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Define Standard Precautions:
they are a routine of clinical safeguards that are used for every patient regardless of their perceived infectious status.
Why are standard precautions essential?
- As patients may be unaware of the infections they have, which means staff and other patients may be at risk of cross-infection
- If patients infectious status is unknown and lab tests need to be performed, wont be completed in time to provide emergency care
- Patients may be infectious before lab tests are positive or signs of disease have manifested.
- Introduction of them means no patients feels discriminated against.
Why is a medical history important to take?
A medical history identifies any conditions that may compromise the patients health during dental treatment. It heaps identify any communicable disease from which a patient may be suffering and be aware of but not know the relevance to the dentist.
What are additional precautions or "risk-based" precautions needed for
Protecting staff and patients from transmission of a particular disease through airborne, droplet or direct or indirect contact. Required for those diseases that are dangerously infectious.
What does PPE involve? And what additional standard precautions are there?
- face mask
- hair control
- safety glasses (for both the patient and staff)
- single use gloves
- Sharps bin
- clean and contaminated zones - keeping them separate
- sterilisation of instruments through ultrasonic cleaners or autoclaves
- frequent washing of hands
Give some examples of medical conditions that can affect oral health and specify the impact.
- - Diabetes: if poorly controlled or if patient has trouble controlling their blood glucose levels, they are more likely to have periodontitis. If the periodontitis is not treated (which can actually help control blood glucose levels) and the diabetes remains poorly controlled, it can speed up the insulin resistance in the body.
- - Asthma: inhaled steroids or cortisols increases the risk for oral candidiasis
- Studies have shown that bad oral health is a risk towards Cardiovascular Disease. Evidence of this has shown that microorganisms of the oral cavity have been found in atherosclerotic lesions e.g. P. gingivalis and Chlamydia pneumoniae.Respiratory disorders such as pneumonia also has oral health risks as the bacteria has to travel through the oral cavity to get the the lungs.
- Having better oral care has shown a decrease in rate of respiratory infections in intensive care patients and a decrease risk of CVD.
A complex microbial community found on tooth surfaces.
Define Material Alba:
Chalky white substance found on tooth surfaces.
Mass of cells, bacteria and left over food that you can scrape off your teeth.
Explain the development of the plaque biofilm:
- 1. Acquired pellicle formations:
- - protein in saliva sticks to tooth
- 2. Attachment of single bacterial cells
- - aerobic species attach to pellicle e.g. Streptococcus mitis3. Growth of bacterial to form micro organisms
- - grow and attach to one another, very organised
- 4. Microbial succession and increase species diversity
- - structure = very complex = defend itself so can sustain its environment
- - aerobic to anaerobic environment
- - Fusobacterium nucleatum is very important as a link of the Gram positive and Gram negative organisms
- 5. Mature Biofilm/ complex community:
- - increase in anaerobic species at base (nice and thickly attached)
- - aerobic organisms loosely found on top
- - organised defence systems e.g. water channels to flush out dead aerobes and nutrient systems
- *Can actually move and colonize elsewhere
How can we disclose plaque and test the biofilm?
Using plaque disclosing tablets or two tone disclosing gels which die young and mature plaque either pink or purple respectively.
Identifies to patient where they arent cleaning properly
* Halitosis - mature plaque biofilm and tongue coating
Goals of Mechanical Plaque control:
- Keep biofilm young and keep oxygen flowing through it - preventing the nasty anaerobes
- prevent oral diseases
What is the best technique to use when brushing your teeth? Explain it.
What is the best time to floss?
- The Modified Bass Technique:
- - hold tooth brush (soft bristle and small head) at a 45o angle to long axis of teeth directed towards the gingival sulcus
- - circular, vibrating motion
Are electrical toothbrushes better?
Can be better as removes plaque faster BUT it depends on how you use it and how well you use it in disrupting the biofilm and keeping it young.
What are some other aids of mechanical plaque control?
- Super Floss
- Interdental Brushes
- Special Purpose Brushes
Why is having a dental team important?
- - delegation of tasks
- - allow training and supervision
- - efficient and effective delivery of services
- - effective management - hierarchy of professionals
- - job variety
List some Clinical members of the team:
- -dentists/ dental specialists
- - oral health therapists
- - dental therapists
- - dental hygienists
- - dental prosthetist
- - dental assistant.
List some non-clincal members of the dental team:
- - receptionist
- - treatment co-ordinator/ practice manager
- - dental technician - both on and off site.
Difference between Dental Therapy and Dental Hygiene:
Dental therapists can only perform procedures on 4-17 year old. Basically carry out all procedures dentists can except for invasive treatments. E.g. charting and examinations, local anaesthetics, extractions of primary teeth, cavity prepping for primary and permanent teeth.
Dental hygienists can work on people of all ages and can track signs of periodontal disease, perform prophylaxis, remove sutures and perio-packs and perform orthodontic needs, along with many other tasks.
List some traditional and expanded duties of a Dental Assistant:
- - reception
- - data entry
- - chairside assist
- Expanded Duties:
- - impressions and study models
- - photography
- - saliva/ plaque testing
- - diet analysis and lifestyle counseling.
How is the role of a dentist changing?
- Dentists are perceived as more of a physician of the mouth
- There is a greater stress on prevention rather than intervention
- Are involved in both general and surgical procedures