The Pregnant Patient
During the early stages of pregnancy, the embryo is highly susceptible to injuries, malformations, and mortality.
______________ effects can be produced by maternal poor nutrition, infections, and drug intake.
Teratogenic effects
P. 782
What is the difference between 'biological age' and 'chronological age'?
Chronological - age set by birth year
p. 824
Define ADLs in relation to one's ability to brush
ADL O
ADL 1
ADL 2
ADL 3
ADL O Can brush independently w/o no assistance
ADL 1 Can brush with some assistance from adaptive/mechanical aid
ADL 2 Needs some help brushing with partial help from another person
ADL 3 Needs complete aid in the task of brushing
The ADA defines an individual with a disability as a person who has a physical or mental impairment that limits ______ major life activities.
one or more MAJOR life activities:
-caring for oneself
-performing manual tasks
-seeing or hearing
-communication
-eating
-sleeping
-movement (walking, standing, lifting, bending)
-breathing
-learning and reading
-concentrating
-thinking
-working
Parkinsons disease affects what part of the brain
Basal ganglia
Dopamine!
What can develop after a traumatic event that involves physical harm or the threat of physical harm?
Posttraumatic Stress Disorder
In fetal development, at what week is a cleft lip evident?
By the 8th week
-Cleft palate is by the 12th week
-Tooth buds, between the 5th and 5th week
-Lips from 4-7th week
Atherosclerosis is associated with aging. What three factors can influence the fatty deposits in arteries?
1. Diet
2. Smoking
3. Lack of exercise
Describe orofacial characteristics of a patient with Down syndrome
epicnathic folds
Broad, flat nose/face
microglossia
fissured tongue
Etc
A provider who does not feel adequately trained to safely treat a patient with a disability displays what type of barrier to dental care?
Attitude Barrier
What is the sudden loss of brain function, resulting from an interference of the blood supply to part of the brain?
Cerebrovasucular accident (CVA), stroke
3rd leading cause of death
Ischemic stroke - a blood vessel in the brain is blocked (atherosclerosis)
Hemorrhagic stroke - blood vessel ruptures (aneurysm)
Predisposing factors: atherosclerosis, hypertension, hypercholesterolemia, tobacco use, DM, oral contraceptives, drug abuse
p. 896
Antidepressants are the preferred pharmacologic treatment for patients with anxiety disorders.
List two common side effects of many antidepressant medications.
1. headaches
2. weight gain
3. tremor
4. irritability
5. xerostomia
Name three communicable diseases that have serious health effects to a developing fetus.
German measles (rubella), varicella, herpes simplex virus, syphilis, gonorrhea
p. 782
TRUE OR FALSE
(First Statement) The immune system declines with age. (Second Statement) Changes in the immune system result in an increased incidence of infections and diseases.
What is hydrocephalus?
larger skull size, filled with fluid
A self-care aid must be have all of the following characteristics:
Durable
Replaceable
Affordable
Disinfectable
Bells Palsy is the paralysis of the facial muscles innervated by the facial or ________ cranial nerve.
Seventh
Etiology is unknown
Bacterial or viral infections suspected
Injury, trauma from extractions, or oral surgery risk factors increase
During the postpartum period, many physiologic and psychologic stresses are related to changes taking place in a mother's life. When does postpartum depression typically "peak" after the delivery of the baby?
2-6 months
Signs that last longer than two weeks:
1. depressed mood, 2. loss of interest, 3. feelings of hopelessness, worthlessness, guilt, 4. memory or concentration difficulties, 5. appetite disturbance, 6. insomnia, 7. suicidal thoughts (intrusive thoughts)
p. 984
Why should -cycline antibiotics be avoided during pregnancy?
___________ is the severe impairment of cognitive abilities, thinking, memory, and judgement.
Dementia
Alzheimer's disease is a nonreversible type of dementia and the most common of all dementias.
List 5 common physical characteristics of a patient with Down Syndrome
-Poor muscle tone
-Short neck
-Flat nasal bridge, flat facial profile
-Slanted eyes with epicanthic folds
-Small hands, short fingers, singular transverse palmar crease
-small mouth, large tongue
-GI issues
p. 852
People with disabilities have the highest prevalence of oral disease due to access to care issues. Creating a barrier-free environment is one way to increase access to dental care for people with disabilities.
What is the measurement of the distance for all walkways and passageways in order to allow navigation for patients in wheelchairs.
3-feet wide
p. 870
What is bradykinesia?
Slowness in movement
Commonly seen in patients with Parkinson's disease (progressive disorder in the CNS, degeneration of the basal ganglia of the brain and depression of dopamine is noted)
p. 898
Define Diabulemia
Eating disorder for those who are diabetic
Diabulimia
Signs and symptoms:
-rapid weight loss
-Body size obsession
-High A1C
-Bulimia nervosa
Morning sickness with vomiting over an extended period can lead to demineralization and acid erosion.
What are three recommendations you can give to the patient?
1. Small, non-cariogenic meals throughout the day
2. Sodium bicarbonate rinses
3. Xylitol products
4. Soft TB and low abrasive TPs
Denture stomatitis and angular cheilitis are common forms of what oral infections?
p. 831
Why do patients with Down Syndrome have an increased risk of infections?
Abnormalities of the immune system:
-compromised immune response
-disease severity increase
-Increase the risk of infections, lower WBC counts
How can a caregiver adapt a toothbrush for a patient with limited shoulder dexterity?
a lengthened toothbrush with tongue depressors, kitchen spatula or wooden spoon.
Scleroderma causes complications to the skin and underlying connective tissues. What oral complications can patients with Scleroderma have during dental treatment?
1. Tightening of the mouth
2. Limited opening, xerostomia, increases caries risk due to ineffective biofilm removal
3. CT = widening of PDL and increase of periodontal infections.
Prevented by:
semi-upright chair positioning
Changes to a patient's tongue can be found as the patient ages. One common condition is called Atrophic glossitis (burning tongue).
Describe the clinical appearance of atrophic glossitis.
smooth, shiny, bald, atrophied papillae
Due to anemia (iron deficiency), caused by nutritional factors
What common desensitization technique can help reduce anxiety for a patient with anxiety and/or cognitive impairment?
"show-tell-do"
Define Decubitus Ulcers
Pressure sores, bed sores
What medication often used for patients with Bipolar syndrome can cause a metallic taste in the mouth?
Lithium
Anorexia nervosa