*Golden - NBDE II- ethics/ pt. management
Terms in this set (203)
self governance/ privacy/ pt. has the right
do no harm
*keeping skills/ knowledge up to date
what do you 1st do before choosing informed consent?
make sure pt. can sign or has guardian
90 yr old comes in w/ younger person who hands dentist a paper saying that the pt. has a legal guardian.. now what?
you have consent from that guardian before treating pt.
the 16 yr old can make decision for the elderly pt if...
the kid has the power of an attorney
when should pt. sign IC for surgery?
after there has been a discussion w/ dentist about surgery
treatment w/o IC (pt. doesn't sign) =
dentist keeping up w/ new data
knowing your limitations and referring pts. out to specialists
rapport is best with
- understanding patients feelings and talking w/ pt.
- mutual openness
- harmonious relationship
best way to communicate w/ pt...
empathy is NOT
(open mindedness/ sharing personal experiences/ reflection and showing understanding)
shared personal experiences
acknowledging a pt.'s concerns
when should the dentist NOT use paraphrasing
when giving factual values
the closest a dentist should get to a pt. is..
tap their shoulder
reason to not have parent in the room w/ dentist and kid
communication barrier between dentist and child
don't have parent in room w/ child...
disrupts relationship between child and dentist
precontemplation/ contemplation/ action- definition
"I do not have time to quit smoking." - what health behavioral sage?
removal of reinforces to decrease a behavior
(child cries, don't give attention)
how to reduce stress-dental anxiety
tell show do
providing positive reinforcement for approximation of behavior you are desiring
pt. is given oral habit reducing appliance to prevent oral habit... what is this considered?
6mn old retarted child... what type of behavior?
best way to treat a mentally disabled child..
disabled pt. comes in and not cooperative, how do you act?
mentally disabled, approach by dentist ??
pt. w/ autism will usually show...
heightened sense of lights and sounds
providing reward for desired behavior
eye contact, smiling, tell pt. doing good job, pat on back
purpose of voice control technique?
set boundaries --> aversive conditioning
young kids are scared of dentist?
if child is afraid...
allow them to express fears
best way to treat fearful child
desensitization works best if the base of the behavior problem is
how to treat a fearful child
let them watch another patient
child is scared bc he is not in control/ helpless.. how to reduce this?
tell pt. to raise their hand when feel pain
pt. is very young and fearful the 1st time you meet them...
try to talk to them going down at their height
2 yr old pt and scared.....
ask parent to position patient for you
the restraining of an uncooperative 2 yr old should be done by...
1-2yr old, best way to position them?
parent and dentist and knee to knee w/ baby's head in DENTISTS lap
8 yr old.. when will he behave better...
when mom/dad are out of office
pediatric fears are correlated w/...
1-3yrs old fear
4-6yrs old fear
used when kid is afraid and use a sibling or someone older to who how they should behave
a pt. recently got a flu vaccine, has never been to the dentist and is now afraid of needles... fear is due to>>
replacing words like LA w/ sleepy juice...
example of classic condition?
(you see a dentist and you assume pain)
example of stimuli in classic conditioning (in a pt. that has previous bad experience)?
*dental chair (or dentist)
operant extinction/ behavior
removal of reinforces to decrease a behavior
fear vs anxiety
- fear --> on something --> painful
- anxiety --> is everything --> a disease
anxiety according to Freud and K
an Inadequate Resolution
(indicates a child's insecurity and anxiety)
Frued's concept of anxiety:
pt. w/ dental fear most likely due to..
previous traumatic experience
constantly exposing the pt. to get from the fear factor is
what is maturity?
1st pedo visit, anesthesia is fine but pt. begins to cry once tx starts...what to do?
what is not included in the ADA code of ethics?
(licensure by credential/ advertising/ issues concerning pt/ fees)
each of these is covered in the ADA code of ethics except?
a dentist has an ethical obligation to report a colleague in all situations... except?
(working under substance abuse/ advertising on electronic media/ abusing patients)
advertising on electronic media
if you find problems.. medical conditions occurring with a certain drug, who do you contact?
if there is an adverse reaction/ allergy to medication in the office, who do you report to?
if a pt. has a toxic rxn to a med the dentist should contact..
correct statement for HIPPA
must give privacy form to pt. but you don't need confirmation of receipt, fax and email standard..
poor; covers dental
elderly (65yr + and most permanently disabled); does NOT cover dental
where does the government spend all of its DENTAL money?
which insurance have dental coverage?
what sector of government provides funding for dental care?
who pays for Medicaid
states and federal
who pays for Medicare
where does the government spend all of its DENTAL monday?
Where does the government spend most of the money?
T/F --> Medicare is a federal thing that provides health care for elderly. It does not cover dental.
most aid for finance is in?
most of the dental payments are by?
case for service- 67%
most dental procedures for the elderly are paid for by..
out of pocket cash
which of the following is the leading payer for dental tx?
who pay for most of dental care?
majority of health service in USA
who pays most of dental tx?
56% pts; 33% 3rd parties private insurance
a 65yr old pt makes $23,000/yr... how should she receive dental care?
what is the name of the federal funded medical care for elderly and its coverage?
medicare w/o dental coverage
health care plan adverse beneficiary risk
dentist is paid a fixed fee to see patients enrolled in program
capitation dental plan =
which is related to employee insurance, where you get a discount from the insurance and also you can go to a dentist of your preference?
(reduced fee for service)
insurance allows pt to only see certain set of providers
which is related to dental insurance that only allows you to go to a group of dentists at a specific location?
company offers dental insurance to its employees that can go to selected dentist...
patients receive care at specified facilities from a limited number of dentists
if you are an employer and you provide your employee w/ reimbursements for dental care they received from a dentist of their choice...
pt. needs to pay something before being seen..
dentist didn't ask for copayment and he didn't report to insurance...
if a dentist waives the copayment and doesn't tell the 3rd party this is called...
you let pt. not pay copay but you tell the insurance that you charged the pt ...
dentist charge for crown 500, insurance only covers 400, dentist waives copay (100) but still tells insurance he charges 500 for crown...
bill out for a core and crown, insurance says only build up is covered..
*the insurance company bundles the two procedures into 1
when you bill out for 2+ things (same procedure based) and only 1 thing is covered
dentist charges separately for core and crown, insurance says core is part of crown (bundle the 2 procedures into 1)..
dentist did tx for 2 crowns but insurance pay for 1 crown
you did 2 surface resto and coded it that way, it came back with coding for only 1 surface resto
when you charge for multiple codes but you only did 1 thing
one big procedure but you divide it into may sub procedures
pt. asks you to change the date of service on insurance claim...
not the reason for rising dental costs?
the number of dental students in dental school
when treating an elderly pt. what should you be concerned with..
health of pt.
it is not mandatory to report..
reaction to a drug
it is mandatory to report...
who do you report child abuse to?
social services/ dept of health and human services
elderly abuse is...
what is not true of elder abuse?
its often over reported and exaggerated
what makes opening a dental practice more successful
finding out whether a pt. is listening
dentist reports most problems with..
unconscious redirection of feelings from one person to another
pt. was bothering dentist, assistant drops instrument and dentist yells at assistant
who is most at risk for eye injury?
least chance of needle injury
most injury/ percutaneous cuts happen when?
most likely to get puncture wound
test for what every year
dentist can diagnose...
what is not true about TP?
cannot guarantee success of treatment
emergency, disease control, re-evaluation, definitive, maintenance
2 most important steps for diagnosis
history and clinical exam
test that is not accurate but gives consistent results
what is necessary for a test to be accurate
nonverbal vs. verbal communication
nonverbal = not as reliable
what happened in 1997
SCHIP- pays for kids that cannot afford dental coverage even w/o insurance
SCHIP or CHIP
State children's health insurance program / children's health insurance program
who is protected under Americans w/ disabilities act?
AIDS (HIV) pts. and accommodate the handicapped
T/F--> Americans disabilities act does not include HIV
let sit for 10 min then wipe off
inanImate objects ... kills microorganisms (not bacterial spores)
(*disinfectants = inanimate objects)
20 min, 121 C and 15psi
which method of sterilization needs higher temperature?
dry heat - 320
temperatures in autoclaves governed by
benchmark for sterilization
outside office (for transferring in/out of office)
OHSA guidelines updated
once a year
OSHA does not include
OSHA bloodborne pathogen standard
HIV and HBV
who is in control of writing MSDS
dentist potential for abuse/ addiction most not likely due to...
(vulnerability/ pressure of being perfect/ knowledge and access to drugs/ stress)
compare the means of 2 groups are statistically different- small sample size
compare the means of 2 groups are statistically different- large sample size
(start w/ disease and look back for exposure)
(look forward from exposure to disease development)
*quotient/relative risk ratio
- studies the entire population (not a specific group broken up)
studies a certain set of people over a long period of time
randomization and blinding
where would you look in an article for the dependent and independent variables
where is article you find a summary, it states the purpose of the research
what are the qualities of a double blind study except...
2 control groups (you don't need this, exception!)
research done to determine caries rate at a nursing home... study type?
type of case that lets you have a risk quotient/ relative risk ratio
type of case study w/ odds ratio
case control (retrospective)
studying for the next 10 year... case type?
study of smokers vs non smokers in a period of 6 yrs to develop disease...
how do you find causation
myesthena gravis, how many have perio dx...
study group A and B given agent for plaque control, then compare which agent is more effective...
study designed to determine the relationship between emotional stress and ulcers
analyze statistical difference between 2 means?
(compares MEAN VALUE of 2 groups... the difference between the 2 means)
how do you compare 2 CONSTANT variables?
comparing answers from 2 groups of people.. use
(measures ASSOCIATION between 2 variables to compare 2 groups)
chi square test
two common variables
test measuring 2 nonparametric data
if you have a study of confounding variable...
minimize confounding variables by randomizing
(controlled variables are used to reduce confounding variables)
Type I error
false rejection of null hypothesis
Type II error
false acceptance of null hypothesis
error of less or equal of 0.5 = no statistical sig
if P-sig value is 0.01.....
reject null (means your theory is right)
the power of a stat analysis is to...
reject the null
people w/ disease
people free of disease
new cases of disease
the statical measurement for the total number of cases per population regardless of time of onset
the research divided the number of disease cases by the number of people... this will calculate
95 out of 100 people have the disease, what is the lab value
a study failed to report 5 cases of caries... what is this called
biggest difference across culture regarding pain
variability in pain tolerance rather than pain threshold
what does not describe the spread of data
use for average
the variability about the mean-value of a group of observations?
histogram is used to show
scale of 1,2,3...
GI mild, mod, severe scale..
BP, pulse, Kelvin scale...
smoking ... 5 A's