Theory II


what are the five steps of the dental hygiene care plan?


assessmentdiagnosisplanningimplementationevaluation


what are the six parts of the assessment process


chief complaintrisk factorspt overall health statusoral healthcare knwledge level of the ptpt self care abilitydocumentation of assessment data


____ supersedes dh treatment


PAIN


what is a cheif complaint?


reason for seeking dental or dental hygiene care


what are the seven risk factors for periodontal infections?


behavioral factors (inadequate biofilm removal, diet, noncomplience)tobacco usesystemic conditions (diabetes, osteoporosis, osteopenia)hormonal considerations (pregancy, menopausenutritional statusiatrogenic factors (overhangs, open contacts residual calc)genetic factors


t/f periodontal infection is a contributing factor to a variety of systemic conditions
True False


true


what are 5 systemic conditions that can be affected by periodontal disease


infective endocarditiscardiovascular disease and atherosclerosisdiabetes mellitusrespiratory diseaseadverse pregnancy outcomes


what are three risk factors for oral cancer?


tobacco usealcohol usesun exposure


what are 8 risk factors for dental caries?


behavior factors (inadequate biofilm removal)diatary factorslow fluoridetooth morphology and positionxerostomiapersonal and familiy history developmental factorsgenetic factors (immune response


the patientes overall health status is determined by the pt's ______, ______ and ______ risk


medicalphysicalpsychological


what are the two systems or guides used to help determine modifications necessary when providing pt care


ASAOSCAR


what modifications to treatment are needed for ASA I


no modifications necessary


what ASA class is without systemic disease a normal healthy pt with littler or no dental anxiety. Able to walk one flight of starits with no distress


ASA I


what ASA class is mild systemic disease or extreme dental anxiety, must stop after walking one flight of staris because of distress. Could be a well controlled chronic condition, upper respiratory infection or healthy pregnant woman or person with allergies


ASA II


what dh tx considerations are needed for ASA class II


minor modifications to tx and or pt education may be necessary


what ASA class is a systemic disease that limits activity but is not incapacitiating. Must stop en route of walking one flight of stairs, chronic caridovascular conditions, controlled insulin dependent diabetes, chronic pulmonary disease, elevated blood pressure


ASA III


what dh tx considerations are there for ASA III


elective tx not contraindicated but serious condsideration of treatment and or pt/caregiver education modifications may be necessary


what ASA class is incapacitiating disease that is a constant threat to life, unable to walk up one flight of stairs, unstable cardiovascular conditions, extremely elevated bood pressure, uncontrolled epilepsy, uncontrolled insulin dependent diabetes


ASA IV


what are the DH tx considerations for ASA IV


conservative non invasive management of emergency dental conditions; more complex dental intervention may require hospitaliztion during tx, caregiver training for daily oral care may be necessary


what ASA class is pt is moribund and not expected to survieve, end stage renal, hepatic, infectious disease or terminal cancer


ASA V


what is the DH tx consideration for ASA V


only palliative tx delivered, caregiver training for dialy oral care may be necessary


what are the five parts of the OSCAR planning guide?


oralsystemiccapabilityautonomyreality


what are the factors of concern for the oral issue (OSCAR) 11


teeth, restorations, prostheses, periodontium, pulpal status, oral mucosa, occlusion, saliva, tongue, alveolar bone


what are the factors of concern with the systemic issue (OSCAR) 4


nomative age changes medical diagnosespharmacologic agentsinterdisciplinary communication


what are the factors of concern with capability (OSCAR) 6


functional ability, self care, caregivers, oral hygiene, transportation to appts, mobility within dental office


what are the factors of concern with autonomy (OSCAR) 2


decision making abilitydependence on alternative or supplementa decision makers


what are the factors of concern for reality (OSCAR) 3


prioritization of oral healhtfinancial ability or limitationssignificance of anticipated life span


what are the four parts for the basis for a dental hygiene diagnosis


pt interview dataphysical assessment datatreatment or education needsreferalls to specialists/consultation


_____ means a look ahead to an anticipated outcome or end point


prognoses


what are four factors determining prognoses


current disease statusrisk factorsOHITx Options


what would the prognosis be for a pt with adequate control of etiologic factors, pt has self care ability and periodontal support


Good


what prognoses would a pt be with adequate control of etiologic factors, pt has self care ability, has less thatn 25% attachment loss and has class I or less furcation involvement


Fair


what prognoses would a pt be that has greater than 50% attachemnt loss with class II furcation and pt self care is difficult due to location and depth of furcation


poor


what prognoses would a pt be with greater than 50% attachment loss with poor crown to rot ratio, poor root form, inaccessible class II furcation or Class III furcation, greater than 2+ mobility, significant root proximity


questionable


what prognoses would a pt be with inadequate attachment to maintain the tooth?


hopeless (if their teeth fold over while taking radiographs I think they could be considered hopeless, poor Molly)


what is the three part care plan for expected out come?


gingival/periodontaldental cariesprevention


what are seven examples of expected outcome for prevention?


elimination of iatrogenic factors (calc, restoration overhangs)increased % of biofilm free areaspt demonstration of oral care procedurescompliance w/daily care compliance with maintenance care intervaltobacco freemodification/stabilazation of systemic risk factors


what are the seven examples of expected outcome for gingival/periodontal?


biofilm reductionreduce/eliminate BOPreduced probe depthsmaintain attachment leveldecreased/maintain mobilityresolve erythematous tissuereduce swelling/edema


what are the five examples of expected outcome for dental caries


no new demineralized areasno new carious lesionreduction of cariogenic foodsplace sealantsincreased fluoride use


what is the purpose of tissue conditioning?


gingival healingreduction of bacterial accumulationpt education


what is the procudure for tissue conditioning?


biofilm removalantibacterial rinseantibiotics


what are five indications for anesthesia?


previous pain control experienceseverity of infectionpocket depthtissue sensitivitycalculus distribution