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DENTAL HYGIENE CASE STUDY PRESENTATION

Transcript: DENTAL CHART REFERRAL LETTER Molars cannot be accessed because #19 & #30 are missing. Right and Left Canine: Class III Edge to Edge: 8 & 9 Open Bite: 1-7 & 10-16 Midline Shift: 1mm to the RIGHT Quadrant One- (02/6/2014) BP 130/85 R 20 P 66 Temp 97.5 Oraquix was discussed with patient and patient consented. Ms. MC wanted to try another route of anesthesia besides "with a needle". Oraquix was applied to quadrant one; above the gumline (both buccal and lingual) and then inside the sulcus. Prophylaxis began with cavitron and patient experienced tooth sensitivity on #3. After patient expressed her complaint, I handscaled the fine residual calculus after exploring. Quadrant one had generalized moderate subgingival calculus and light to moderate supragingival calculus with moderate bleeding. The patient took frequent breaks due to lower back pain. Quadrant Four- (03/04/2014) BP 122/78 R 16 P 66 Temp 98.2 Local (1 carpule of 2% lidocaine with epinepherine) was administered. Prophylaxis began with cavitron and was followed up by fine scaling with hand instruments. Patient had to be readjusted in chair several times with the addition of a pillow due to lowerback pain. Moderate generalized subgingival and moderate interproximal supragingival calculus (localized to anteriors) was removed with light to moderate bleeding. The patient tolerated the procedure with high sensitivity between 31 and 32 due to large carious lesion. Mesial Drift: #17 & #31 #14 super erupted Lamina Dura fuzziness between #29-#31 & #17-#20 30 DAY RE-EVALUATION "Numerous studies have reported positive associations between periodontal infections and clinical cardiovascular disease. Among these studies, a pattern has emerged in which findings are markedly stronger for stroke as compared to coronary outcomes. One possible explanation for these trends is that periodontal infections might contribute to clinical CVD through risk factors that are more strongly linked to stroke than to coronary pathophysiology. While both hypertension and abnormal cholesterol profiles are established risk factors for stroke and coronary heart disease, it is generally accepted that hypertension is a stronger risk factor for stroke while cholesterol profiles are more strongly linked to CHD. Therefore, if periodontal infections contribute to the development of hypertension but have little or no influence on lipid metabolism and cholesterol levels, one would expect periodontal infections to be more strongly associated with stroke, as compared to CHD. There is currently a need for more research on periodontal infections and hypertension to inform this hypothesis, although it is noteworthy..." INITIAL TREATMENT PLAN Host Factors PROCEDURES Dental Experiences & Symptoms COMPARISON Local Etiologic Factors Occlusion DENTAL HYGIENE CASE STUDY PRESENTATION PERIODONTAL SUMMARY Ms. MC never consumes alcohol or uses tobacco products. She uses: Breath Mints (2x daily) Chewing Gum (2x daily) Canned/Bottled Liquids (daily) Sugared Liquids (2x daily) Quadrant Three- (02/18/2014) BP 128/86 R 18 P 68 Temp 97.8 Local for quardrant three was set up but it was too late into the clinic time for this to be administered. The situation was discussed with patient and the patient consented to moving forward with quardrant three with only Oraquix. One carpule of Oraquix was applied to quadrant three; above the gumline (both buccal and lingual) and then inside the sulcus. Prophylaxis began and patient tolerated handscaling only in this quadrant with generalized moderate supragingival and subgingival calculus with moderate bleeding. The patient adjusted several times in the chair and took small breaks due to lowerback discomfort. DENTAL HISTORY Restorations present: 3, 14, & 15 Decay present: 1, 15, 17, 31, & 32 Extracted: 18, 19, & 30 Lingually displaced: 7 & 10 Mesial Drift: : 18 & 31 Super Erupted: 14 Mesially Rotated: 29 Ms. MC documented that her dental home care routine consists of a medium bristled toothbrush, fluoride toothpaste, and mouth rinse with fluoride. She estimates that she brushes for 3 to 5 minutes twice daily. She never flosses. She states that her busy schedule as a phlemotomist makes it difficult for her to brush as many times throughout the day as the would like. Overview Medical History Review Vital Signs Extra/Intraoral Exam Restorative/Hard Tissue Charting Complete Periodontal Evaluation Xrays Scaling & Root Planing (DOD III) Ultrasonic/Caviron Anesthesia: Oraquix (Quad 1) & Local (Quad 2, & 4) OHI: BASS method toothbrushing ASSESSMENT OF ETIOLOGIC FACTORS ...continued Oral Habits Bacterial Etiology BEFORE PROPHYLAXIS Extent of Plaque: Ms. MC has moderate generalized plaque intra-orally. Current homecare practices: She documents her dental home care routine of a medium bristled powered toothbrush, fluoride toothpaste, and mouth rinse with fluoride. She estimates that she brushes for 3 to 5 minutes twice daily. She never flosses. She states that her busy schedule as a

Dental Case

Transcript: Dental Case No. 54337: Zaldana, Mirna Lizbeth, RDA Case no. 54337: Zaldana, Mirna Lizbeth, RDA *On December 11, 1999 the Dental Board of California issued Registered Dental Assistant License No. 54337 to Mirna Lizbeth Zaldan. *Mirna was convicted of violating vehicle code section 23152, driving under the influence of alcohol not only once but multiple times. *The RDA License was in full force and effect at all times relevant to the charges brought. ???? Fifth and sixth Cause for Discipline *Mirna was Convicted of five separate misdemeanor alcohol-related criminal offenses. *Mirna was caught driving on a suspended license *She was caught shop lifting at a Mission Viejo Macy's department store, totaling $281.49. *On May 12, 2011, the Board received Mirnas RDA/EF Renewal Application, and she failed to tell the truth when item 4 of the application stated if she had been convicted of any crime in any state since she last renewed her license. Mirna checked No By: Vickie Reyes *Did Mirna get a fair punishment for all of her misdemeanors? *What would have been a fair punishment? PARTIES *Richard DeCuir, Executive Officer of the Dental Board of California *Karen M. Fischer, Executive Officer of the Dental Board of California *Kamala D. Harris, Attorney General of the State of California * Amanda Dodds, Senior Analyst First and Second Cause For Discipline *Driving under the influence with a Blood Alcohol Concentration over .08, a misdemeanor, not only once but several times. *As a result of her first conviction, on June 6, 2008, Mirna was granted 36 months summary probation, and ordered to complete a three month First Offender Alcohol Program. she was ordered to pay $1,546.38 in fees, fines and restitution. her probation was revoked twice for failing to comply with its terms. *As a result of her second conviction, on December 2, 2011, Mirna was granted five years formal probation, and ordered to serve 60 days in the Orange County Jail. she was ordered to complete an 18 month Multiple Offender Alcohol Program. Third and Fourth Cause For Discipline *Respondent has subjected her license to disciplinary action, for unprofessional conduct in that on March 7, 2008, September 24, 2010 and May 7, 2011 *Used alcohol and was impaired in a manner that was dangerous or injurious to herself and the public. Decision And Order *Mirna plead guilty for all of her misdemeanors and surrendered her license. *The Dental Board of California accepted the surrender of Mirnas RDA license. *Also, the Board decided that Mirna will have to pay $1,002.50 to the agency of investigation and enforcement for the costs of investigation. *She cannot apply for licensure or petition for reinstatement for three years from the effective date of the Dental Board of California’s Decision and Order which was on January 10, 2014.

Dental Hygiene Case Presentation

Transcript: DH: many restorations Major learning moment: get a completion check! Success: Completed patient HH: High BP, allergies (seasonal, processed meats), melanoma (right leg, removed 1994) Occlusion: class I bilateral, with a class II tendency from a canine relation. 4mm overjet, with a moderate overbite Subjective/Objective Implementation Treatment Planning IO/EO: WNL, bilateral linea alba, bilateral mandibular tori, exostosis near #20 and #21 Analysis Difficulties: Instrumenting while patient slept Patient was eager to learn about homecare, involved in her treatment and seemed very compliant. Dental Hygiene Case Presentation I learned to value the relationship and trust that is built between a patient and clinician. Through treatment, I was able to show my patient the improving indice scores, and it turn I think she began to trust me more. Appointment 2: HH, vitals, IO/EO, velscope, complete perio maintenance quads 3 and 4, and begin on quads 1 and 2, OHI flossing with recommended floss. Moderate caries risk Difficulties: Patient built calculus quickly Contributing factors: plaque biofilm, existing restorations, medications, and xerostomia. Therapy outcomes: prevent further bone loss, improve plaque biofilm scores, home care, and xerostomia, and reduce the plaque biofilm build up. Constraints: medications and compliance. Process: started on quads 3 and 4 due to heavy supra calculus build up. When patient returned at next appointment, it was all back. Patient Appointment 1: HH, vitals, IO/EO, assessment, nutritional counseling, perio maintenance on quads 3 and 4, OHI brushing. Recommend: Bass method 3 Mos. Perio maintenance interval Modifications: Due to not completing quads 3 and 4 at appointment 1, another appointment was needed. Biotene for patient's xerostomia was also added in. CC: 3 mos. perio maintenance recare Implementation 73.9% Plaque Indice I always tend to look at small details when treating a patient, and through this I was allowed to see how all of the pieces fit together. Gingival Health: Periodontitis Subjective/Objective Vitals: 4/16/14; BP 144/78, P 60, R 18 5/6/14; BP 130/70, P 58, R 16 5/13/14; BP 124/82, P 76, R 18 5/21/14; BP 126/76, P 64, R 16 Success: O'herir for supra calculus removal Med Alert: Allergic to some BP medications ASA:II Plaque indice scores started as 73.9% on 5/6/14, then 68.75% on 5/13/14, finally 56% on 5/21/14. PN: Retired DH Diagnosis: AAP Perio Case Type II, generalized moderate, localized severe in her molars. Self Assessment Appointment 3: HH, vitals, IO/EO, complete perio maintenance quads three and four, coronal polish, and fluoride. OHI with recommended ACT rinse. Subjective/Objective Instrumentation Many restorations 85 year old female 24 teeth present Evaluation

Dental presentation

Transcript: Given remit for this lecture “Its something of an overview of what it’s like to work in Community Dental Services”. Who knows the difference between working in the Community Dental Services and the High Street GDP? IT IS THE SAME AS WORKING IN ANY DENTAL PRACTICE! The main different in my opinion is a) the allocation of time for the patient’s care b) there is no hassle as to the number of (units of Dental activity) UDA that is required per week, month or year. c) the patient is treated more as a person than as a number. Some cautionary notes Not much of the pharmacological processes of any drugs or the pathology of the diseases has been entered into. In all medical emergencies of the ‘special needs’(and other patients) if treatment had started, you MUST STOP at wherever you are and manage the patient FIRST. What is said here is not strictly for the Community dental services, hopefully you should find it useful for life. Be sure to know where the emergency medicines are stored in the surgery you are practicing especially the Oxygen and masks. Lecture notes bordering on medical emergencies would be mentioned when applicable. This proves that no patient could be managed in isolation from their medical needs. In other words, either the patient is in control or the condition is. It may seem as though the lecture contradicts itself, as on one hand, for example "diabetes" is considered "special needs", BUT not all diabetes are accepted as special needs patients. What you hear today, is the same requirement expected from you even in the GDP surgery. In reality, every child and every parent for that matter, has a very special need for love, acceptance and a feeling of belonging from the other members of its family. In the United Kingdom, it appears that "special needs" often refers to special needs within an educational context and it is a way to refer to students with disabilities. In the USA, "special needs" is a term used in clinical diagnostic and functional development to describe individuals who require assistance for disabilities that may be physical/medical, cognitive/mental, or psychological. Children and adults including the middle aged with disabilities and additional needs pose numerous challenges to the provision of oral healthcare. The number of middle age people with disabilities and additional needs is increasing for a number of reasons, including: 1: Improved paediatrics care – more children born with complex and multiple disabilities are surviving into adulthood. 2: Life expectancy for people with disabilities and chronic disease is increasing and more of them survive into middle age. 3: Individuals may acquire a disability or progressive disease in middle age. As well as increasing numbers of individuals, other challenges include: The deinstitutionalisation of adults from large institutions and care homes to smaller community group homes, where clients are encouraged to live more independently and where there may be less rigorous daily oral care, less supervision of diet and less support in accessing oral health services. The lack of a register for people with disabilities and additional needs makes it difficult to ensure equitable access to oral healthcare. People with severe disabling conditions may be overwhelmed by the physical, medical, social and financial demands of the disability so that oral care takes a low priority in their life until there is a problem. Criteria for the Community Dental Service include: Adults and children with learning disabilities Adults and children who are housebound – domiciliary Adults and children with physical (including sensory) disabilities Adults and children with complex medical histories Adults and children with severe mental health problems Adults and children with severe dental phobia (Subject to a referral from a healthcare professional) Adults and children with behavioural problems Adults and children with drug or alcohol problems Adults and children with HIV, AIDS, hepatitis C Adults and children who are homeless or temporarily housed Adults and children under the care of social services or children with complex social problems COMMON SPECIAL NEEDS The special needs list is endless: Mental health problems: Dementia Agoraphobia ŸMedical conditions: Asthma Diabetes Epilepsy Huntington disease Kidney disease Developmental conditions: - Autism - Agoraphobia - Dyspraxia - developmental dyspraxia is an impairment or immaturity of the organisation of movement. It affects the planning of what to do and how to do it. It is associated with problems of perception, language and thought. - Hearing impairments - ŸMobility impairments - Visual impairments Complex medical needs: Physical disabilities or challenges – wheelchair users. Emotional challenges – dental phobias, anxiety etc Patients who have developmental disabilities and epilepsy can be safely treated in a general dental practice. A thorough medical history should be taken and updated at every visit. A

Dental Presentation

Transcript: or When most people think of why they take care of their teeth, it is because they wouldn't want gross teeth. Which for the most part is true, but there are many more reasons. 2. For their job or career Dental Field -For others, having good oral health helps them earn a living and can influence how much they get paid. Ex: waitress and chef Your teeth affect your overall health in many ways. They are what we eat our food with, without them we could not chew our food, and end up choking on food too big to swallow. They also control our speech, by helping keeping your tongue in our mouth. If you do not maintain a good oral health, it can lead to disease and a lot of problems . A theory done by the University of Chicago concluded that individuals whose wages depend on the whiteness of their teeth will spend approximately half their lives brushing . 1. Racial segregation in dental schools After searching relevant keywords i was able to find a lot of information on factors affecting peoples oral health and why people maintain oral hygiene. Reasons people maintain good oral health 5.People have a "taste for brushing" what about the dental field? Maintaining a good oral health isn't just something that you decide to do one day after you roll out of bed. It is instilled in you as a child by most likely your mother. People not only like a clean mouth, but also have a taste for brushing. What i mean is that for some people, they enjoy doing it. Because people naturally do not like the taste of their mouth, gum companies have cashed in on this problem and are very well off. There is actually a theory looking at peoples "taste for brushing" but because there is lack of testable predictions, it is uninteresting. 4. Its good for you! People brush there teeth for many reasons. It could be because they don't want bad looking teeth, because they need to for their job, or just because they enjoy doing it. People have done it for thousands of years, and will continue to do it because it is very important to your health. 3. Its what they've been taught to do The End Because the waitress is in constant touch with the public and relies on tips for most of their income, bad breath or yellow teeth could have negative effects on their earnings. In contrast, a chef is in the kitchen, not seen by the public and paid by salary, will not be affected by having bad teeth. 2. What is the importance of teeth and why do people choose to, or not to, take care of them? 1.The obvious answer The "mother told me so" theory created by Alan S. Blinder supports this statement by suggesting that people who brush their teeth three times a day do so because their mothers forced them to do so at a young age. Due to lack of new information or scholarly sources i decided to think of a new topic -For some people, their job requires them to represent something or someone, and having a clean mouth and white smile portray a good image about what they are representing. Ex: orbit commercial

Dental Presentation

Transcript: First 3 years of College build resume by doing service, leadership, Shadowing, work experience etc. April-June Study for DAT Submit AADSAS application June ~15 June/July Fill out secondary Applications wait wait wait Interview in Feburary Accepted in March COST TO APPLY Dat Study Materials $500 -old text books from gen chem and ochem, dat destoyer, kaplan text book, etc. Application cost $1,598 Secondary App. $600 Interviews $1,770 Two interviews Total: $5,068 Items to pay for upon acceptance Tuition Deposit $2,450 Moving $2,200 Utility Deposits $120 New ID $20 renters policy Varies school fees.... Varies Housing Deposit $650 Total: $5,555 Total Cost To date:$10,623 Pros: Small Class Size. 38 Students Six International Enter clinic early-Second semester of school Patient base grows each year Simulation of actual dental office High student to faculty ratio Mid-range tuition cost: $57,100 Boards Free babies Each child receives a check each month from the government Don't have to apply through AADSAS Tuition includes all fees ADVICE Cry Pray to your Deity Offer sacrafices Major selection isn't as important as good grades. Submit application early Even if you have not taken the DAT Build a good application not just good DAT score and GPA There's no perfect formula to get you in Work experience, shadow opportunities Good letters of Recommendation Save your money now! Questions? My stats DAT Score First time I got 16 Second time 17 PAT 19 Total Science 18 Overall GPA 3.25 However Last 2 years I had 3.6-4.0 GPA Biology Major I've taken almost every -ology offered on campus. So lots of Science course work. Spencer Knight I've always been a saver. Use Credit card to pay for it, then I could pay more than the minimum balance and avoid a finance change. Allowing me to spread the cost out over two months, instead of one. Utah State University Go into dentistry because you love the field, not because of the money you hope to make one day! Average Utah dentist makes about $120k a year. Average pharmacist makes more than that! How did I handle the cost? Beacon of Hope Timeline My Journey Canada EH? MY SCHOOL My spencer@ssknight.com Fake it until you make it! Cons: International student Cost of living Cell phone Car insurance Distance DalHousie University Halifax, Nova Scotia, Canada

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