OS Other notes

• Medical history is the most useful information in deciding on a treatment plan and is tailored to each patient.
• Medical problems, age, intelligence, lifestyle, planned procedure, and anesthetic methods should be considered in medical history.
• Red flags in medical history include allergies, multiple sexual partners, and pregnancy.
• Biographic data includes name, address, age, gender, occupation, marital status, and chief complaint.
• The chief complaint should be asked to every patient.
• History of present illness includes descriptions of pain, date of onset, intensity, duration, location and radiation, factors that worsen and mitigate the pain, and medical history.
• Chlordiazepoxide is used in dentistry.
• Phenobarbital is used in dentistry.
• Diazepam and other benzodiazepines are used in dentistry.
• Nitrous oxide, if exposure is greater than 9 hours per week or oxygen concentration is less than 50%, is used in dentistry.
• Diphenhydramine hydrochloride, if chronically used, is used in dentistry.
• Morphine is used in dentistry.
• Corticosteroids are used in dentistry.
• Pentazocine hydrochloride is used in dentistry.
• Promethazine hydrochloride is used in dentistry.
• Medical history includes history forms (questionnaires) for conditions like angina, myocardial infarction, heart murmurs, rheumatic heart disease, bleeding disorders, asthma, chronic lung disease, hepatitis, sexually transmitted infections, diabetes, corticosteroid use, seizure disorder, stroke, artificial joint or heart valve, allergies, pregnancy, and physical examination.
• Physical examination begins with the measurement of vital signs, including blood pressure, heart rate, respiratory rate, temperature, and focuses on the oral and maxillofacial region.
• The four primary means of evaluation are inspection, palpation, percussion, and auscultation.
• The fourth principle of surgical incision is that surfaces that the surgeon plans to reapproximate should be made with the blade held perpendicular to the epithelial surface.
• Incisions in the oral cavity should be properly placed.
• The base of flaps should not be excessively twisted, stretched, or grasped with anything that might damage vessels.
• The surgeon must remain focused on the blade to avoid accidentally cutting structures such as the lips when moving the scalpel into and out of the mouth.
• When possible, an axial blood supply should be included in the base of the flap.
• The surgeon must incise only deeply enough to define the next major layer when making incisions close to where major vessels, ducts, and nerves run.
• Incisions through attached gingiva and over healthy bone are more desirable over unhealthy or missing bone.
• The third principle of surgical incision is that the surgeon should carefully avoid cutting vital structures when incising.
• The length of a flap should be no more than twice the width of the base.
• The apex (tip) of a flap should never be wider than the base unless a major artery is present in the base.
• American Society of Anesthesiologists (ASA) classifies patients into six categories: ASA I, ASA II, ASA III, ASA IV, ASA V, and ASA VI.
• Systemic conditions include cardiovascular, pulmonary, renal, hepatic, endocrine, hematologic, neurologic, and pregnancy.
• Cardiovascular system includes ischemic heart disease, angina pectoris, and heart attack.
• Angina pectoris is a symptom that can radiate into the left shoulder and arm and even into the mandibular region.
• Signs to watch out for in angina pectoris include complaining of an intense sense of being unable to breathe adequately, stimulation of vagal activity, and disappearance of the symptom once the myocardial work requirements are lowered or the oxygen supply to the heart muscle is increased.
• Preventive measures for angina pectoris begin with taking a careful history of the patient's angina, questioning about the events that tend to precipitate the angina, and considering medical history, medical problems, age, intelligence, lifestyle, planned procedure, and anesthetic methods.
• Socket heals by secondary intention, and many months must pass before a socket heals to the degree to which it becomes difficult to distinguish from the surrounding bone when viewed radiographically.
• The removal of a tooth initiates the same sequence of inflammation, epithelialization, fibroplasia, and remodeling seen in prototypic skin or mucosal wounds.
• Ingrowth of fibroblasts and capillaries occurs during the second week of healing.
• Cortical bone continues to be resorbed from the crest and walls of the socket, and new trabecular bone is laid down across the socket during the seventh week of healing.
• The osteum should be reflected from the underlying cortical bone in a single layer with a periosteal elevator.
• Not until 4 to 6 months after extraction is the cortical bone lining a socket usually fully resorbed.