ch 44 theory II

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ch 44 theory II
2011-03-01 20:32:31
theory II

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  1. what are the final steps in providing evidence based dental and dental hygiene care?
    evaluation of tx outcomes and oral health education interventions
  2. ______ ________ at the end of a sequence of dh interventions determines whether or not the goals in the pts care have been met
    summative evaluation
  3. when can info regarding the need for modifications of the original pt care plan be evaluated?
    during the ongoing evaluation of tissue changes and pt sel care ability during multi-appt tx
  4. a plan for evaluation of a pt care outcome includes: (3) during each appt
    • informal monitoring
    • feedback
    • modifications
  5. at the beginning of tx, methods for evaluating the success of dh tx include what?
    re-collection of same clinical data (i.e. probing depths, bleeding)
  6. what are the overall purposes of tx during maintenance? (4)
    • arrest disease
    • provide oral health
    • function
    • comfort for pt
  7. maintenance = ________ ______
    continuing care
  8. oral diseases do or do not recur? what is possible through combined personal and professional effort?
    • DO RECUR
  9. t/f lifelong preservation of teeth and their supporting structures is a realistic goal
  10. success of the maintenance program depends on the _________ by the pt of the maintenance procedure
  11. a way to help the pt become aware of the concept of the maintenance phase is in the _______ ______ ______
    initial care plan
  12. t/f a fixed schedule is used for all pt's in oral health because the frequency is similar for each pt
    FALSE! NO fixed schedule because the frequency depends on the needs of each pt
  13. for maintenance, appts may vary from ____ to ____ months
  14. what are some predisposing diseases, conditions, and behaviors for periodontal disease?
    • diabetes
    • HIV/AIDS
    • host genetic factors
    • smoking
    • stress
  15. what are local factors of maintenance? (1)
    rate of calc formation
  16. what are restorative complications of maintenance? (2)
    implants, prosthetic replacements
  17. what are three "risks" for contributing factors of maintenance frequency?
    • perio disease activity
    • dental carious lesions
    • oral cancer: tobacco and alcohol users
  18. which 6 categories of pt's may need intervals of 2-3 months for special appointment requirements?
    • mentally or physically disabled
    • diabetes
    • cardiovascular disease
    • pt undergoing extensive dental care
    • rampant dental caries
    • ortho therapy
  19. why might someone with diabetes need to be on a 2-3 mo recall??
    it can predispose pt's to lowered resistance to infection; tissues MUST not be allowed to develop advanced disease
  20. why might short appts be necessary for someone with cardiovascular disease?
    • brushing is a difficult procedure to carry out
    • fort appts can be tolerated because of the fatigue factor
  21. when a pt is undergoing ___________ ________ _________, the gingival or perio tx may be completed by the time appts for restorative phases of tx are underway. the first maintenance needs to be dated from the _______of the initial gingival and perio tx.
    when extensive restorative prosthetic, or tx is in progress, the frequent tissue maint. during long term therapy is essential
    • extensive dental care
    • completion
  22. why would someone with rampant dental caries need to have 2-3 mo interval appts?
    • topical fl2 application
    • dietary supervision
    • personal factors for biofilm control
  23. what is PMT?
    perio maint. therapy
  24. what are the four PMT's?
    • preventive
    • trial
    • compromise
    • posttreatment
    • ALL P to the M to the T
  25. to prevent the initiation of disease in individuals without perio = (what PMT?)
    preventive PMT
  26. to proved an interm study period for borderline pts with conditions that ust be observed and further evaluated before a decision can be made for correctvie surgery or whether maint is possible wi/out further advanced disease therapy = (what PMT?)
    trial PMT
  27. to slow the progress of disease in pts for whom corrective surgery and advanced tx are indicated but cannot be implemented for reasons of health, economics or other personal factors= (what pmt?)
    Compromise PMT
  28. to prevent the recurrence of disease and maintain the state of perio health attained during perio therapy. It may be surgical or nonsurgical = (what PMT?)
    Posttreatment PMT
  29. t/f at maintenance appt assessment preparations are the same plan as for a new pt?
  30. what needs to be completed at EVERY maintenance appt whether it is 3, 6, whatever month intervals for a pt of any age?(3)
    reassessment, progress diagnosis, and maint. care plan
  31. t/f radiographs are taken routinely
    FALSE! it is based on the dentist's determination of an individuals needs
  32. what should be examined of the teeth during maint. appts?
    • integrity of restorations and sealants
    • dental caries: demineralization, early dental caries, and cavitated lesions
    • sensitivity
  33. during a perio exam with complete probing of maint appt, what three things are taken into consideration?
    • BOP
    • attachment levels
    • compare with previous probings to check for changes
  34. after applying a disclosing agent relating biofilm to teeth can help see areas of _______ ______, ________ and other signs of inflammation
    • gingival redness
    • enlargement
  35. areas of special problems include __________ treated teeth, __________ areas, implants, _____ factors, and prosthetic appliances
    • endodontically
    • postsurgical
    • occlusal factors
  36. during continuing care, the pt is considered a _________
  37. a perio pocket exam with bop indicates need for deep ______ and ______ _______
    scaling and root planing
  38. what type of anesthetic might be needed for perio scaling and debridement?
    local anesthesia or subgingival gel
  39. local delivery of antimicrobials when doing perio scaling and debrid should be administered for isolated ______ _____ _____
    persistant deep pockets
  40. should you plan on a number of appts for scaling and debrid?
    yep, unless you are houdini and make the calc disappear (hey! maybe i should practice being a magician!)
  41. what are the three points during pt care when the hygienist may confer with the dentist to determine the need for referral to a periodontist?
    • initially
    • later during reevaluation
    • during maintenance
  42. if a new pt comes in and has severe advanced perio or has uncommon perio disease (juvenile perio), NUG or NUP, or a drug-induced gingival enlargement (phenytoin for seizures), when would this be noticed during which of the three point referral stage?
  43. after perio quad scaling for nonresponsive or refractory type of mod or advanced perio condition, when would this be noticed?
    later during the reevaluation for poss referral
  44. pocket depth that prohibits access to complete debrid, furcation involvements that cannot be accessed without surgical methods, mucogingival problems (lack of attached gingiva near healthy receded gingival margin, and perio disease that is refractory (not responsive) should: be ________ _______ _______
    referred during maint
  45. recurrence signs and symptoms of perio infection indicates what?
    recolonization of perio pathogens
  46. recolonization of a pocket can occur within HOW MANY DAYS?
    42 days!
  47. without dail personal dental biofilm control and regular professional supervision and maint. procedures, _______ can recur
  48. t/f it depends on the pt how soon after completion of tx recurrence of perio happens.
  49. what are 6 CONTRIBUTING factors for recurrence of perio disease?
    • insufficient biofilm removal
    • lack of compliance with maint appts
    • incomplete professional tx
    • tobacco use
    • systemic diseases
    • genetic factors