©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Preparation for Patient Care Chapter 13

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Patient Record Personal Information –Patient registration form Medical history Dental history/presenting problem

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Personal Information Name and address Social security number Insurance information Physician name Emergency contact

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Medical Information Past surgeries Systemic diseases Allergies Injuries

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Dental Information Patient concerns and reason for appointment Patient attitude toward dentistry Quality of previous dental care

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Clinical Observation and Physical Assessment Gait Speech Behavioral problems Eyes –Dilated Facial symmetry –Droopy eyelids

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Clinical Setting Signing of consent forms Referral information Radiographs, if necessary

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Clinical Examination Mouth and lips –Cracking or ulceration –Smile line –Vermillion border –Commissures External floor of mouth Lymph nodes

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Clinical Examination TMJ Visual inspection of interoral –Lesions –Abscessed teeth –Color changes Floor of mouth Tongue

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Smile line Vermilion border Commissures of the lip Examining the Lips © Cengage Learning 2013

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Examining External Tissue of Mandible and Floor of Mouth © Cengage Learning 2013

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Examining the Cervical Lymph Nodes Swelling Abnormalities Tenderness Infection © Cengage Learning 2013

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Examining the TMJ Noises Tenderness Pain Limited function © Cengage Learning 2013

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Examining the Floor of the Mouth Tenderness Abnormalities Lesions Bony tori © Cengage Learning 2013

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Examining the Oral Mucosa and Frenum Frenum attachment –Narrow band of tissue that connects two structures © Cengage Learning 2013

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Examining the Tongue and Palate Palatal tori Geographical Tongue Lesions © Cengage Learning 2013

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Examining the Tongue Color Papillae Coating Abnormalities © Cengage Learning 2013

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Dental Check By performing a visual examination of the internal oral structures, what are some observations the DA may make? –Identification of lesions, abscessed teeth, and color changes in mucosa

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Diagnosis and Treatment Plan Dentist will: –Evaluate all observations –Reach conclusion –Formulate treatment plan Treatment notes updated each visit

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Vital Signs Body temperature Pulse Respiration rate Blood pressure

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Body Temperature Antipyretic –Cold pack –Alcohol rub –Aspirin Hypothermic –Too much aspirin –Prolonged exposure to cold © Cengage Learning 2013

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Pulse Beating sensation felt in artery Sites: –Radial –Carotid –Temporal © Cengage Learning 2013

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Radial Pulse Adults –60 to 90 beats per minute Children –90 to 120 beats per minute

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Pulse Rates Tachycardia –Abnormally rapid resting pulse rate Bradycardia –Abnormally slow resting pulse rate

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Respiration Inhaling and exhaling (breathing) Normal respiration –Adults 10 to 20 breaths per minute –Children 20 to 26 breaths per minute

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Respiration Tachypnea –Abnormally rapid resting respiratory rate Bradypnea –Abnormally slow resting respiratory rate

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Blood Pressure Amount of labor heart has to exert to pump blood throughout body © Cengage Learning 2013

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Normal Readings Adults: 120/80 –Systolic: below 140 –Diastolic: below 90 Children: 100/66 Adolescents: 118/76

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Systolic First sound heard when taking blood pressure Highest number in reading Caused by heart contracting and forcing blood through arteries

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Diastolic Reflects heart muscle at rest Heart takes blood to be oxygenated before next contraction

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Taking Blood Pressure Extend patient’s arm to level of heart Make sure arm is supported and relaxed Wrap and secure cuff 1 to 2 inches above antecubital space Expel all air from cuff beforehand Inflate cuff to 160 to 180 Release 2 to 4 millimeters (mm) mercury per second

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Locating the Brachial Artery © Cengage Learning 2013

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Dental Check Which pulse site is depicted here? –Carotid © Cengage Learning 2013