivenesss
floss is the primary recommendation but patient compliance Is low
54
flossing may not be as effective for which patients ?
perio patients: recession, attachment loss, size of gingival embrasure space are limiting factors
55
floss indications for use
patient with type 1 embrasure space and excellent compliance
56
floss holder recommended for
physically challenged,
*caregivers providing oral hygiene care
57
floss holder indications
type 1 embrasure, pt is motivated but has dexterity challenges
58
tufted dental floss use
under pontics of bridges or ortho appliances
59
tufted dental floss indications
type 2 embrasure spaces, fixed bridges, distal surface of last tooth, proximal surface or widely spaced teeth
- under pontics of bridges or ortho apliances
60
interdental brush indications
-type 2 or 3 embrasure spaces
-distal surface of last tooth
- exposed class 4 furcations
- embrasure spaces with exposed root concavities
-ortho appliances, prostheses, dental implants
61
for interdental brushes be cautious because the
inner wire must be plastic coated to avoid scratching cementum or implant oxide layer
62
end tuft brush indicated for
type 3 embrasure spaces,
*hard to access areas: 3rd molars, crowded teeth
lingual of mandibular teeth
open proximal spaces
exposed furcation
fixed partial dentures, pontics, ortho
63
pipe cleaner indications for use
type 3 embrasure
exposed furcation areas that permit insertion
64
*what is the best choice for exposed class 4 furcations
wooden toothpick in holder
65
wooden toothpick in holder indications
exposed class 4 furcations*
interdental cleaning- concave proximal surfaces
biofilm removal at ginigival margins above ortho appliances
root concavities
type 2 or 3 embrasure
66
wooden wedge shape
triangular , made from birch
67
wooden wedge indication
interdental areas with exposed root surfaces (recession)
type 2 + 3 embrasure
68
rubber tip stimulator indications
after perio surgery
69
rubber tip simulator is used for
massaging the gingiva to improve blood circulation, increase keratinization and provide epithelial thickening
- can do plaque removal but not the primary use
70
things responsible for halitosis
voilate sulfur compounds- family of gasses
hydrogen sulfide
methyl mercaptan
71
tongue cleaning is indicated to remove
the bulk of voilate sulfur compounds forming bacteria and debris which accumulate mostly within filiform papillae and on the back of tongue
72
90% of oral malodor orginates from
mouth and oropharynx
73
10% of oral malodor originates from
systemic disorders
74
contributing factors to oral malodor
oral dryness from alcohol, medications, caffeine, smoking
post nasal drip, nasal odor
perio infections, overnight denture wearing
75
therapy for controlling oral malodor
tongue cleaning *
abstain from tobacco alcohol and caffeine
stimulate salivary flow by chewing gum, xylitol, antimicrobrial agents, sugar free sprays/breath fresheners/drops
nasal sprays or humidifiers
76
dentifrice for caries
fluoride
77
dentifrice for tartor control
pyrophosphates
78
leading cause of dentinal hypersensitivity
pyrophosphates
79
dentifrices for antihypersensitivity
- potassium nitrate
- strontium chloride
-sodium citrate
80
dentifrices for antibacterial
triclosan
81
dentifrices for whitening
carbamide peroxide or hydrogen peroxide
(carbamide peroxide breaks down hydrogen peroxide and urea
82
in essential oils, you should assume there is _____ unless otherwise stated
alcohol
83
considerations for essential oils? what is the most common
most common is burning sensation associated with alcohol content
slight extrinsic staining
84
essential oils are contraindicated for
current or recovering alcoholics
85
quaternary ammonium compounds: considerations/side effects
staining
burning sensations
increased supragingival calculus
86
fluoride for pre-eruptive*
systemic
87
fluoride for post eruptive
topical
88
water is both topical and systemic
89
dietary fluoride supplements are recommended for
for children who live in areas with inadequate water fluoridation
90
dietary fluoride supplements are NOT recommended for
NOT recommended for pregnant women
91
optimal level of water fluoridation
0.7ppm
92
extrinsic (exogenous) stains are
removable
93
intrinsic (endogenous) are
not removable
94
where can extrinsic staining become intrinsic
in demineralized areas
95
extrinsic staining causes
certain bacteria
other sources such as food, beverages, tobacco
96
intrinsic staining causes (4)
pulpal necrosis, internal resorption, excessive systemic fluoride, use of tetracycline during tooth development
97
clinical uses for chlorhexidine (5)
- preprocedural rinse prior to aerosol generation
- decrease supragingival plaque formation, inhibit gingivitis
- short term adjunctive therapy following surgery
-implants
-patients with high risk for caries. suppress S.mutans
98
what is the #1 side effect of chlorhexidine
stains teeth, tongue, restorations
99
side effects/considerations of chlorhexidine
#1- stains teeth, tongue, restorations
- alters taste sensation (dysgeusia) including bitter taste
- can irritate and burn oral mucosa
- increase in supragingival calculus formation related to decreased bacteria action
- inactivated by sodium lauryl sulfate
100
for patients with cancer with oral mucositis you should
rinse with baking soda or saline solution followed by plain water rinse
101
for plaque-induced gingivitis, slight-to- moderate chronic perio, NUG/NUP and periodontal maintenance you should recommened
chlorhexidine BID
102
for patients with an alcohol conditions you should recommend
non-alcohol rinses
103
alcohol rinses are contraindicated with patients who are being treated with Antabuse because
may induce nausea and vomiting
104
fluoride is an essential nutrient in the formation of
teeth and bones
105
is fluoride acquistion topical or systemic
both topical and systemic
106
where is fluoride absorbed
GI tract (small intestine)
107
fluoride is excreted where
in urine (kidneys)
108
fluoride uptake depends on
the amount of fluoride ingested (note delivered) and the length of time of exposure
109
what is the halo effect
refers to the unintentional addition of fluoride to a concentrated beverage or food that is from a water supply containing fluoride
110
fluoride interferes with
bacterial metabolism
111
in high concentration (professionally applied) fluoride is
bactericidal (destructive to bacteria
112
bactericidal means
destructive to bacteria
113
in low concentrations (at home applications) fluoride is
bacteriostatic (restricts growth or multiplication of bacteria)
114
bacteriostatic
restricts growth or multiplication of bacteria
115
do you need to polish teeth prior to fluoride application? why or why not?
DO NOT need to polish teeth because fluoride penetrates through pellicle and plaque
116
what is more effective: professional fluoride 2x per year or daily at-home rinse?
daily at home rinse
117
fluoride has substantivity which is
the ability to bind to the pellicle, plaque, and tooth surface and be released over a period of time with retention of potency
118
fluorides aid in accelerated maturation:
fluoride continues to accumulate in the outermost portion of enamel
119
pre eruptive systemic examples
water, supplements, food
120
systemic fluoride circulates in _____ and is incorporating into developing ______
systemic fluoride circulates in __bloodstream___ and is incorporating into developing __enamel____
121
what foods contain large amounts of fluoride
tea and fish contain large amounts of fluoride
122
what is the most cost-effective and efficient fluoridation method
water fluoridation
123
a larger community has _____ costs vs a smaller community has ______ costs
a larger community has LOWER costs vs a smaller community has HIGHER costs
124
what does environmental protection do (2)
monitors concentration levels in drinking water
sets limits on bottled water
125
what are compounds used to fluoridate water (3)
sodium fluoride
sodium silcofluoride
hydrofluorosilicic acid
126
what is school fluoridation for
decreasing dental caries in student population
127
school fluoridation is adding how much fluoride?
5ppm to a school's water supply
128
why is there an increase in ppm in school fluoridation
due to the fact that children consume only part of their water consumption through school hours
129
ppm means
parts per million
130
self- applied fluoride is topical or systemic
topical
131
self applied fluoride provides additional forms of
frequent low concentration fluoride to promote remineralization (bacteriostatic effect)
132
dentifrice range between what ppm
400-1500ppm
133
rinse contain what %/ppm
0.05% NaF daily = 225ppm
134
children under what age should not use fluoride rinses because
children under 6 years of age should not used fluoride rinses due to the risk of ingestion (LOOK AT PT AGE ON CASES)
135
example of professionally applied fluoride ?
acidulated phosphate fluoride,
sodium fluoride and varnish
stannous fluoride
136
acidulated phosphate fluoride is not ideal for what patients
bulimic, xerostomia, chemo
137
acidulated phosphate fluoride pH level
3.0-3.5pH
138
acidulated phosphate fluoride is contraindicated when? and why
in the presence of tooth- coloured restorations and porcelain and acid can etch the glass components and cause roughening. due to its pH
139
acidulated phosphate fluoride side effect
can convert extrinsic stain to intrinsic
140
acidulated phosphate fluoride application
tray or painting with gel like (thixotropic) or foam for 4 min application
141
sodium fluoride is safest used for
tooth coloured restorations and porcelain restorations, veneers, crowns , bridges , acid erosion patients
142
sodium fluoride is used in patients suffering from what
bullimic, chemotherapy and xerostomia
143
sodium fluoride application
4 min application for maximum efficiency
144
sodium fluoride aftercare
instruct pt not to smoke/drink for 20 mins
145
sodium fluoride 0.05% daily rinse is used on
children OVER 6 years of age and adults with CARIES susceptibility
146
sodium fluoride 0.2% weekly rinse is used for what program
school based programs
147
sodium fluoride 1.19-2% gel in a tray used for
used for rampant caries and pt undergoing radiation therapy
148
5% sodium fluoride varnish is used for
desensitizing exposed roots and caries prevention, remineralization
149
fluoride is least effective where?
in pits and fissures
150
less fluoride is required where? and why? how much
in warmer environments because people drink less water.
0.6ppm
151
5% sodium fluoride varnish is recommend how many times a year `
2-4 times a year
152
5% sodium fluoride varnish is most effective in what than other fluoride
caries reduction
153
5% sodium fluoride varnish is retained for how long? retained for what?
it is retained for 24-48 hours for high substantivity for fluoride release into underlying enamel
154
5% fluoride varnish is effect for use on infants and small children because
decreased risk of ingestion
155
5% sodium fluoride varnish, is it for home use or no?
NOT for home use
156
excellent candidate for 5% sodium fluoride varnish is
hypersensitivity patient due to recession
157
corresponding with eruption of primary and permanent molars, fluoride can be applied how often? after that how often can it be applied
4x at once a week intervals, after that 6-month intervals
158
sodium NaF concentration and pH
2%
pH- 7.0
159
varnish concentration and pH
5%
pH-7
160
Acidulated Phosphate fluoride concentration and pH
1.23%
pH-3.0-3.5
161
stannous (SNF2) concentration and pH
8%
pH-2.1-2.3
162
stannous fluoride an ___ solution and must be mixed ____
stannous fluoride is an UNSTABLE solution and must be mixed FRESH
163
stannous fluoride has an unpleasant taste because
tin ion provides metallic taste
164
stannous fluoride adverse reactions
sloughing of gingiva
stains demineralized areas and porcelain veneers, crowns,bridges ,margins of restorations,
brown stain
165
why does stannous fluoride stain
reaction of fluoride tin ion in the compound
166
stannous fluoride daily rinse concentration and use
0.63%
use for high susceptibility to root surface caries and dentinal hypersensitivity
167
stannous fluoride brush-on gel concentration and use
use for high caries rate and sensitivity
168
sodium fluoride application frequency
4x/year for ages 3,7,10,13
(corresponds with the eruption of primary and permanent molars )
169
sodium fluoride varnish application frequency
3-6 months
170
APF fluoride application frequency
1-2x/year
171
stannous fluoride application frequency
1-2x/year
172
emergency tx for acute fluoride toxicity
1. induce vomiting using stimulation or syrup of ipecac
2. ingest milk/limewater
- vomiting should not. be induced with APF)
173
fluoride mouthrinses are indicated for
moderate to high-risk caries
ortho or prosthetic appliances
xerostomia, recession, demineralization
174
fluoride mouth rinses are used weekly in_____ and contain
fluoride mouth rinses are used weekly in school rinse programs without water fluoridation and contain 2%NaF
175
school rinse programs uses ___mL for younger children and __mL for older children and swished for ___ seconds
school rinse programs uses _5__mL for younger children and 10mL for older children and swished for _60__ seconds
176
most common school-based program in US
weekly rinse
177
certainly lethal dose (CLD)
the amount of drug likely to cause death if not intercepted by antidotal therapy
178
safely tolerated dose (STD)
1/4 of CLD
179
toxicity symptoms begin within when and last when
begin within 30 mins and can last up to 24 hours
180
fluoride toxicity symptoms
fluoride in the stomach reacts with hydrochloric acid to form hydrofluoric acid causing irritation to the stomach lining
nausea, vomiting, diarrhea
abdominal pain
increased salivation and thirst
181
systemic involvements of fluoride toxicity result in
symptoms of hypocalcemia (calcium too low)
hyperreflexia (overactive body reflexes)
convulsions, paraesthesia (burning/prickling sensation)
cardiac failure or respiratory paralysis
182
tx for <5mg/kg fluoride ingested*
administer fluoride-binding agent (anything with calcium)
183
tx for >5mg/kg fluoride ingested (toxic dose)*
1. emesis (induce vomiting)
2. adminster fluoride binding agent
3. seek medical treatment
184
tx for >15mg/kg (lethal dose)*
1. seek medical treatment
2. induce vomit
3. cardiac monitoring
185
dentinal hypersensitivity occurs
on root-exposure areas, where recession may has occcured
186
characteristics of hypersensitive dentin
open, large, and numerous tubules
thin/poorly calcified smear layer
187
what is a smear layer
deposit of salivary proteins, debris from dentifrices, and other calcified matter
188
a-delta fibers
myelinated fibers that can conduct stimuli rapidly and line the pulp
189
c-delta fibers
unmyelinated fibers that can conduct stimulus more slowly
190
who accounts for 80-90% of oral cancer
smokers (cigs, cigars, pipes, smokeless tobacco) and heavy alcohol drinkers
191
tobacco users had approx ten-fold increased chance of developing what compared to non-smokers
squamous cell carcinoma
192
oral virus
HBV
HIV
HPV
helicobacter pylori
193
recent studies suggest oral cancer is related to
HPV-16
194
oral cancer found primarily where
tongue , oropharyngeal area (throat, back third of tongue, soft palate, side and back walls of throat and tonsils
195
oral cancer traditional risk factors
-prior oral cancer lesion
-older age
-frequent sun exposure
- low consumption of fruits and veggies
196
tobacco smoking is associated with what (8)
-atherosclerosis
-Cardiovascular disease
-hypertension
-spontaneous abortion
-fetal death
-neonatal death
-SIDS
-COPD
197
tobacco causes an increased risk of
perio
198
tobacco quit aids (3)*
Buproprion/wellbutrin
Zyban
Chantix
199
nictoine replacements (5)
transdermal patch
gum
nasal spray
inhaler
lozenge
200
Tobacco cessation counselling 5 A's?
1. Ask
2.Advise
3. Assess
4.Assist
5. Arrange
201
tobacco prognosis?
202
black line stain has what kind of bacteria and where is it located
-gram-positive bacteria
typically located on cervical 1/3 of facial/linguals
203
brown stain is associated with
poor OH
drinking dark-colored beverages: tea ,coffee, fruit juices and red wine
204
dark-brown/black stain associate with
tobacco use
205
orange stain bacteria +location
is associated with?
chromogenic bacteria in plaque
typically located on anterior teeth at the cervical 1/3
associated with poor OH
206
Yellow-brown to Brown stain associated with
chlorhexidine use or stannous fluoride
207
green stain can be embedded where? and is associated with
poor OH
chromogenic bacteria, fundi, gingival hemorrage
can be embedded into decalcified surface enamel
