Flashcards in Test 3 Deck (37)
How does an emotionally compromised child act?
Anxious. Developmental delay. Can have broken homes, poverty and abuse. Therapy is helpful.
How does a shy child act?
Stressful, compensatory whimpering, communication and rapport needed.
How does a frightened child act?
Intellectually unable to arrest fears. Overreacting. Acquired and learned fears. Need to avoid increasing fears.
How does a child who is aversive to authority act?
Annoying, irritating, teasing disruptive (undue attention). Struggle for power. Retaliation/revenge. Inadequacy.
Describe a Frankl 1
Refusal of treatment, crying forcefully, fearful, or any other overt evidence of extreme negativism. Treat with GA.
Describe a Frankl 2
Reluctant to accept treatment, uncooperative, some evidence of negative attitude, but not pronounced. Sullen or withdrawn. Treat with nitrous oxide, sedation or GA.
Describe a Frankl 3
Acceptance of treatment. At times cautious. Willingness to comply with the dentist, at times with reservation, but patient follows the dentist's directions. Treat with nitrous, sedation or HS.
Describe a Frankl 4
Good rapport with dentist, interested in the dental procedures, laughing and enjoying the situation. Treat with HS.
What are the aversive techniques?
Restraints, HOM, HOMAR, Hold and go.
When do you use protective stabilization?
Immediate treatment. Physical or mental disability. Safety. Sedated patient.
How does nitrous work?
Changes pain threshold and improves communication. Decreases gag reflex.
What is procedural sedation?
Oral meds, monitors, child is conscious and breathing on own.
What type of anesthetic is lidocaine?
What is the pH of commercial lidocaine solutions?
Enhances solubility and prolongs shelf life.
How much lidocaine and epi are in a 1.7 ml carpule of 2% lido and 1:100k epi?
34 mg of Lido and 0.017 mg of epi.
How do you calculate how much lido is in a carpule?
Percentage times 10 times 1.7 ml.
34, 51, 68
What is the max dose?
In a child, where is the MN foramen located?
Slightly below the plane of occlusion.
How rapid is the onset of action?
Less than 20 seconds to brain. 2-3 min for clinical action. 3-4 min for peak clinical effect.
How fast is the recovery?
3-5 min after 100% O2 inhalation.
What are some disadvantages?
Expensive. Cooperation needed. Staff training. Hindered axis. Occupational exposure
Is treatment of a phobia through nitrous indicated?
No. Only pain, fear or anxiety. A phobia is an irrational fear of something specific.
What are the absolute contraindications of Nitrous?
1st trimester of pregnancy. MTHFR. Bleomycin sulfate therapy within 12 months. Pneumothorax. Bowel obstruction. Recent pneumo-encephalography. Middle ear infections.
Does Nitrous have color?
No. Colorless. Non irritating, allergenic, flammable, explosive. Sweet smelling. Insoluble in blood.
What does Nitrous Oxide replace?
Replaces the N2 in blood as it is 35 times more soluble. The O2 molecule is not available for use in tissues.
What does scavenging equipment do?
Collects exhaled and leaking gases.
What are some safety considerations for cylinder handling?
No grease, oil or lubricant. Store in a vertical position in constant temp. Avoid heat, dropping and contamination.
What are the colors of O2 and N2O?
O2 is green. N2O is blue.
What is the minimum O2?