Plane of occulsion on facebow is usually:

Left to right=

Anterior to posterior=

Left to right= level

Anterior to posterior= "up hill"

In facebow the casts are in ________

what does this mean?

MIP

miximum intercuspation

Moves like the patient- open, close, right, and left

protrusive and retrusive

Facebow: an instrument used to record the spatial relationship of the _______arch to anatomic reference points and then transfer this relationship to an articulator

Facebow: an instrument used to record the spatial relationship of the MAXILLARY arch to anatomic reference points and then transfer this relationship to an articulator

1. facebow

2. bite fork

3. transfer assembly

4. compound

5. bard parker knife

6. registration material (compound vs. wax)

In preparing the facebow

 Center the __________ on the cross bar; Then attach ____________ with the knob to the left

1.     Center the nasion relator assembly on the cross bar; Then attach indirect transfer assembly with the knob to the left

1.     Clean and properly disinfect (Caviwipe) the plastic ear pieces before each use

2.     A finger cot (latex) placed over each earpiece will help facilitate proper disinfection of the facebow.

1.     Center the nasion relator assembly on the cross bar; Then attach indirect transfer assembly with the knob to the left

2.     Loosen the thumb screw (center of facebow)

                                1.     Warm one sheet of base plate wax (pink) in a water bath (don’t want it too mushy but soft enough to fold into a square)

                                2.     Fold the wax square on the facebow fork

                                3.     Fold excess underneath

2.     Chill the wax record under tap water after removing from mound OR before removal, use air/water tip to cool the wax with air

1. transfer base assembly

2. transfer assembly

3. support bar

4. facebow fork

what is the working time for mounting stone?

what is the setting expansion?

working time= 2 to 3 minutes

setting expansion= very low 0.08%

·      Listening empathetically builds ______

1.     Individual feels valued and empowered

2.     You gain insight into the situation and perspective of the individual

3.     You formulate a more appropriate response in accordance to the needs of others

1.     Hearing the message (sensing)

2.     Interpreting the message

3.     Evaluating the message content ( what does it mean to me or them?)

4.     Retaining and responding to the message (memory) 

1.     lack of interest

2.     distracting delivery (accent, spitting sound, dress, speech pattern)

3.     external and internal noise (external- phone ringing, child crying, internal- inside thoughts, “I’m running behind on time”)

4.     arrogance and disrespect

5.     pre-programmed emotional responses

6.     ambushing- you can’t listen to their message bc you don’t agree with it, so you are waiting for them to finish so you can tell them they are wrong

7.     listening for facts

8.     faking attention (making eye contact, nodding, smiling at the speaker)

9.     thought speed

1.     paraphrase—putting something in your own words

2.     express understanding

3.     ask questions—probing open ended questions, how long? When? Why?

4.     Communicate nonverbally—nodding head, eye contact

what are examples of some effective feedback methods?

o   Talk first about yourself not the other person

o   Uses descriptive statements without judgment, exaggeration, labeling, or attribution of motives

o   State facts specifically as possible

o   Restrict feedback to things you know for certain

o   Phrase the issue as a statement not a question

o   Provide both positive and negative feedback

o   Constructive Feedback: use “I” not “you”; use descriptive statements without judgment, state facts specifically; tell how it affects you; let the other person respond.  

o   Teamwork-->communication

o   Produce knowledge-->synergy

o   Equifiniality

o   Identify and articulate common purpose/vision

o   Seek information

o   Motivate/inspire/encourage

o   Manage conflict

A: doer

B: influencer

C: relator

D: thinker

Non-aureus

Staphylococcus epidermis (epidermidis)

Commensals: normal skin inhabitants

Generally considered a mild pathogen

Opportunistic pathogen--IV drug users, newborns, elderly, catheters

Staphylococcus aureus

Staph

Common bacteria of skin and nose

~30% have Staph in our noses (carriers)

Colonization rates > in:

Type 1 diabetes

IV drug users

Hemodialysis

Dermatologic conditions

AIDS

Common cause of skin infections

Pimples

Serious infections:

Surgical wound, blood, pneumonia

Resistant to beta-lactam antibiotics (penicillin)

The penicillin family Penicillin, amoxicillin, cephalosporins

By late 1960’s >80% resistant

1. indiscriminate use of antibiotics

2. non compliance with infection control practices

3. antibiotics in food products

MRSA: Type of Staph resistant to penicillin and other antibiotics

• Methicillin-resistant Staphylococcus aureus “Mersa” or “Mursa”

• Methicillin introduced 1959

• Non beta-lactam AB

• Resistance: England 1961, US 1968

• “Superbug”

HA-MRSA

• Common in healthcare facilities especially in the sick: Healthcare associated-MRSA
• Elderly, ICU pts, hx of surgery

• Diabetes, AB use, central lines, IV drug users

• Surgical wound, urinary tract, blood, pneumonia

• 1974: 2% of ICU Staph infections

• 2007: 70%

• IV Vancomycin is treatment of choice

Antibiotic that cannot be taken orally so it will send a patient to the hospital for several days

• 19,000 deaths/year

CA-MRSA

• Community acquired-MRSA

• MRSA infections in people who have not been recently hospitalized

• May have unique biologic properties

• Generally susceptible to non-penicillin AB, but culture and sensitivity tests needed (at least to penicillin and another)

CA-MRSA CDC Population-Based Surveillance Definition

• MRSA culture in outpatient setting or 1st 48-hours of hospitalization AND patient lacks risk

What does a MRSA infection look like?

• Abscesses, pustular lesions, “boils”

• “Spider bites”

 Cellulitis

Factors for an increased risk of getting CA-MRSA:

• Close skin-to-skin contact, cuts or abrasions, contaminated items, crowded living conditions,

poor hygiene

• Athletes, military recruits, children, prisoners 

Hospital workers & MRSA: 

who had most and least prevalence and what were the percentages?

Nursing: 9.6%

Administrative: 0.8%

“Five Cs” of CA-MRSA transmission

“Five Cs” of CA-MRSA transmission

• Contact (direct skin-skin contact)

• Cleanliness

• Compromised skin integrity

• Contaminated objects and environment

• Crowded living

Alcohol Hand Sanitizers

Need >60% alcohol

• Little information on kill times

MRSA: 2 minutes

Staph aureus: 3 minutes

VRSA

• Vancomycin-resistant Staphylococcus aureus

• 2002

• Pray!

T/F Tears, feces, urine, saliva, nasal secretions, sputum, sweat, vomit not infectious, not considered source of BBPs unless visibly contaminated with blood