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Menopause is the end of fertility due to decreased production of what hormones produced by the ovaries?
Describe 3 main symptoms of menopause.
- vasomotor reactions: hot flashes; headache, flushing face, heart palpitations, dizziness, chill, few-more than 30 mins.
- Vaginal changes: dry, irritated, thinning tissue, more infections, decreased estrogen
- emotional disturbances: mood swings, depression, irritability, difficulty w/concentration or membory, decreased interest in sex, anxiety, tension, feeling useless, weight gain esp. around waist
Taste perception may be altered in women going through menopause, what are 3 ways they may describe taste?
What are 5 oral changes that are common in women going through menopause?
- shiny tissue
- burning mouth syndrome
- altered salivary composition due to psychological stress
- thin and atrophic epithelium, decreased keratinization
- gingival changes representing an exaggerated response to biofilm
Appearance and adverse changes of the mucosal tissues from menopause frequently resemble those associated with vitamin deficiencies, particularly which vitamin?
What is a dynamic period of development marked by rapid changes in body size, shape, and composition? A sign of growing up?
Which gender usually goes through puberty first? At which age do the secondary sex characteristics begin to appear in girls? And in boys?
erosion of enamel and dentin as a result of chemical and mechanical effects.
The following psychosocial developmental factors describe which phase of adolescence?
less interest in parental activitieswide mood swingspreoccupation with self and pubertal changes
uncertainty about appearance
intense relationships with same-sex friends
increased fantasy world
idealistic vocational goals
increased need for privacy
lack of impulse control
The following psychosocial developmental factors describe which phase of adolescence?
peak of parental conflicts
general acceptance of body
concern over making body more attractive
peak of peer involvment
conformity with peer values
increased sexual activity and experimentation
increased scope of feelings
increased intellectual ability
feeling of omnipotence
The following psychococial developmental factors describe which phase of adolescence?
reacceptance of parental values
acceptance of pubertal changes
peer group less important
more time spent in sharing intimate relationships
practical, realistic vocational goals
refinement of moral religious and sexual values
ability to compromise and to set limits
What is the relationship of the parotid gland with bulimia nervosa?
- the gland enlarges
- enlarement may occur for 2-6 days after binge
- cause is unkown
- degree of enlargement increases with frequency of vomiting
- gland functions normally and is not sensitive to palpation
What are 11 oral findings common with bulimia nervosa?
- perimylolysis: chemical erosion of tooth surfaces by acid from regurgitation of stomach contents
- evidence of bulimia on smooth palatal surfaces of teeth
- restorations raised because of erosion of enamel
- increase in caries
- decreased saliva
- hypersensitive teeth
- trauma; from devices or fingers to induce vomiting
- enlarged parotid gland
- impairment of taste perception
Which teeth typically exhibit erosion in pts with bulimia nervosa?
- palatal surfaces of teeth
- lingual surfaces of maxillary anterior teeth
What are 7 prenatal BIOMEDICAL risk factors for mental retardation?
- chromosomal disorders
- single-gene disorders
- metabolic disorders
- cerebral disorders
- maternal illnesses
- parental age
What are 3 perinatal BIOMEDICAL risk factors for mental retardation?
- birth injury
- neonatal disorders
What are 6 postnatal BIOMEDICAL risk factors for mental retardation?
- traumatic brain injury
- seizure disorders
- fetal alcohol syndrome
- congenital heart disease
What are 4 prenatal SOCIAL risk factors for mental retardation?
- maternal malnutrition
- domestic violence
- lack of access to prenatal care
What is a perinatal SOCIAL risk factor for mental retardation?
lack of access to birth care
What are 5 postnatal SOCIAL risk factors for mental retardation?
- impaired child-caregiver
- inadequate parenting skills
- family poverty
- chronic illness in the family
What are 4 prenatal BEHAVIORAL risk factors for mental retardation?
- parental drug use
- parental alcohol use
- parental smoking
- parental immaturity
What are 2 perinatal BEHAVIORAL risk factors mental retardation?
- parental rejection of caretaking
- parental abandonment of child
What are 5 postnatal BEHAVIORAL risk factors for mental retardation?
- child abuse and neglect
- domestic violence
- inadequate safety measures
- social deprivation
- difficult child behaviors
What are 2 prenatal EDUCATIONAL risk factors for mental retardation?
- parental cognitive disability without supports
- lack of preparation for parenthood
What is a perinatal EDUCATIONAL risk factor for mental retardation?
lack of medical referral for intervention services at discharge
What are 5 postnatal EDUCATIONAL risk factors for mental retardation?
- impaired parenting
- delayed diagnosis
- inadequate early intervention services
- inadequate special educational services
- inadequate family support
What are 2 effective ways to help prevent caries in the mentally retarded pt?
- fluoride therapy: fluoride varnish
What are 3 common oral manifestations of pts with autism?
- previous dental care: low priority, not seek dental services, dental neglect
- dental caries: given food that will be accepted regardless of nutrition, diet limited by needs for sameness, sweet foods as a reward for good behavior
- oral hygiene: daily oral care procedures may be inadequate
What are 9 appointment planning and managing tips for pts with autism?
- work with pt: review histories, gather info about them
- short orientation and familiarization apptmnts first
- involve same members of dental team at each appt with the pt
- four-handed dental hygiene
- frequent apptmnts to include all phases of prevention: biofilm control, scaling, fluoride, sealants
- provide predictable and consistent experience
- quiet environment
- "show-tell-do" instructions
- physical immobilization: may be necessary
Pt instruction for the autistic pt tak the form of ______________ repeated many times
What is an atypical antipsychotic medication that has been shown to be significantly more effective than placebo in improving behavior, representing the largest positive effect by a medication ever observede in children with autism?
What are 4 types of drugs that are used to pharmacologically treat autism?
- stimulants: methylphenidate, ritalin
- opiate blockers
What is a collection of conceptual, social, and practical skills that have been learned by people in order to function in every day life? It includes:
conceptual: language, reading, self-direction
social: responsibility, self-esteem, law abiding
practical: daily living activities, occupational skills
What are 4 common characteristics in the autistic pt?
- problems with social interactions
- problems with verbal and nonverbal communication
- ritualistic or compulsive behaviors
- atypical responses to the environment
dentistry pertaining to or used in legal proceedings
clinical presentation of an initial HSV infection from HSV-1 (oral) or HSV-2 (genital) that can appear as multiple ulcerations on both keratinizing and gland-bearing mucosa
acute primary herpetic gingivostomatitis
ill health, malnutrition, wasting (emaciating)
discoloration on the skin that is blue-black with irregularly formed hemorrhagic areas. color changes with time to yellow or greenish brown
What phase of dental hygiene treatment are you most likely to identify abuse?
intra and extra oral exam
What are 7 common extraoral signs of abuse in children?
- skull injuries: edema with ecchymosis of varying phases
- bald spots: traumatic alopecia
- raccoon sign
- nose fracture or displacement
- lip bruises and lacerations
- marks on skin that form a pattern of an object like a belt buckle or handprint
- human bite marks
Wha are 3 common extraoral signs of abuse of domestic and intimate partner abuse?
- bruises in various degrees of healing frequently involving the face, eyes, and neck
- partner reluctant to admit abuse because of fear of threats
- deny abuse
What are 4 common intraoral signs of abuse seen in children?
- lacerations of tongue, buccal mucosa, or palate
- lingual and labial frenal tears
- teeth that are fractured, displaced, avulsed, or nonvital
- radiographic evidence of fractures in different degrees of healing
What are 8 common intraoral signs of abuse seen in adults?
- fractured, displaced, or avulsed teeth
- bruising of edentulous ridge
- STDs such as condyloma acuminatum and primary herpetic gingivostomatitis
- lesions or sore areas in mouth from ill-fitting dentures
- fractured denture
- poor oral hygiene
- rampant dental caries
- untreated periodontal disease
What group of people are typically the primary elder abusers?
What are 5 common signs of sexual abuse in children?
- bruising or petechiae of the palate: forced oral sex
- sexually transmitted gental lesions found intraorally
- exhibits difficulty in walking or sitting
- extreme fear of the oral examination
- pregnancy, especially in the early adoscent years
What is the ability to endure without effect or injury. increased amount of the drug is needed to achieve the same effect?
What is a feeling of well-being, elation; without fear or worry?
What is a condition of deteriorated mentality characterized by a marked deline of intellectual functioning?
What percent of alcohol is absorbed by the liver?
true or false. alcohol passes freely across the placenta
What is the brand name of the drug used to treat alcholism?
true or false. Alcohol CAN be spread through breast milk, so you should refrain from drinking.
What are 2 oral manifestations of the mucosa, lips, and tongue due to drug abuse?
- dry: drug induced xerostomia, soft tissue abnormalities
- tongue coated: glossitis related to nutritional deficiencies
What are 6 oral manifestations of the gingiva due to drug abuse?
- poor oral hygiene; heavy biofilm
- calc deposits generalized
- mod to severe gingival inflammation
- bleeding gingiva spontaneously or on probing
- gingival lesions resulting from the direct application of cocaine
- higher incidence of perio infections than peers
What are 3 oral manifestations of the teeth due to drug abuse?
- chipped and fractured from falls and injuries; stained from tobacco
- attrition secondary to bruxism
- erosion secondary to frequent vomiting, wine consumption, and meth mouth
What are 5 oral manifestations of dental caries due to drug abuse?
- increased risk factors: poor diet, lack of dental care, accumulation of biofilm, and xerostomia
- diet high in cariogenic substances
- root caries if gingival recession is evident
- open rampant carious lesions, abuse of analgesic drugs results in indifference to pain
- tooth loss
What are 3 oral manifestations of minimal professional care due to drug abuse?
- substance abuse pt tends to put off dental and dental hygiene care
- any available money is used in the purchase of the drugs
- dental care is used on an emergency basis to alleviate any pain or discomfort, and to obtain prescriptions for drugs
true or false. Ultrasonic scalers and air-powder stain removal devices should be used with caution to prevent inhalation of oral microorganisms by the pt
warning sensation felt by some people immediately preceding a seizure; may be flashes of light, dizziness, peculiar tast, or a sensation of prickling or tingling
true or false. When experiencing an aura, a pt may seek a safe place to sit or lie down in privacy
What are 4 seiqure 'triggers'?
- psychological stress; apprehension
- fatigue; sleep deprivation
- sensory stimuli, such as flashing lights, noises, peculiar odors
- use or withdrawal of alcohol or other addictive drugs
What type of seizure: the loss of consciousness begins and ends abruptly in about 5-30 seconds
most common in children
pt has blank stare, usually doesn't fall but becomes fixed and drops what they're holing
twitching of eyelids, brows, head, or chewing
attack ends abruptly; pt is unaware
petite mal (absence seizure)
What type of seizure: has the epileptic cry
loss of consciousness is sudden and complete, pt may fall
tonic phase, followed by clonic movements
pale to bluish
loss of bladder
lasts 1-3 minutes
has preictal, ictal, and postictal phases, may continue to status epilepticus
tonic clonic (grand mal) seizure
What are 3 different classifications of seizures?
- partial: simple (w/out loss of consciousness) complex (impairment of consciousness
- partial evolves to ->
- generalized: nonconvulsive; convulsive
- generalized evolves to ->
- unclassified epileptic seizures
What are 12 side effects of common seizure drugs?
- allergic reaction, rash
- fatigue, drowsiness, weakness, ataxia, headache, slurred speech
- nausea, vomiting
- memory loss; behavioral and cognitive deficiencies
- damage to loiver
- thrombocytopenia; decreased platelet aggregation; increased bleeding
- increased or unknown risk of birth defects
- oral change of gingival enlargement (phenytoin)
- drug interactions
What are 4 different treatment options for seizures?
- vagus nerve stimulation
- ketogenic diet
What are 8 emergecy procedure steps to do incase of a seizure in the dental office?
- do not try to stop seizure or restrain pt
- stop procedure and call for help
- protect pt from injury
- don't place anything between teeth
- establish airway monitor vitals
- stay with pt
- check for consciousness
When do you activate the emergency medical system in the event of a seizure?
if the seizure is still recurring, or has recurred within 5 minutes
gingival overgrowth/ hyperplasia occurs in what percent of persons using phenytoin for seizure treatment?
What mechanism of phenytoin causes gingival hyperplasia?
- it may cause fibroblasts and osteoblasts to deposit excessive extracellular matrix
- local irritants (biofilm) make response more excessive
if the gingival overgrowty appears as a painless enlargement of interdental papilla, with signs of inflammation, and eventually the tissue becomes fibrotic, pink, and stippled. with a mulberry or cauliflower like appearance, how sever is it?
early clinical features
If gingival overgrowth appear increased in size, extends to include the marginal gingiva, and covers a large portion of the anatomic crown, often, cleft-like grooves occur between lobules, how severe is it?
If gingival overgrowth appears large, bulbous gingiva that may cover the enamel, tend to wedge the teeth apart, and interfere with mastication, how severe is it?
What are 6 medications that may cause gingival enlargment?
- antiepileptic medications: phenytoin, ethosuximide, valproic acid, primidone
- Calcium channel blockers
- immunosuppressant cyclosporin
What is a substitute drug that may have less occurance of gingival overgrowth?
What is the difference between primary and secondary seizures?
- primary (idiopathic): genetic predisposition
- secondary (symptomatic): congenital conditions
- perionatal injuries
- brain tumor
- degenerative brain disease
- metabolic and toxic disorders
- complication of cancer
involuntary movements of the mouth, lips, tongue, and jaws, usually associated with long-term use of antipsychotic medication
impairment in uttering words due to diseases that affect oral and pharyngeal muscles
inability to sit still
When is the optimal time to treat a pt with schizophrenia?
when the pts symptoms are reasonably controlled by medication
What are 4 different types of anxiety disorders?
- panic attack
- panic disorder
- posttraumatic stress disorder
- generalized anxiety disorder
Which type of panic dosorder results in shortness of breath, dizziness, palpitations or accelerated heart rate, shaking, sweating, clammy hands, choking, nausea, numbness, flushes, chest pain, frear of dying or going crazy, may be uncued, or cued
Which type of panic disorder is characterized by recurrent panic attacks? may occur with agoraphobia (fear of being in places that might be difficult or embarassing)
Which type of panic disorder, occurs when an initiating traumatic event has occured outside the range of human experience, flash backs occur, pt might feel they are reliving the event, may experience depression
posttraumatic stress disorder
Which type of panic disorder is there persistant anxiety and excessive worry not associated with life-threatening fears, and may be complicated by depression, alcohol abuse, or anxiety related to a general medical condition?
generalized anxiety disorder
What is a major oral health problem with medications for depression?
What are 4 common types of drugs taken for depression?
- SSRIs (selective serotonin re-uptake inhibitors): fluoxetine (Prozac), sertraline (Zoloft) paroxetine (Paxil) fluvoxamine (Luvox)
- SNRIs: serotonin, noradrenergic re-uptake inhibitors
- Tricyclic and heterocyclic antidepressants
- MAOIs (monoamine oxidase inhibitors)
What are 7 side effects of lithium?
- GI irritation
- fine hand tremor
- muscular weakness
- renal tube damage