Summary Class notes - NBDHE

Course
- NBDHE
- JCNDE
- 2017 - 2018
- Kirkwood
- Dental Hygiene
951 Flashcards & Notes
1 Students
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Summary - Class notes - NBDHE

  • 1485644400 Fluoride

  • At what pH does demineralization happen?
    Enamel:4.5-5.5
    Cementum: 6.0-6.7
  • Purpose of Fl
    Fl interferes with bacterial metabolism
    In high concentrations, Fl can be bactericidal
    In low concentrations, Fl is bacteriostatic
    It has the ability for a long lasting substantivity
    It penetrates through pellicle and plaque
  • Pre-eruptive Fl therapy treatments
    Systemic:
    water
    supplements
    food
  • Post eruptive Fl therapy treatments
    Topical:
    water
    toothpaste
    rinses
    Fl treatments
  • Pre-eruptive Fl characteristics
    circulates in bloodstream and incorporated into the enamel
    absorbed in stomach and small intestine
    excreated through kidneys
  • Water Fluoridation optimal level
      Optimum: 0.7 ppm of Sodium Fluoride
  • Fl supplements
    recommended for children in areas with inadequate water Fl, NOT for pregnant women
  • Supplemental Fl dosages
    Birth-6 months: NONE
    6 months- 3 years: Water Fl less than 0.3= .25mg daily
                                     Water Fl more than 0.3= NONE
    3-6 years: Water Fl less than 0.3= .50 mg daily
                      Water Fl 0.3-0.6= .25mg daily
                      Water Fl more than 0.6= NONE
    6-16 years: Water Fl less than .03= 1.00mg daily
                        Water Fl 0.3-0.6= .50mg daily
                        Water Fl more than 0.6= NONE
  • Post-eruptive Sodium Fluoride
    9,050 ppm
    2%
    used with tooth-colored and porcelain restorations
    tray method: 4 minute treatments
    no drinking, eating or smoking for 30 minutes
    recommended for bulimics
  • Post-eruptive Sodium Fluoride Varnishes
    22,600 ppm
    5% NaF used to desensitize roots
    retained for 24-48 hours with substantivity
    2-4 times per year
    effective for small children and infants
    NOT for home use
  • Post-eruptive Acidulated Phosphate Fluoride
    12,300 ppm
    1.23%
    causes etching in tooth-colored and porcelain restorations
     tray or painting with applicator
  • Post-eruptive Stannous Flouride
    19,360 ppm
    8%
    unstable
    stains demineralized areas or margins
    causes tissue sloughing
    does NOT  decrease sensitivity
  • Application to Boards:
    Know what Fl is used in community water
    Proper Fl % and ppm
    Know adverse rx of Fl
  • Fl in rinses and dentrifices
    Rinses: 0.05% NaF 225ppm
    Dentrifices: 400-1500 ppm
  • Under what age should children NEVER use a Fl rinse
    6 Years
  • Levels of toxicity of Fl
    Certainly Lethal Dose (CLD): amount likely to cause death
    Safely Tolerated Dose (STD): 1/4 of CLD
  • Acute Fluoride toxicity
    Symptoms begin 30 after ingestion and last up to 24 hours
    Nausea, vomiting, diarrhea, abdominal pain, increased salivation
    Systemic reactions:
    hypocalcemia, convulsions, paresthesia, cardiac or respiratory paralysis
  • Treatment for less than 5mg Acute Fl toxicity
    administer Fl binding agent - Calcium
  • Treatment for more than 5mg Acute Fl toxicity
    induce vomiting, administer Fl binding agent, seek medical treatment
  • Treatment for more than 15mg Acute (Lethal) Fl toxicity
    seek medical treatment, induce vomiting, cardiac monitoring
  • Application to Boards:
    Know medical emergency tx for amount of Fl given
    Know symptoms for acute Fl toxicity
  • Chronic Fl toxicity causes
    Skeletal Fluorosis due to long time exposure to high levels
    Dental Fluorosis due to high Fl during amelogenesis
  • Levels and color of fluorosis in teeth
    mild-white
    moderate- tan
    severe- brown
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Epinephrine
cardiac patients: 0.04mg or 2 cart. 1:100,000
NOT to use with: asthma, hyperthyroidism, cocaine/methamphetamine users
drug interactions: cardiac glycosides, non-selective beta blockers, tricyclic antidepressants, buproprion
Pregnancy
hormonal changes
pregnancy gingivitis, pyogenic granuloma
nutritional counseling
provide are in 2nd trimester
left side with pillow to elevate right hip
no fluoride supplements
no nitrous
Geriatric Patient
depression, hearing loss, malnutrition, dehydration 
xerostomia, increased cancer risk, caries, perio
fragility of skin and bones
emphasis good water intake and nutrition
social interaction
Tobacco Smoking
associated with atherosclerosis, CV disease, cancer 
increased risk for perio
internalize reason for stopping
increased risk for oral cancer
Methamphetamine
CNS stimulant 
tweaker, parkinsons features
xerostomia, caries
delay tx for 24 hours
Cocaine
stimulant 
dilated pupils
xerostomia, caries, bruxism
perforated palate   
delay tx for 24 hours after use
Heroin Addiction
opioid 
drowsiness, bradycardia
pinpoint pupils
methadone used to tx withdrawal
Narcan used to tx overdose
dont give opioid
increased risk for infective endocarditis
Fetal Alcohol Syndrome
consumption during pregnancy
dose dependent
cleft palate, gingivitis, tooth malformation
tell, show, do
Alcohol Addiction
poor nutritional habits
dangerously low blood pressure
severe liver damage
NO narcotics, sedatives, nitrous
avoid drugs metabolized in liver
Scleroderma
overproduction of collagen
Raynaud's Phenomenon: vasoconstriction of digits, white discoloration related to cold
xerostomia
widening PDL
hygiene aids
shorten recall appointments