Prometric

• Blood pressure categories

  • Normal
  • High normal
  • Mild hypertension (Stage 1)
  • Moderate hypertension (Stage 2)
  • Severe hypertension (Stage 3)
  • Very severe hypertension (Stage 4)
• Systolic


  Top number in blood pressure reading
• Diastolic


  Bottom number in blood pressure reading
• Recommendations for blood pressure categories

  • Recheck at recall
  • Recheck within 1 month; if still elevated have patient evaluated by physician within 1 month
  • Recheck within 2 weeks; if still elevated have patient evaluated by physician within 2 weeks
  • Have patient evaluated by physician within 1 week
  • Have patient evaluated by physician immediately
• Compression only CPR


  Only for the lay person, NOT for trained medical professionals such as dental hygienists
• CPR guidelines


  1. Step 1- 2 rescue breaths

  2. Step 2- 30 compressions

  3. 1 shock with AED followed by CPR

  4. Start immediately with compressions, not rescue breaths

  5. For ALL ages except newborns
• Aspirin


  • Salicylate drug
  • Causes bleeding
  • Often taken as an antithrombotic
• Antithrombotic


  A drug which reduces thrombus formation
• Hemostasis


  The physiologic process whereby bleeding is halted, thus protecting the integrity of the vascular system after tissue injury. It is responsible for minimizing blood loss. It is commonly referred to as stoppage of bleeding.
• Your patient is taking aspirin, and you will be performing scaling and root planning on 2 quadrants with local anesthetic and placing 3 sites of Arestin. Excessive bleeding can occur, what meds is he taking?

• Prednisone impairs wound healing
• Steroids cause delayed wound healing
• Prozac causes xerostomia
• The most likely side effect of Clariten is xerostomia
• Cyclosporine, an immunosuppressant, causes gingival enlargement
• Your 10 am patient requires premedication. He is allergic to Penicillin and takes Clindamycin. He tells you that he only took one 300mg pill. What should you do
• The most common cause of drug-induced xerostomia is the altering of neural pathways that stimulate salivary gland secretion.
• Drugs that have an anticholinergic action reduce the volume of serous saliva, including antihypertensives, antihistamines, antidepressants, antipsychotics, antiemetics, antispasmotics, and anti-parkinsonian drugs.
• Aspirin causes increased risk of bleeding
• Warfarin (Coumadin) also increases the risk of bleeding
• NSAIDs such as ibuprofen can also increase bleeding as they are known to reversibly decrease platelet aggregation
• Drug classes associated with causing xerostomia

  • Anorexiants
  • Antiacne agents
  • Anticholinergics/antispasmotics
  • Anticonvulsants
  • Antidepressants
  • Antidiarrheals
  • Antiemetics
  • Antihistamines
  • Antihypertensive
  • Anti-inflammatory
  • Analgesics
  • Antinauseants
  • Antiparkinsonian agents
  • Antiphyschotics
  • Bronchodialators
  • Decongestants
  • Diuretics
  • Muscle relaxants
  • Narcotic analgesics
  • Sedatives
• A patient on an anti-hypertensive is most likely to experience what problem in the dental chair?
• Procardia, a calcium channel blocker for high blood pressure, causes gingival enlargement/overgrowth
• Corticosteroids and anti-inflammatory medications can cause delayed healing
• The Hep B vaccine also protects you from Hepatitis D (Delta)
• Conditions requiring antibiotic prophylaxis for dental procedures

  • Artificial heart valves
  • A history of infective endocarditis
  • Certain specific, serious congenital heart conditions
  • A cardiac transplant that develops a problem in a heart valve
• Antibiotic prophylactic regimens for dental procedures

  • Oral Amoxicillin (2g for adults, 50mg/kg for children)
  • Ampicillin or Cefazolin/Ceftriaxone (2g IM or IV for adults, 50mg/kg IM or IV for children) if unable to take oral medication
  • Cephalexin, Clindamycin, Azithromycin or Clarithromycin (600-2000mg for adults, 15-50mg/kg for children) if allergic to penicillin or ampicillin and able to take oral medication
  • Cefazolin/Ceftriaxone or Clindamycin (600-1000mg IM or IV for adults, 20-50mg/kg IM or IV for children) if allergic to penicillin or ampicillin and unable to take oral medication
• There is a high probability of you needing to know the procedures and landmarks involved when performing an extra oral examination on a patient.
• Types of occlusion


  • Normal occlusion
  • Class I malocclusion
  • Class II malocclusion
  • Class III malocclusion
• Crossbite


  Upper teeth fit inside lower teeth

  
• Class III


  Protruding lower teeth, "underbite"
• Class II/Overjet


  Protruding upper teeth, "buck teeth"
• Deep bite


  Upper front teeth hide lower teeth

  
• Medications that can cause gingival overgrowth

  • Anticonvulsants, such as phenytoin, succinimides and valproic acid
  • Calcium channel blockers, such as nifedipine and verapamil
  • Cyclosporin, an immunosuppressant
• Uncontrolled diabetes can cause inflammation
• Nikolsky's sign


  Fragile mucosa may be induced to blister or slough when pressure is applied. It is particularly useful in differentiating pemphigus vulgaris, which causes a positive sign, from bullous pemphigoid, in which the sign is usually absent.
• A frenum attachment can be the cause of recession
• When the gingival margin is at the CEJ, no calculations are needed because the probing depth and the clinical attachment level are the same
• Teeth with periodontal abscess are vital