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Copy of Dentist

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on 5 April 2014

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Transcript of Copy of Dentist

What Do They Wear for Surgery?
When working you must wear many protective items such as safety shoes, glasses, gloves, hearing protection, a hard hat or personal flotation devices. You must also wear scrubs when you are performing surgery.
Did You Know?
An Oral Surgeon's salary is calculated by the US Government Bureau of Labor Statistics.

An Oral Surgeon works an average of 40 hours per week. Which is 2080 per year.

The top 5 states to earn an Oral Surgeon's salary are Washington, South Dakota, Maine, Kentucky and Kansas.
Tumor in the Mouth
By: Renee Gittings
Kendra Costner
Jessica Jensen

The end :D
Any questions?
Information obtained from Health History

Follow-up Questions
Physician Requirements
Potential Problems to Dental Care
Oral Manifestations
Oral Manifestations
Possible Drug Interactions
ASA Classification

The University of Texas Health Science Center at San Antonio (D)
Emergency Prevention

Communication skills. Dentists must have excellent communication skills.

Leadership skills. This requires them to have the ability to manage and lead a staff.

Patience. Dentists may work for long periods of time with different patients. Young to old.

Stamina. Dentists should be comfortable working long periods of time, and be able to treat multiple patients a day.
Patient Management {Treatment Modifications}
The University of Texas Health Science Center at San Antonio Requirements

-A grade point average (GPA) of at least 2.5 for
all college courses taken
-Completion of a 3‐credit hour computer
science course and 3 credit hour statistics
course (may be part of Texas Core Curriculum)
-Along with all sciences, english, and biology courses

-ACT/SAT/DAT test(s) and meningitis shot
Hemophilia is a rare bleeding disorder in which the blood doesn't clot normally.

Do not bleed any faster than normal but bleed for a longer time after an injury due to little to no clotting factor in blood.
Damaging organs and tissues that may be life threatening.
Inherited; More common in men than women (recessive X linked trait)

What is the type, cause and severity of your bleeding disorder?
What medications are you currently taking?
How is the condition being treated? How do you treat a minor bleeding episode and is it controlled?
Have you had any prior problems associated with dental treatment because of the condition?
•What is the contact information of your Hemophilia Treatment Center?
Has your physician told you to take special precautions prior to dental care?
Have you had a joint replaced or a central venous line (port) inserted?
Then determine whether you need to pre-treat with factor concentrate nasal desmopressin or an antifibrinolytic agent before any oral procedures/surgeries.
Receiving dental care on regular basis- usually pt's neglect treatment in fear of bleeding
Following preventative regimen to reduce future problems (ie extractions, invasive procedures and PD problems)
Routine cleanings do not require pre-treatment with a clotting factor- but consult with pt's physician
Mucosal bleeding
Gingival bleeding
Bullous hemorrhages may appear on buccal mucosa

Mucosa Bleeding
Gingival Bleeding
Bulbous hemorrhages on buccal mucosa
Advice from physician regarding Severity of Bleeding disorder
Moderate/Severe hemophilia (less than 5% CF) -Specialist setting
Mild hemophilia can be seen in general practice settings
Extra care with soft tissues- including x-ray sensors or films and impression trays
Pre-operative measures- Factor replacement therapy
Factor concentrates
DESMOPRESSIN (derivative of the antidiuretic hormone)
Antifibrinolytic agents are used to effectively prevent/stop bleeding of the mouth with dental surgery.
Avoidance of dental blocks due to muscle bleeding; if unavoidable pt. factor replacement prior to treatment
Infiltrations considered
Avoid injury by:
- Careful use of saliva ejectors
-Careful removal of impressions
-Care in the placement of X-ray films (esp. Sublingual region)
-Protection of soft tissues during restorative treatment (rubber dam or applying yellow soft paraffin (vaseline®))
-Periodontal health critical with patients with bleeding disorders- inflamed and hyperemic gingival tissues are at increased risk of bleeding
-Fear of bleeding during tooth brushing/flossing so higher risk of gingivitis, periodontitis and caries
-Periodontal probing, supragingival scaling and polishing can be done normally without the risk of significant bleeding
-If done carefully, factor replacement is seldom needed for subgingival scaling and root planning procedures
- Ultrasonic instrumentation may result in less tissue trauma
Drugs that can aggravate bleeding include aspirin and ibuprofen (Advil, Motrin, others)
Use acetaminophen (Tylenol, others), safer alternative for mild pain relief.
Avoid certain blood-thinning medications, (heparin and warfarin (Coumadin)), which prevent blood from clotting.
ASA lll- A patient with severe systemic disease
Anurag Gupta, BDS; Joel B. Epstein, DMD, MSD, FRCD(C); Robert J. Cabay, MD, DDS, . N.p.. Web. 17 Feb 2014.
Bryg J, R.. N.p.. Web. 17 Feb 2014.
D'Amato Sandra- Palumbo, RDH, MPS. "Dental Management of Patients with Bleeding Disorders" Course 319.
Genetics Project- Hemophilia
Pickett Frieda; Gurenlian JoAnn. Preventing Medical Emergencies. Use of the Medical History. 2011
The Dental Department, National Centre for Hereditary Coagulation Disorders " Hemophilia and Dental Care"
Some evidence suggests that Hypnosis can be effective in reducing "bleeds" and thus reduce the frequency of need for prophylaxis
Additional (Interesting) Information
Before 1938, the average lifespan was 11 years old.
Abraham Lincoln had hemophilia, along with Mother Theresa
About 17,000 people in the United States have hemophilia. Its severest form only occurs in 1 in 100,000. So very rare.
-Consult w physician to determine risk for uncontrolled bleeding during apt
Requires consultation with physician and administration of necessary agents before appt. -Most patients do well with proper medical management involving administration of drugs to decrease bleeding or the infusion of platelets or plasma containing clotting factors.
Hematologic laboratory tests before Trx to determine: -PT/INR (measures blood clotting range) and the aPTT
Physician would supervise administration of blood transfusions and determine the timing btw the medical management and appt's for oral healthcare
Clinician monitoring bleeding levels during trx
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