chlorhexidine gluconate 2.5mg (broad spectrum)

bacteriocidal microbial agent (used withSRP)

slow released 7-10 days (peaks at 4 hrs, and again at 72hrs)

used with srp and patient with good OH and regular denta visits. (use once every 3 months on pockes 5mm or more)

removal is not necessary(biodegradable)

microbial cell surface is destroyed  by chlorhexidine gluconate.

precipitates cytoplasm leading to cell death

lidocaine 2.5% and prilocain 2.5%

subgingival anesthetic

synthetic polyoxomers

does not provide vasoconstriction

no more than 5 cartridges / pt

pt ed and give time to re-assess and re eval if pt is implementing possitive change.

if no postive change occurs controlled delivery system should be considered.

fiber with tetracycline antibiotic 12.7%

ethylene acetate copolymer time released for 10 days

contraindications: pregnant/tetracycline allergies

removal is needed by healthcare provider

10% doxycyline hyclate

(polyactic acid gel and drug mixed chairside and delivered to bottom of pocket using small cannula)

21 day release

kills p.ging, t forsythia,

dont brush/floss area for 7 days

more cost efficient than arestin

minocycline HCL (microspheres)

1mg doses

do not eat hard, sticky food

GI imbalance

Nausea

Diarrhea

Rash

Risk of resistence

pt compliance (not taking pills as prescribed)

tetracycline

metronidazole (flagyl)

clindamycin

ciprofloxacin

penicillin

 affects AA

and is used in juvenile perio 

anticollegenase properties 

sytemic

500mg per day for 3 days

 enzymes reduce increased colleganase found in crevicular fluid.

one 20mg capsule taken 2x per day 1 hr before mealtime

doxycycline hyclate

 a teaching  tool, not for diagnosis!!!!

determines morphology and activity of live organisms

size, shape, motility

nozzle tip 4-5mm from tooth

small controlled circles

55-65 degrees for anterior

80 degrees for posterior

90 degrees for occlusal

 powder used for prophy jet

has calcium phosphate and silica to keep free flowing

mohs: 2.5-7.4 

 first alternative to sodium bicarbonate (prophy jet)

for low sodium/sodium restricted pts.

amino acid

prophy jet use

naturally occuring antacids

powder for prophy jet

bioactive glass good for sensitivity

prophy jet use

diagnodent

occlusal surfaces only

does not detect interproximal decay

not with restorations on tooth

0-10 healthy

11-20 outer half enamel caries

21-31 inner half enamel caries

30 dentin caries, high pitch

bacteria (caries)

periodontal disease

mechanical injuries

thermal injuries

prior to ortho

perio surgery

restorative procedures

discoloration of crown

fracture

large carious lesion

fistula

thermal

electrical

stimulus to create pain

pulp tester determines conduction of stimuli to sensory receptors

vitality of pulp depends upon blood supply and not nerve supply

pain threshold 

carcinogenic nitrosamines

polonium 210

carbon monoxide

cigarettes 1-2%

smokeless tobacco 1.48-8%

oral cavity

absorbed through gingiva

 also intestinal absorption

hits brain in 20 seconds

metabolized in liver

peak plasma concentration 10 minutes

spread to all body tissues

on small puff effects on body last 8-12 hours

COPD

cardiovascular disease

cancer (75% of oral cancer related to smoking)

pregnancy risks: low birth weight, cleft lip/palate, miscarraige, sudden infant death syndrome

children:lung development, asthma, ear infections

gingivitis

periodontitis

altered antibody production

lowers immune response

subgingival temp lowered

prevalence and severity lessen with cessation.

risk for implant failure

 use for 12 weeks

causes mouth soreness

no contraindications

start 1-2 weeks prior to smoking cessation

7-12 week maintenace for up to 6 months

xerostomia

contraindications: seizure history, eating disorders

local irritation of mouth and throat

6-16 cartridges / day

can be used for up to 6 months

prescription only

nicotrol ns (prescription only)

nasal irritation

8-40 doses/day for 3-4 months

nicoderm CQ (over the counter)

generic patch (prescription and otc)

nicotrol (otc)

causes local skin reactions, insomnia

21mg/day

take for 4 weeks then 2 weeks

no nicotine contained

uses same receptor as nicotine

blocks nicotine from receptor

44% success rate

1mg 2x daily

start 1 week prior to quitting, take for 12 weeks

nausea

bizarre dreams

insomnia

bad taste

constipation

clonidine (catapres, an antihypertensive)

prescription only 

transdermal

used for rebound hypertension

dry mouth

use 3-10 weeks

risk of arrythmia

dry mouth

12 week use

prescription only

not approved by FDA

ASK

ADVISE

ASSESS

ASSIST

ARRANGE

N2O/O2

effective method for pain management and anxiety

no adverse effects, no allergies

1 1/2 times heavier than air

95% liquid, 5% vapor

turns into gas upon exposure of ambient air

not metabolized in liver

miniscule amount metabolized in GI

colorless

odorless

low potency

t/f

when nitrous oxide is combined with an intravenous agent it is  a good general anesthetic

device must have exhaust vent to vent exhaled gas out of building.

35%

the range is 10-50

100% oxygen for 2-3 min

then gradually add in 5-10% increments.

onset occurs in 3-5 min

cns depression

analgesia

amnesia

auditory function may still be present: calm environment is needed

out of body or floating experience

inability to move/communicate

not pleasant

danger of aspiration of vomitus-life threatening

surgical stage

laryngeal and pharngeal reflexes disapear, pt cannot breath independently.

 nitrous oxide exits faster than nitrogen that replaces it

oxygen saturation decreased

headache, lethargy, lightheadedness

loss of carbon dioxide stimulus

give 100% oxygen to cure

respiratory obstruction (cold)

COPD

pregnant

abuse

emotional instability

phenothiazines

lithium

tricyclic antidepressants

counseling

short wave diathermy

megapulse

physiotherapy ( acupuncture, massage, thermal, exercise, )

analgesics combo of aspirin/codiene, NSAIDS for osteoarthritis

tricyclic antidepressants, benzodiazepines

bite gaurd

LOIS splint

stabilization splint

surgery

migrains

pain on palpation

limited muscle movement

joint sounds