Exam II contemporary tobacco

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Author:
darbydo88
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46333
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Exam II contemporary tobacco
Updated:
2010-10-31 21:01:30
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contemporary
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tobacco
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  1. single most preventable cause of disease and premature death
    tobacco
  2. most addictive substance in tobacco
    nicotine (not most harmful)
  3. Metabolism of nicotine in smoking
    • nicotine absorbed through lungs
    • remains in body 8-12 hrs (one puff)
    • concentration declines over 20-30 min
  4. metabolism of smokless tobacco
    • absorbed throuh oral cavity and intestines
    • 2-3 times more nictine absorbed than a cigarette
    • concentration declines over 2 hrs
  5. systemic effects of tobacco affect which organ systems
    All
  6. desease consequences of tobacco use are in 3 categories
    • Cardiovascular (atherolsclerosis)
    • pulmonary (COPD)
    • Cancer (oral cavity 75% and lungs87%)
  7. COPD
    chronic obstructive pulmonary disease
  8. Respiratory diseases casued by tobacco use
    • COPD
    • Emphysema
    • Bronchitis
    • Asthma
    • Bacterial pneumonia
    • tuberculosis
  9. cardiovascular diseases caused by tobacco
    • atherosclerosis
    • coronary artery disease
    • hypertension
    • aortic aneurysm
    • arterial thrombosis
    • stroke
  10. ETS
    Environmental Tobacco Smoke
  11. The principal contributor to ETS is
    Sidestream smoke
  12. other names for ETS
    • passive
    • secondary
    • second-hand
  13. Toxicity of ETS
    • many of the same chemicals are found
    • some toxic components are actually in higher concentrations in sidestream smoke than in mainstream
  14. Primary cause of lung cancer
    smoke
  15. what are the most commoly reported symptoms of nonsmokers
    eye and nose irritation
  16. most deaths that occur annully from exposure to ETS are attributed to
    heart disease
  17. problems of ETS in utero
    • risk of miscariage
    • placenta previa (placenta implanted in lower segment of uterus)
    • low birth weight
    • increase in perinatal mortality
    • cleft lip/palate
    • delayed tooth formation
  18. problems of ETS in infancy
    • chemicals passed through breast milk
    • lower respiratory illness
    • SIDS
  19. problems of ETS in young children
    • Affects lung development (coughing phlegm, and wheezing)
    • higher risk for asthma
    • inceased middle ear infection
    • possible behavioral and low academics due to missed days of school from other illness
  20. Major risk factor for periodontal disease
    tobacco
  21. Effects of smoking on Periodontal tissues
    • Gingivitis is REDUCED compared to nonsmokers
    • Increased rate and severity of periodontal destruction
    • increased severity
    • bone loss
    • attachment loss
    • pocket depths,
    • recesssion in anterior regions
    • tooth loss
  22. Mechanisms of periodontal destruction
    • host response: lowered immune factors
    • imparied neutrophils: decreased chemotaxis, phagocytosis, and adhearence
    • altered antibody production: decreased serum IgG
    • Imperment of revascularization: impact on healing
    • negative effect on bone metaboism: influences osteoperosis
  23. Smoker's response to treatment
    • delayed healing
    • resistance to conventional therapy
    • greater risk for implant failure
  24. nicotine withdrawal syndrome
    • dysphoric (depressed mood)
    • insomnia
    • irritability, frustration, and anger
    • anxiety
    • difficulty concentrating
    • restlessness
    • decreased heart rate
    • increased appetite or weight gain
    • cravings for tobacco
  25. reasons for quitting
    • general health awareness
    • specific health problem related to tobacco
    • effect on family (rolemodel, or ETS)
    • effect of smoking druing pregnancy
    • cost
    • social pressure and restrictions
  26. self-help strategies
    • go cold turkey
    • reduce number of dialy exposures
    • OTC nicotine replacement
    • Join family or friend
  27. assisted strategies
    • counsling
    • pharmacotherapies
    • combination
  28. NRT
    Nicotine replacement therapy
  29. 5 NRTs
    • gum (transmucosal)
    • patch (transdermal)
    • inhailer (transmucosal)
    • Nasl spray (nasal mucous membrane)
    • Lozenge (transmucosal)
  30. Nicotine free therapy
    • Bupropion SR (Zyban)
    • Varenicline tartrate (chantix)
    • Other therpies are not approved for tobacco dependence therapy
  31. What is included in the dental hygiene assessment of a tobacco patient
    • Patient history
    • viatal signs
    • extraoral examination
    • intraoral examination
    • consulatation
  32. Extraoral exam
    • Halitosis
    • fingers(yellow brown)
    • skin (wrinkles)
    • lips (at risk for lesions)
  33. Intral oral exam
    • detection of intraoral lesion/problem: show, explain, record
    • Refer: (if lesion persists for more than 2 weeks, biopsy indicated)
    • oral self-exam: (teach patient how to do self-exam)
  34. First prioraty in clinical procedures
    dental biofilm control
  35. Clincal treatment and procedures
    • dental biofilm removal
    • scaling and root planning
    • Patient instruction
    • tobacco cessation program
  36. What are the 5A's
    • Ask
    • Advise
    • Assess
    • Assist
    • Arrange
  37. Explain Ask
    • Health history: ask patient about tobacco use
    • Present questions carefull
    • Obtain patient's confidence
    • children affected by habit
  38. Explain Advise
    • Never Users/former Users
    • Stop-look-listen approach (avise about stopping now, show patients how to look in their mouths, listen to patients reasons for now quitting)
    • brief advice to patients
  39. Explain Assess
    • Ask patient "are you ready to quit"
    • If yes, proceed to assist
    • If no, go to 5 R's
  40. Explain Assist
    • Establish a quit plan
    • provide practical counceling
    • pharmacotherapy
    • provide education material
  41. Explain arrange
    • contact the patient before the quit date
    • follow up contact (phone or email)
    • actions during follow up contact (congradulate, encourage, restore confidence)
  42. what are the 5 R's
    • Relevance
    • Risks
    • Rewards
    • Roadblocks
    • Repetition
  43. Factors to teach patient
    • Perform self-exam
    • risks of tobacco use in pregnancy
    • risks of addiction
    • effects of ETS
    • advocacy for patients and community

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