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1

Patient Assesment

-history
-exam
-rad
-assesment
-treatment plan
-treatment
-prescription

2

Vital Signs

-measure most basic body functions
-BP, pulse, temp, resp rate

3

measuring BP

-force on artery walls
-look for anything that can cause orthostatic hypotension
-change chair position slowly so they can get equilibrium
-no clutter w/ easy exit and entrance


-systole= contraction
-diastole= dilation

4

BP devices
1-auscultatory
2-oscillometric
3-measuring BP

1-measures sounds---korotkoffs sounds (stethoscope and cuff)

2-measurement of vibrations---automatic inflation

3-cuff/stethoscope, finger measurement, wrist measurement

5

Seating Patient for BP

-upright
-go to bathroom before
-factor in nervousness
-feet on floor
-arm at heart level---relaxed/supported
-place cuff in front of elbow (antecubital)

6

BP errors
1-too narrow/short
2-too loose
3-patient raises arm
4-arm too low
5-arm too high 
6-rapid deflation
7-congestion of arm

1-false high
2-false high
3-false high diastolic
4-false high
5-flase low
6-low SP/ high DP
7-low SP/ high DP

 

7

Contraindications of BP

-lymphadema?---dont take BP on arm take on other arm
-ask to see if had surgery that infects lymph flow
 

-no upper limits for BP

8

Normal BP vs others

-normal bp= 120/80
-high bp= 120-139/80-89 (prehyp)
-mild bp= 140-159/90-99 (stage 1)
-severe bp= 160/greater than 100 (stage 2)


symptoms= headache, dizziness, blurred vision, nausea, chest pain

9

Control BP

-smoking cessation

-lose weight

-relax

-decrease caffeine

-exercise

10

oral side effect of antihypertensive drugs

-dry mouth
-mouth ulcers
-enlarged gums bc of Ca channel blockers

11

Pulse---heart rate

-radial artery (near wrist), carotid artery, or brachial artery
-dont use thumb

newborns= 70-190
infants= 80-120
children= 70-130
10 and over= 60-100
athletles= 40-60

12

Respirations
1-newborns
2-less than 1
3-toddlers
4-3-6
5- 6-12
6- 12-17
7-adults

1-30- 40 bpm
2-30-40 bpm
3-23-35 bpm
4-20-30 bpm
5-18-26 bpm
6-12-20 bpm
7-12-20 bpm

-done surreptitiously 

13

BG 

-inc pee
-inc thirst
-weight loss

-blurred vision
-older
-fat
-high BP
-inc cholesterol

normal= less than 110: 65-104

14

Testing BG

-glucometer
-test strip---look at control #
-retractable lancet
-alc wipe
-bandaid 

-insert test strip into glucometer w/ electrode up
-make sure it shows control #
-use finger not normally used

15

Recording in axium

-vitals---FORMS ---> medical history

-not intuitive
-nothings erased
-collected and analyzed

16

Slidematic Facebow

-bitefork
-reference point locator/pen
-articulator index table
-facebow
-transfer jig assembly

17

Essential Features of Epidemiology

-groups are the focus of the study 

-study people w/ and w/o disease

-study of groups allow for valid estimates when looking for variation

18

Uses of Epidemiology

-see extent of disease in a community

-find associations relating to a disease (risk factors)

-test new preventative and therapeutic measures

19

Periodontal Conditions that are Typically measured

-amt of debris (plaque, calculus)

-color + form of gingival tissue

-bleeding on probing

-clinical probing depth, gingival recession, mobility of teeth, furcation

-radiograph marg. bone levels

20

1-prevalence
2-extent
3-severity

1-proportion of diseased individuals 

2-number of proportion of affected subunits (teeth, surfaces)

3-amt of attachment loss, depth of perio pockets

21

Oral Hygiene Index ---Greene/Vermillion

-Debris Index---DI: coronal extension of plaque score

  • 0= no debris/stain
  • 1=debris <1/3rd tooth surface
  • 2= between 1/3 and 2/3 
  • 3= debris >2/3 

-Calculus Index---CI: coronal extension of supragingival +/- extension of subgingival calc score

  • 0= no calculus
  • 1= supraign calc <1/3 
  • 2=between 1/3= 2/3 and subgin calc
  • 3=supraign > 2/3 surface and band of subgin calc

22

Oleary

Plaque Control Index---

PI= (# of sites w/ plaque/ # of sites evaluated) x 100

whole mouth view

23

CDMI Plaque Control Index

-calculated as number of surfaces w/ plaque on 6 teeth divided by total number of tested surfaces (24)

24

Loe & Silness

Gingival Index
0= normal gingiva
1= mild inflammation---slight color change, slight edema, no bleeding 
2= moderate inflam---redness, edema, glazing, bleeding 
3= severe inflamm---redness, edema, ulcerations, spont bleeding

25

Ainamo & Bay

Gingival Bleeding Index

=(# of bleeding sites/#of sites evaluated) * 100

26

Combined Indices

-systems combining assessment gingivits, periodontitis, plaque, calculus, and overhang restorations

27

Russell

Periodontal Index
0= normal gingiva= no inflamm nor loss of function bc of destruction
1= mild gingivitis= area of inflamm in free gingiva
2= gingivitis=inflam around whole tooth but no break in attachment

6= gingivitis w/ pocket formation---epithelial attachment broken but has pocket...mastication is normal

8= advanced destruction w/ masticatory loss---tooth is loose and drifted, depressible in socket

28

1-Combined: Russell

2-Combined Ramfjord

1- 1/2= localized circumf gingivitis, 6= periodontitis w/o impairment, 8= advanced periodontitis w/ impairment


2- 1/3= severity of gingivitis, 4/6= attachment loss uup to 3-7 mm

29

Community Periodontal Index of Treatment Needs

-divided into sextants
-ainamo


0= health
1= BoP w/o pockets or calculus, overhangs
2=PD < 3mm, plaque retentive factors= calculus
3= Pd 4-5 mm
4= Pd> 6 mm

30

Prevalence of Gingivitis

-40-60% of kids

-82% of adolescents and 50% of adults

-peaks after puberty (bc of hormonal sometimes systemic)

-more boys than girls