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Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED. 1
Chapter 11
Preparation for Patient Care
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Information Gathering
• Personal
• Medical
• Dental
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Personal Information
• Name and address
• Social security number
• Insurance information
• Physician name
• Emergency contact
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Medical Information
• Past surgeries
• Systemic diseases
• Allergies
• Injuries
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Past Surgeries
• Heart valve replacement
• Joint replacement
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Antibiotic Prophylaxis
• American Heart Association guidelines– Amoxicillin/penicillin
• 2 grams 1 hour before procedure
– Clindamycin• For patients allergic to penicillin• 600 mg 1 hour before procedure
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Systemic Diseases
• Heart disease
• Epilepsy
• Diabetes
• Asthma/emphysema
• Parkinson’s disease
• Multiple sclerosis
• Cancer
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Health Alerts for Antibiotic Prophylactics
• Mitral valve prolapse (MVP)
• Heart murmurs– Valvular regurgitation
• Prosthetic heart valve
• Systemic pulmonary shunts
• Past surgeries
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Allergies of Concern
• Anesthetic
• Latex
• Medication
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Injuries
• Back
• Jaw
• Neck
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Dental Information
• Patient concerns/reason for appointment
• Patient attitude toward dentistry
• Quality of previous dental care
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Clinical Observation
• Gait
• Speech
• Behavioral problems
• Hands and fingernails
• Eyes– Dilated
• Facial symmetry– Droopy eyelids
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Extraoral Evaluation
• Mouth and lips– Cracking or ulceration
• External floor of mouth
• Lymph nodes
• Temporomandibular joint (TMJ)
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Intraoral Evaluation
• Lesions
• Abscessed teeth
• Color changes
• Tissue irregularities
• Soft tissue: oral mucosa
• Hard tissue: teeth
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Charting Existing Conditions
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Examining the Lips
Smile line
Vermilion border
Commissures of the lip
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Examining the External Tissue of the Mandible and the Floor of the Mouth
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Examining the Cervical Lymph Nodes
• Swelling
• Abnormalities
• Tenderness
• Infection
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Examining the Temporomandibular Joint
• Noises
• Tenderness
• Pain
• Limited function
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Examining the Floor of the Mouth
• Tenderness
• Abnormalities
• Lesions
• Bony tori
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Examining the Oral Mucosa and Frenum
• Frenum attachment: a narrow band of tissue that connects two structures– Labial– Buccal– Lingual
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Examining the Tongue and Palate
• Palatal tori
• Geographical tongue
• Precancerous lesions
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Examining the Tongue
• Color
• Papillae
• Coating
• Abnormalities
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Vital Signs
• Body temperature
• Pulse
• Blood pressure
• Respiration rate
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Antipyretic: Method of Reducing Fever
• Cold pack
• Alcohol rub
• Aspirin
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Hypothermic
• Body temperature is below normal.
• Possible causes:– Too much aspirin– Prolonged exposure to cold
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Radial Pulse
• Adults:
– 60 to 90 beats per minute
• Children:
– 90 to 120 beats per minute
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Pulse Rates
• Tachycardia
– Rapid resting pulse rate
• Bradycardia
– Abnormally slow pulse
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Respiration
• The process of inhaling and exhaling (breathing)
• Normal respiration– Adults
• 10 to 20 breaths per minute– Children
• 20 to 26 breaths per minute
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Blood Pressure
• The amount of labor the heart has to exert to pump blood throughout the body
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Normal Readings
• Adults: 120/80
– Systolic: below 140
– Diastolic: below 90
• Children: 100/66
• Adolescents: 118/76
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Systolic
• The first sound heard when taking blood pressure
• The highest number in the reading
• Caused by the heart contracting and forcing blood through the arteries
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Diastolic
• Reflects the heart muscle at rest
• Heart takes blood to be oxygenated before the next contraction
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Taking Blood Pressure
• Extend the patient’s arm to the level of the heart.• Make sure arm is supported and relaxed.• Place the cuff 1 to 2 inches above the antecubital
space.• Wrap and secure cuff around arm.• Expel all air from cuff before taking BP.• Inflate cuff to 160 to 180.• Slowly release 2 to 4 mm mercury per second.
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Locating the Brachial Artery