Term
| why do a risk assessment for individual patients? |
|
Definition
| to determine which patient's are more or less likely to prevent or control their dental disease |
|
|
Term
| what will the level, high or low risk tell us in the clinic? |
|
Definition
| guide clinical decisions in the treatment of disease |
|
|
Term
| how will this risk assessment help with referrals? |
|
Definition
| it will guide our decision for referrals for the patient |
|
|
Term
| what is patient centered care? |
|
Definition
| care driven by individualized needs. |
|
|
Term
| what are the five steps in oral risk assessment? |
|
Definition
gather
assess
plan
recommend
evaluate or reevaluate |
|
|
Term
| What is done in the gather stage of oral risk assessment? |
|
Definition
| gather and review all patient assessment data |
|
|
Term
| What is done in the assess stage of oral risk assessment? |
|
Definition
| assess and analyze patient data for potential oral concerns (oral risk) |
|
|
Term
| What is done in the plan stage of oral risk assessment? |
|
Definition
| outline goals of therapy for professional and patient self-care |
|
|
Term
| What is done in the recommend/treat stage of oral risk assessment? |
|
Definition
| provide specific oral care products and an oral self care regimen |
|
|
Term
| What is done in the evaluate or reevaluate stage of oral risk assessment? |
|
Definition
| evaluate outcomes of clinical dental hygiene therapy and recommend alternatives as appropriate |
|
|
Term
| What is the main goal in the clinic for us? |
|
Definition
| to maintain or bring oral state back to health |
|
|
Term
| What are the 6 risk assessments we will do? |
|
Definition
Dental caries
TMD- how wide they can open their mouth
Oral cancer
Medical emergencies
gingival and Periodontal disease
Obstructive sleep apnea (OSA) |
|
|
Term
|
Definition
| increase one's susceptibility to periodontitis by modifying or amplifying the host response to the bacterial infection |
|
|
Term
| What 3 things may increase a persons risk factors? |
|
Definition
| Host, environmental (local) and Systemic. |
|
|
Term
| How do these 3 risk factors modify the body? |
|
Definition
| by modifying the response to bacterial pathogens in plaque, resulting in greater variability in individual susceptibility to disease. |
|
|
Term
| what are the 2 TYPES of risk factors? |
|
Definition
Modifiable and
Non-Modifiable |
|
|
Term
| what are modifiable risk factors? |
|
Definition
| those that can be changed |
|
|
Term
| what are non-modifiable risk factors? |
|
Definition
| those that cannot be changed |
|
|
Term
| Increase plaque retention (or pathogenicity) is what kind of risk factor? |
|
Definition
|
|
Term
| What can increase plaque retention be caused by? |
|
Definition
| Defective restorations, caries, tooth anatomy & position, orthodontics, ineffective oral hygiene, calculus. |
|
|
Term
| What are local risk factors that cause direct damage to the periodontium/ hard tissues? |
|
Definition
| Malocclusion (most untreated problem), TB trauma, factitious disease, chemical injury, food impaction, mouth breathing |
|
|
Term
| what are conditions, habits or disease that increase susceptibility to infection? |
|
Definition
| Systemic/acquired factors |
|
|
Term
| what do systemic factors interfere with? |
|
Definition
|
|
Term
| do systemic factors require modifications? |
|
Definition
| yes they will require modifications of treatment |
|
|
Term
| what can systemic factors complicate? |
|
Definition
| factores associated with patient cooperation |
|
|
Term
| Identification of risk indicators: what are some socioeconomic/ psychological factor indicators? |
|
Definition
-Age, race, gender
-frequency of dental care
-level of education
-economic status
-psychological factors |
|
|
Term
| Identification of risk indicators: what are some cultural influences of risk indicators? |
|
Definition
| Valued customs and behaviors |
|
|
Term
| What are some systemic / Acquired risk factors? |
|
Definition
-Genetics influenced
- Drug induced
-Psychosocial stress
-endocrine disorders
-blood Dyscrasia's
-Immuno-suppression
-Nutritional status |
|
|
Term
| what are 3 drug induced systemic / acquired risk factors? |
|
Definition
tobacco
Alcohol
Medications |
|
|
Term
| what are 4 Endocrine Disorders that are systemic / acquired risk factors? |
|
Definition
Diabetes
Hormones
Menopause
Osteoporosis |
|
|
Term
| What is the host response? |
|
Definition
| The reaction of the immune system to infective microorganisms or their products. |
|
|
Term
| What determines disease onset and severity? |
|
Definition
| the complex interaction between periodontal pathogens and the host response. |
|
|
Term
| What is most of the tissue destruction caused by? |
|
Definition
| The host response to bacterial infection of the periodontium. |
|
|
Term
| what is one of the most significant risk factors for periodontal disease? |
|
Definition
|
|
Term
| How much more are smokers likely to exhibit destruction than nonsmokers? |
|
Definition
| 2.6 to 6 times more likely |
|
|
Term
| at age 65 nonsmokers are what % toothless? |
|
Definition
|
|
Term
| at age 65 what % of smokers are toothless? |
|
Definition
|
|
Term
| In an assessment on a smoker will we see an increase in the inflammation and bleeding of the gingiva? |
|
Definition
| No it is more absent in smokers |
|
|
Term
| What will the tissue look like in a smoker? |
|
Definition
| tissue tends to be fibrotic with thickened rolled margins and pale pink color. |
|
|
Term
| will there be a change in the plaque levels of a smoker? |
|
Definition
|
|
Term
| what will there be an increase of in smokers? |
|
Definition
|
|
Term
| are the tissues tight or loose with a smoker? |
|
Definition
|
|
Term
| what TYPE of risk factor is smoking? |
|
Definition
|
|
Term
| what may help smokers reduce their plaque other than daily self care? |
|
Definition
|
|
Term
| what does cessation seem to do? |
|
Definition
| gradually erase the harmful effect on the periodontal health |
|
|
Term
| What are the 3 things we can do to help a patient who smokes? (the ADA smoking cessation initiative) |
|
Definition
|
|
Term
| what are the 3 ways we can approach the Ask, Advise and refer system? |
|
Definition
1. interested in quitting?
2. Encourage an action plan
3. take 30 seconds to refer a patient to a quit-line |
|
|
Term
| is Genetic markers a factor in periodontal disease? |
|
Definition
|
|
Term
| what % accounts for genetic influence in periodontal disease? |
|
Definition
|
|
Term
| periodontal disease is a common complication of? |
|
Definition
|
|
Term
| If Periodontal disease is untreated it makes it difficult for a patient to control? |
|
Definition
|
|
Term
| what are controlled glucose levels? |
|
Definition
|
|
Term
| Will uncontrolled diabetics respond well to non surgical periodontal therapy? |
|
Definition
|
|
Term
| what is a Hemoglobin A1C number? |
|
Definition
| it monitors blood glucose over time. Amount of sugar attached to hemoglobin |
|
|
Term
| If a diabetic has a % of less than 7% are they at risk for complications? |
|
Definition
| less than 7% the chance for complications decreases |
|
|
Term
| over 8% sugar bound to hemoglobin does what? |
|
Definition
| raises the risk for complication and more susceptible to infection and decrease healing/potential for medical emergency. |
|
|
Term
| if a Patient has well controlled diabetes are they at a greater risk than someone without diabetes? |
|
Definition
| No they are at the same risk level |
|
|
Term
| does periodontal disease develop at the same rate as someone without diabetes ? |
|
Definition
| No a diabetic is 2-3 times greater |
|
|
Term
| A diabetic over the age of 45 is how many more times likely to experience sever perio? |
|
Definition
|
|
Term
| in a diabetic and increase of ____________ increases the likelihood of developing periodontitis and tooth loss? |
|
Definition
|
|
Term
| Dental offices fall under what in terms of glucose testing? |
|
Definition
| Clinical laboratory improvement amendment (CLIA) |
|
|
Term
| What can a change or imbalance in estrogen and progesterone cause? |
|
Definition
| gingivitis and periodontitis are more sever |
|
|
Term
| Pregnancy, Pubertal and postmenopausal patients may exhibit what kind of change to local risk factors? |
|
Definition
| exaggerated inflammatory response |
|
|
Term
|
Definition
| disorder characterized by loss of bone mineral |
|
|
Term
| who does osteoporosis occur most frequently in? |
|
Definition
| postmenopausal women, sedentary individuals, and patients on long term steroid therapy |
|
|
Term
| A loss of density of the alveolar bone in osteoporosis may cause what? |
|
Definition
| exacerbate the bone resorption in periodontitis |
|
|
Term
| what does immunosuppresion mean? |
|
Definition
| impairment of the host response to combat infections |
|
|
Term
| what is an example of an immunosuppressed Person that a degree of immunodeficiency influences the prevalence and severity of the periodontal disease? |
|
Definition
|
|
Term
| what effects do medications have on salivary flow? |
|
Definition
Physical flow reduced
antimicrobial components
repair and regenerate tissues
over 400 OTC & RX drugs have xerostomia as a side effect |
|
|
Term
| what medications cause the effect of gingival enlargements? |
|
Definition
anticonvulsants- Phenytoin (Dilantin)
Immunosuppressives - Cyclosporine (Sandimmune) |
|
|
Term
| What kind of medication can cause alterations of plaque composition? |
|
Definition
| cough syrups, vitamines that contain sugar |
|
|
Term
| what kind of alterations to plaque will cough syrups and sugary vitamins cause? |
|
Definition
| add significantly to plaque PH and composition |
|
|
Term
| what does Blood Dyscrasia's affect? |
|
Definition
| Disorder that affect cellular elements of the blood (WBC; RBC) |
|
|
Term
| do we see Blood Dyscrasia's in dental offices frequently? |
|
Definition
|
|
Term
| what happens in Blood Dyscrasia's? |
|
Definition
| it is an impaired function of infection-fighting WBC such as PMN's resulting in inability to fight oral infection. |
|
|
Term
| what can Psychological stress increase your risk for? |
|
Definition
|
|
Term
| what is the hypothesis behind stress induced periodontal disease? |
|
Definition
| that corticosteriods released in response to stress act as growth factors for certain periodontal pathogens |
|
|
Term
| immunosuppression can also result from? |
|
Definition
|
|
Term
| changes in behavior and poor OH can also be caused by what? |
|
Definition
|
|
Term
| what is therapeutic intervention? |
|
Definition
| a step or a measure designed to halt or significantly alter the current course of an event. |
|
|
Term
| What is a therapeutic intervention step we take to stop periodontal disease? |
|
Definition
| Debriding the root surface to eliminate gingival inflammation and in arresting bone loss and gingival attachment |
|
|
Term
| what is another therapeutic intervention we will use with all of our patients? |
|
Definition
|
|
Term
| what will we do in periodontitis education? |
|
Definition
teach about perio disease
relationship of plaque/perio/risk factors
relate bleeding index/plaque index to perio activity
toothbrushes
oral aids for reaching pocket depth.... not just floss
tongue cleaners
Intraoral camera for pt education
anti plaque agents / subgingival irrigation
sustained release antimicrobials/ systemic antibiotics |
|
|
Term
|
Definition
| Method that stops or prevents an expected or anticipated outcome from occurring |
|
|
Term
| what can we do to prevent both dental caries and gingival or periodontal disease? |
|
Definition
| removal of bacterial plaque biofilm to biologically acceptable levels |
|
|
Term
| are dental caries an infectious disease? |
|
Definition
|
|
Term
| what are modifiable changes that we can do to help prevent caries? |
|
Definition
| fluoride, xylitol, nutrition changes, ACP |
|
|
Term
| Saliva flow and components, proteins, antibacterials, fluoride, calcium, phosphate, protective dietary components, non-cariogenic sweeteners are all what kind of factors for caries? |
|
Definition
|
|
Term
| Acidogenic bacteria (mutans streptococci and lactobacilli) frequency of fermentable carbohydrate ingestion, reduced salivary function are all factors of what in caries? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Mallampati score 3-4, Narrow Maxilla.mandible, Micrognathia, macroglossia, Elongated uvula, Burxer/Clencher, Occlusal Trauma/Attrition, Large neck circumference, Snores at night/Falls asleep during day if inactive. These are all risk factors of what type of disease? |
|
Definition
|
|
Term
| What are the risk factors for TMJ disease? |
|
Definition
Crepitus/popping
Earaches
headaches
facial pain
Malocclusion |
|
|
Term
| What are the risk factors for oral cancer? |
|
Definition
HPV/HIV
history of oral or other cancer
Tobacco user, present or past
Excessive alcohol use
Sunlight exposure/ fair skinned patient
Abuse of narcotics |
|
|
Term
| what systemic diseases are risk factors for periodontitis? |
|
Definition
Cardiovascular disease
Diabetes
pre-term birth/low birth weight
Respiratory Disease-pneumonia
Gastric Ulcers |
|
|
Term
| what 2 diseases are both associated with a systemic inflammatory response? |
|
Definition
| Periodontitis and cardiovascular disease. |
|
|
Term
| Periodontitis may result in increased cardiovascular risk based on what? |
|
Definition
| Serum C Reactive Protein levels |
|
|
Term
| Perio. and atherosclerosis have what risk factors in common? |
|
Definition
| smoking, diabetes, elevated CRP levels |
|
|
Term
| Problems with glycemic control can be contributed to ? |
|
Definition
|
|
Term
| what does the ADA recommend for Diabetic patients (to Check)? |
|
Definition
On insulin=2x a day
oral meds= 1x a day
Diet control= 1-2x a week
A1C level= 2x a year |
|
|
Term
| will treatment of chronic perio help the glycemic levels in some patients? |
|
Definition
|
|
Term
| Is there enough evidence to say that pre-term/low weight babies are due to periodontal disease? |
|
Definition
|
|
Term
| was there a high rate of pre-term/low weight babies in periodontal grouped patients? |
|
Definition
|
|
Term
| What is the theory behind how periodontal disease would affect/cause pre-term/low weight babies? |
|
Definition
| oral infections will result in prostaglandins released into the bloodstream that can lead to premature cervical changes |
|
|
Term
| What can be caused when, periodontal pathogens found in the oral cavity can be aspirated into the lungs and lead to pneumonia and decreased overall lung function. |
|
Definition
|
|
Term
| what can form in the gut and is shown a relationship to periodontal disease? |
|
Definition
|
|
Term
| Name some problems that we may identify in a patient, these may be our diagnosis? |
|
Definition
-Knowledge Deficit
-Plaque Accumulation (Gingivitis)
-Periodontal Disease (Periodontitis)
-Moderate to high caries risk
-Hypersensitivity
-Xerostomia
-Halitosis
-Malocclusion
-Missing teeth
-Implant Management/ Appliance Care
-Pain Management
-Potential for Oral Cancer |
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|
