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Dental Hygiene III - Chapter 62 - The Patient with Respiratory Disease

compromise dental and dental hygiene care.

Respiratory diseases are common among the general population and can __?

1. Respiratory diseases,
2. Medications used in their treatment,
3. Link with periodontal health and oral hygiene,
4. Implications for dental hygiene care.

To properly manage respiratory disease patients it is important for the dental hygienist to understand __?

1. asthma
2. chronic obstructive pulmonary disease (COPD)

The most frequently encountered respiratory diseases are __?

1. emphysema
2. chronic bronchitis

COPD encompasses which diseases?


This disease has afflicted mankind for centuries and continues to be a worldwide problem.

1. medications used
2. drug interactions
3. complications that may arise from decreased breathing function

Patients with respiratory disease are at greater risk of __?

1. Sinuses,
2. nasal cavity,
3. larynx,
4. pharynx,
5. trachea,
6. bronchi,
7. lungs
8. pleura

The Anatomy of the Respiratory System encompasses __?

1. Passage way for air exchange
2. inhaled fresh air,
3. exhaled air,
4. gas exchange,
5. cardiovascular system

The Physiology of the respiratory systems includes __?

1. Moistens alveolar walls,
2. removes foreign materials

The Function of respiratory mucosa in the respiratory system is to __?

1. congestion
2. asthma
3. chronic bronchitis

When the respiratory mucosa cannot moisten alveolar walls and remove foreign materials, what occurs?

1. Contact lens
2. Cystic fibrosis pneumonia
3. Dental caries
4. Intrauterine device (IUD)
5. Mechanical heart valve
6. Periodontitis
7. Unit water lines
8. Nocosomial infections
9. Intensive care unit pneumonia
10. Endotracheal tubes
11. Ventilator- assisted pneumonia

Some examples of diseases/devices involving biofilms are __?

1. Trachea,
2. lungs,
3. bronchi,
4. bronchioles

Lower respiratory diseases occur in which areas of the respiratory track?

1. Nose,
2. sinuses,
3. pharynx,
4. larynx

Upper respiratory diseases occur in which areas of the respiratory track?

1. Direct oral contact, \
2. Inhalation of droplets,
3. Indirectly (hands/articles) with discharge of nose and throat of infected person

Transmission of a upper respiratory infection occurs how?

standard precautions

The best disease prevention method for preventing an upper respiratory infection is __?

Delay treatment until patient is well

Should you treat a patient with an upper respiratory infection?


An example of acute disease of the lower respiratory tract is __?

1. TB
2. Asthma
4. Cystic fibrosis

An example of chronic disease of the lower respiratory tract is __?

1. viral
2. bacterial
3. fungal

What causes penumonia?

1. Community-Aquired Pneumonia (CAP): person to person

2. Nosocomial Pnemonia: typically affects debilitated and chronically ill patients in hospitals, nursing homes and is a leading cause of death.

What are the 2 types of pneumonia?

lung infections

The Oral cavity serves as reservoir for ___ especially in hospital settings.

oral bacteria within the oral cavity

Improved oral hygiene care can reduce incidence of __?

lots of rest and liquids

What is the medical treatment for a viral infection?

antibiotic therapy

What is the medical treatment for a bacterial infection?

sulfa drugs

What is the medical treatment for a fungal infection?

1. Control of oral/periodontal dx
2. Maintaining biofilm removal

In terms of the Dental Hygiene care you give, what is most important when dealing with patient's with respiratory issues?

mycobacterium tuberculosis

TB is caused by which organism?

coughing, sneezing, talking,

How is TB transmitted?

1. Low grade fever
2. weight loss
3. fatigue
4. Night sweats

1. Persistent cough
2. Chest pain
3. Hoarsness
4. Hemoptysis (coughing up blood)

What are the signs and symptoms of TB?

Antituberculosis drugs used for 6-9 months

What is the treatment for patient's with TB?

1. Appears orally in pat with HIV/Aids
2. Ulcer on dorsal of tongue (figure 62.3)
3. Palate, lips, buccal mucosa, gingiva

What are some of the oral manifestations of patient's with TB?

Extrinsic: allergy induced
Intrinsic: non-allergy induced

What are the 2 types of athmas?


This picture is of what likely condition?

1. Mild intermittent
2. Mild persistent
3. Moderate persistent
4. Severe persistent

What are the 4 categories within the NAEPP for asthma based on severity and frequency of symptoms as well as pulmonary function assessment?

1. Drug of food induced
2. Exercised induced
3. Infection induced

Other forms of asthma include:

1. Aspirin or NSAIDS
2. Beta blockers
3. Nuts, shellfish, milk, strawberries
4. Tartrazine (yellow food dye)

Some examples of drug or food induced asthma triggers are __?

1. adolescents and young people
2. Vigorous physical activity
3. Thermal changes during inhalation (cold air)

Some example of exercise-induced asthma triggers are __?

1. Lung infections caused by viruses, bacteria, or fungi
2. Treatment of infection will improve breathing

Some example of infection-induced asthma triggers are __?

1. chest tightness
2. difficulty breathing,
3. wheezing
4. cough
5. flushed appearance
6. sweating,
7. dilated pupils
8. can't complete sentence in one breath

Signs and symptoms of an asthma attack include __?

1. Stop treatment
2. Assist with inhaler
3. Give oxygen if needed

What do you do as a Hygienist if you suspect that your patient is having an asthma attack?

have on your brachet table, not in patient's pocket or purse

Where should the patient's inhaler be kept during a dental cleaning appt?

1. Dry mouth
2. Increase in dental caries and gingivitis
3. Candidiasis

What are some common oral manifestations for patient's that have asthma?


What may occur from frequent use of a bronchiodilator (inhaler?)

Frequency = 2 per week or less
Night Frequency = less than 2 per month
Pulmonary function = low variability
Treatment = rarely requires daily meds, fast acting inhaler needed

The national asthma education and prevention program classification (NAEPP) describes a mild intermittent category as __?

Frequency = 2 per week or more
Night Frequency = more than 2 per month
Pulmonary function = variable
Treatment = more complex, needs fast acting inhaler

The national asthma education and prevention program classification (NAEPP) describes a mild persistent category as __?

Frequency = daily
Night Frequency = more than 1 per week
Pulmonary function = requires daily monitoring with spirometry
Treatment = multiple agents used, needs fast acting inhaler, patient ed important

The national asthma education and prevention program classification (NAEPP) describes a moderate persistent category as __?

Frequency = daily - limits activity
Night Frequency = common
Pulmonary function = very variable
Treatment = multiple meds daily needed, needs fast acting inhaler, long term antiinflammatory meds needed, other advanced therapies needed, pat ed & compliance important.

The national asthma education and prevention program classification (NAEPP) describes a severe persistent category as __?

1. excessive coughing up mucous,
2. difficulty breathing in and out,
3. over weight
4. "Blue Bloaters" is a term used to describe patients with CB.

Chronic bronchitis is characterized by __?

Chronic Bronchitis

Which disease is associated with the term Blue Bloaters?

1. difficulty breathing only on expiration, 2. minimal dry cough,
3. enlarged chest,
4. weight loss.
5. "Pink Puffers" is a term used to describe emphysema patients.

Emphysema is characterized by __?


Which disease is associated with the term Pink Puffers?


T/F There is NO cure for COPD

1. Stop smoking,
2. Good diet,
3. Plenty of fluids,
4. Exercise,
5. Decrease pollutants,
6. Get pneumonia and flu vaccines,
7. Keep an inhaler

What is the medical treatment for patient's with COPD?

1. Halitosis,
2. nicotine stomatitis,
3. perio infections,
4. oral cancer,
5. extrinsic tooth staining

What are some oral manifestations of COPD patients?

1. Persistent cough and wheezing
2. recurrent pnuemonia
3. excessive appetite but poor weight gain
4. salty skin or sweat
5. Bulky, foul smelling stools

What are the early signs and symptoms of patients with cystic fibrosis?

1. Tachypnea
2. Sustained chronic cough with mucus production & vomiting
3. Barrel chest
4. Cyanosis & digital finger clubbing
5. Exertional dyspnea with decreased exercise capacity
6. Pnuemothorax
7. Right heart failure - soncondary to pulmonary hypertension

What are the late signs and symptoms of patients with cystic fibrosis?

1. Gingivitis,
2. halitosis,
3. lower lip may be enlarged, swollen and dry

What are the oral manifestations for patient's with Cystic Fibrosis?

short morning appts

What is the best time of day for stress reduction in patients with a respiratory disease?

Semireclined or upright position may make breathing easier

What chair position is best for patients with a respiratory disease?

Aspirin and NSAIDS

Which drug especially should be avoided in patients with a respiratory disease?

1. Ultrasonic
2. sonic scalers
3. polishing

What equipment should be avoided when working on patients with a respiratory disease?

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