POSTOPERATIVE PATIENT MANAGEMENT

Question 1

The weakest part of the needle is the hub

Answer 1

T

Question 2

BROKEN NEEDLE is not preventable

Answer 2

F

(preventable)

Question 3

A long needle is preferred for IAN block because the hub must not be reached

Answer 3

T

Question 4

The limit of a long needle is 30 mm while the short needle is 20 mm

Answer 4

T

Question 5

Common pain relievers are?

Answer 5

mefenamic,
ibuprofen

Question 6

NSAIDs
➔ Peripherally active medications that control the central nervous system

Answer 6

F

(NSAIDs
➔ Peripherally active medications that DO NOT
control the central nervous system)

Question 7

➢ NSAIDs

Usual instruction is to take the first dose as soon as possible then wait for __ hrs to take the
second dose

Answer 7

6 hrs

Question 8

➢ The more traumatized the tissue, the more it is inflamed
➢ The more traumatized, the more pain

Answer 8

T

Question 9

DRY SOCKET is an infection

Answer 9

F

(DRY SOCKET
• Not an infection)

Question 10

DRY SOCKET, there is a failure of the blood clot to form on the
extraction site

Answer 10

T

Question 11

DRY SOCKET, Exact opposite when the patient will not feel any
discomfort after surgery, but on the ___ and __ day postoperatively, the patient will experience a very painful episode in the extraction site.

➢ Pain relievers cannot even relieve the pain
➢ Foul smell on the socket
➢ Metallic or bad taste
➢ Most likely the patient comes back to the dental office to complain

Answer 11

3rd, 4th

Question 12

DRY SOCKET The treatment is not antibiotic because it is not
infectious

Answer 12

T

Question 13

Dry socket

Clinically, the appearance would be blackish halo socket

Answer 13

T

Question 14

DRY SOCKET

The right way to control it is to irrigate with ____, more saline, saline isotonic solution

Answer 14

saline solution

Question 15

If at home, the patient can use salt
➢ 1 tsp of salt and 1 teacup of water to have warm saline

➢ Irrigate well and use ZOE (the one used for luting cements and temporary crowns) as to create a toothpaste consistency so as not
easily get washed off

➢ Get a gauze and cut very fine, the mix with ZOE mix to harden and stay in the socket

➢ Within 5 minutes, there will be a little improvement and then slowly improves the condition until such time the patient does
not experience anymore pain

The patient is asked to come back after ___ days
depending if the pain diminishes

Answer 15

2

Question 16

In 2 days, there are already granulation tissues forming at the wall of the socket

➢ ZOE releases the pain and stimulates the production of granulation tissue to cover the
the exposed bony socket

➔ Production of granulation tissue to cover
the exposed bone

Answer 16

Dry socket

Question 17

Dry socket is only fibrinolytic

Answer 17

T

Question 18

BLEEDING
• Can happen intraoperatively or postoperatively

Answer 18

T

Question 19

Intraoperatively while extracting, it bleeds profusely
➢ Never dismiss a patient unless bleeding is controlled

Answer 19

T

Question 20

There are some patients who comes to theNclinic showing homeostasis but when they go
out or go home, it bleeds profusely

Answer 20

T

Question 21

Advise the patient not to keep on spitting and rinsing the mouth after surgery

➢ The patient has to swallow saliva with a little
taste of blood (normal)

Answer 21

T

Question 22

BLEEDING

The patient must be relaxed for at least ___ hrs and never play the area with the tongue

Answer 22

2

Question 23

BLEEDING

The gauze should be wet and thick (damp)

Answer 23

T

Question 24

If the gauze is removed during bleeding, the clotted part will be removed, and a fresh set of
bleeding episode occurs whereas the gauze
gets wet with water

Answer 24

T

Question 25

The blood has a higher density as compared to water, but water has simply occupied already the space ➢ The blood will be forced to stay in the area between the gauze the socket, and it will clot

Answer 25

T

Question 26

Let the patient stop the flow for an hour ➢ After an hour, if the bleeding has stopped, throw it away If bleeding persists, after the removal after an hour, tell the patient to get a tea bag with tea leaves ➢ Get a thick enough tea bag and wet in cold water and put at the area of extraction for ___mins ➢ If thin and lacks bulk, add gauze or cotton for thickness to put pressure

Answer 26

30

Question 27

The tea bag is effective because it’s thickness applies pressure in the area

Answer 27

T

Question 28

Each tea bag contains ___or ___ very good in stopping the bleeding at the surgical site ➢ This is a method that the patient can do at home to control the bleeding

Answer 28

tannic acid, tannin

Question 29

Tea bag pressure is more effective

Answer 29

T

Question 30

The best vasoconstrictor to control bleeding ____ concentration of epinephrine ➢ BUT after a certain period of time the vasoconstrictor disappears ➢ Can lead to secondary bleeding

Answer 30

1:50,000

Question 31

___ cell is a regenerated cellulose like a gauze in form

Answer 31

Surgery

Question 32

Put gel foam or surgery cell in the bleeding socket left uncleaned

Answer 32

T

Question 33

The ___ is a gelatin sponge

Answer 33

gel foam

Question 34

These would expand in size capable of carrying volumes of blood more than their actual size and produce pressure to the sides or to the area where there is active bleeding

Answer 34

gel foam or surgery cell

Question 35

These would also serve as a matrix for the platelet to attach themselves to aid in bleeding

Answer 35

gel foam or surgery cell

Question 36

____ is an oxidizer, generated cellulose more effective because it cannot be pushed out by the blood

Answer 36

Surg cell

Question 37

The gel foam when put in if the bleeding is fast, it is removed out of the socket

Answer 37

T

Question 38

Electrocautery causes burning of tissue to coagulate the bleeding vessel by burning the tissues around it to stop the bleeding ➢ Cannot be used in areas where there are nerves because it damages

Answer 38

T

Question 39

Use egg and ball burnisher ➢ Using the ball part, the smaller, heat in alcohol lamp red hot and put on the obleeding vessel ➢ Be careful it would not touch the tissues around

Answer 39

T

Question 40

Before suturing, the bleeding must be controlled by applying pressure with gel foam or surgery cell to avoid ballooning of tissues ➢ Once the vessel becomes equal to the pressure outside, the bleeding will stop once the pressure within the vessel equalized to the pressure outside or the pressure outside

Answer 40

T

Question 41

Do not suture the punctured side ➢ To allow drainage

Answer 41

T

Question 42

Chlorhexidine ___% or 1% povidone iodine is very effective in minimizing the number of microorganisms in the mouth to infect the soft tissues

Answer 42

12

Question 43

If the patient is immunocompetent, do not give antibiotics automatically after extraction especially if it is only a simple extraction

Answer 43

T

Question 44

If not loosened the tooth properly before extracting the socket, if bone is broken, it is sharp and irregular causing trauma to the soft tissues ➢ Smoothen it up, irrigate well and suture the tissues

Answer 44

T

Question 45

Procedures with open technique are more traumatic than close technique

Answer 45

T

Question 46

Inflammation sets in if there is trauma

Answer 46

T

Question 47

Peak of inflammation will be on the third day and beyond that it will start to lessen until it is gone

Answer 47

T

Question 48

To lessen inflammation and swelling, one option is to given steroids before the procedure and then given after

Answer 48

T

Question 49

SWELLING Instruct patient to put on 30 minutes then 30 minutes off for 24 hrs

Answer 49

T

Question 50

When asleep, do not put on ice, then once awake, repeat applying cold compress for 30 minutes then off for 30 minutes ➢ Not a substitute for pain relivers

Answer 50

T

Question 51

What is this? ➢ Bruises after surgery ➢ Blood vessels in older patients are friable

Answer 51

Ecchymosis

Question 52

If there is infection and swelling, create an incision for drainage ➢ Use blade #____ to open a drainage

Answer 52

11

Question 53

ABSCESS ➢ Put a Penrose drain ➢ After 2 days, the patient comes back and rinse with 1% povidone iodine

Answer 53

T

Question 54

One of the complications of surgical procedures is?

Answer 54

LACERATED TISSUE

Question 55

LACERATED TISSUE Jagged edges—secondary intention healing ➢ Longer time healing

Answer 55

T

Question 56

Silk is not resorbable and continues to stay

Answer 56

T

Question 57

SUTURE TRACT INFECTION Sutures are only effective for 7 to 10 days and should be removed after because it becomes an irritant and not functional anymore ➢ Wicking of microorganisms

Answer 57

T