Patient Assesment
-history
-exam
-rad
-assesment
-treatment plan
-treatment
-prescription
Vital Signs
-measure most basic body functions
-BP, pulse, temp, resp rate
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
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
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)
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
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
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
Control BP
-smoking cessation
-lose weight
-relax
-decrease caffeine
-exercise
oral side effect of antihypertensive drugs
-dry mouth
-mouth ulcers
-enlarged gums bc of Ca channel blockers
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
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
BG
-inc pee
-inc thirst
-weight loss
-blurred vision
-older
-fat
-high BP
-inc cholesterol
normal= less than 110: 65-104
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
Recording in axium
-vitals---FORMS ---> medical history
-not intuitive
-nothings erased
-collected and analyzed
Slidematic Facebow
-bitefork
-reference point locator/pen
-articulator index table
-facebow
-transfer jig assembly
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
Uses of Epidemiology
-see extent of disease in a community
-find associations relating to a disease (risk factors)
-test new preventative and therapeutic measures
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
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
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
Oleary
Plaque Control Index---
PI= (# of sites w/ plaque/ # of sites evaluated) x 100
whole mouth view
CDMI Plaque Control Index
-calculated as number of surfaces w/ plaque on 6 teeth divided by total number of tested surfaces (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
Ainamo & Bay
Gingival Bleeding Index
=(# of bleeding sites/#of sites evaluated) * 100
Combined Indices
-systems combining assessment gingivits, periodontitis, plaque, calculus, and overhang restorations
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
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
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
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
