Pharmacology
With antipsychotic medications, what do dental hygienists need to be most aware of?
Xerostomia
What is the biggest concern of the two broken teeth present in this clients mouth?
Abscess'
Who is responsible for maintaining Graceys oral health?
Gracey is. The DH and the Dentist are responsible for providing the information to her, but ultimately it is Graceys responsibility to ensure she is caring for her teeth in the techniques providing to her by the DH and DDS
What product would you recommend to a client with Xerostomia?
Biotene
Teaching her about cleaning the PUD, smoking cessation and OHI
Which one of the following chemical agents would provide best sensitivity alleviation for the client?
Potassium nitrate
What error is present on the right molar bitewing and left molar bitewing?
Cone cut
Which of the following is the leading cause of this clients multiple carious lesions?
1. Xerostomia
2. Alcohol use
3. Diet
4. Tobacco use
1. Xerostomia; this client has xerostomia from her multiple medications and has suffered from this since her teenage years when she began taking medications. She has not had benefits or the financial means to address this issue.
Which of the following strategies should be first used to encourage clients motivation for up keeping her oral hygiene self care?
1. Disclose teeth and show client with a mirror the areas of dye remaining
2. Provide a brochure with brushing techniques
3. Give her an electric toothbrush
4. Use a digital camera to image areas of stain/plaque and show on a monitor
3. Give her an electric toothbrush
This client would feel extremely happy that you care about her oral health enough o give her an electric toothbrush, that she would feel motivated to use this tooth brush properly as well. The other options are not great, because you could easily embarrass this client due to her BPD she is very sensitive to criticism. Showing her all of the areas that she went wrong may actually make her resent you and not come back to the office.
Which of the following chemotherapeutic rinses would be the best to recommend for this client until her reevaluation appointment?
1. Peridex
2. Prevention mouth rinse
3. Scope
4. Listerine
4. Listerine; the clients periodontal status improved immensely following her initial appointment so she would not need to be on anything stronger. Scope has no medicinal properties.
What etiologic risk factors are evident in Graceys radiographs?
-Widening of PDL
-Horizontal bone loss
-Calculus
-Fractured teeth
What pre procedural rinse should be given to this client, and why?
Nonalcoholic preprocedural rinse should be given because 1. the client is a heavy drinker 2. the client has xerostomia
If stains are present on this patients new anterior restorations at the next appointment, they should be removed with:
1. Ultrasonic scaler
2. Rubber cup with polishing paste for composite material
3. Toothbrush and tartar control toothpaste
4. Airpolisher with sodium bicarbonate
2. Rubber cup with polishing paste for composite material. All others are contraindicated, toothbrush and toothpaste would not be enough to remove the stain.
1. Nitrous Oxide-Oxygen Analgesia
2. Topical anesthetic benzocaine 20%
3. Infiltration anethesia lidocaine 1:100000
4. Noninjectal anesthia prilocaine 2.5% and prilocaine 2.5% gel
3. Infiltration anethesia lidocaine 1:100.000 Epi, this would be best to help control bleeding and last longer, but no more than 2 carps may be given due to her medications.
Which tooth has the worst prognosis? And why?
45 has a worst prognosis due to the RCT did not touch the apices of the tooth. There is a large radiolucency under 45. 36 is broken/decayed to the pulp, but it's mesial root has almost completely calcified
The best form of communication with this client would be using an assertive tone, telling her everything she has done wrong and telling her that she will lose her teeth if she doesn't start changing her behaviour.
True or false? If false, why?
What is an appropriate length of time between periodontal maintenance appointments for this client? why?
3 months; due to multiple medications, xerostomia.
This client's medication puts her at risk for many conditions. Out of the following, which would be the most significant?
1. Xerostomia
2. CNS depression
3. Blood dyscrasis
4. Seizures
5. Mood swings
3. Blood dyscrasia. Even though we think Xerostomia is the worst because of its prolonged side effects, we are more at risk of the client developing blood dyscrasia as we would not know, and this could lead to poor healing, major infections or even uncontrollable bleeding.
Which of the following should the client be referred to first?
1. Endodontist
2. Periodontist
3. Dentist
4. AA (alcoholics anonymous) Group support meetings
3. Dentist; this client has extensive carious lesions and should see a dentist immediately
What should be the emphasis this DH uses when providing smoking cessation to the client?
Positive reinforcement, reminding the client you care about her health and that you are willing to help her on her journey to quitting smoking to improve her quality of life. Always being positive, do not focus on negative and do not much too much weight on the negative aspects of smoking.