*Last ER visit was due to her emotional stress caused by a family member passing away
Social Assessment:
*Limited on the activities she can do with her grandchildren
*Has had asthma her whole life
Medical Assessment:
*Had ER visit 16 months ago due to severe attack
*Uses Albuterol 3-4 times a week
*Takes long-term anti-inflammatory medication
Dental History:
*Recurrent caries on multiple teeth
*Generalized probing depths 3-4
*Localized BOP on molars
*Gold crowns on #2,3, 14, 15, 18, 31
*#19- MOD amal, #30- MOB amal
E/O, I/O Assessment:
*Dry lips
*Xerostomia
Communication:
*Review HHX each visit
*Check expiration date on emergency inhaler, and have out on counter
*Find out the frequency of attacks and her specific triggers
*Make sure she can safely handle the procedure that day
Appt. Planning:
*Make prophy appointments for late morning or early afternoon
*Short appointments to decrease stress on her
Client Positioning:
*Semi supine to patients comfort level
*Assume position that facilitates breathing
DH Procedures:
*Monitor xerostomia
*Avoid causing a coughing episodes by keeping excess water out of patients mouth
*Short appointments to remove new cavities
Safety Precautions:
*During restorative procedures, recommend nitrous to relieve stress
*Do not use ultrasonic scaler or air polisher
*Keep bronchodilator available at each appointment
OHI:
*Prescribe fluoride
*Have patient rinse her mouths with water after each use of inhaler
*Recommend Biotene products and Xylitol
Personal Reflection:
I chose to do this assignment on asthma because I have seen it on health histories in the past while working at dental offices and wanted to know how to handle it in more detail. While learning about this topic, I noticed that special care should be taken when you have patients with asthma. I have worked in the dental field for many years and I feel that some offices do not consider all the medical emergencies that can arise from this special need.
Additional Information:
http://www.asthma.com/learn/index.html This website was helpful for those who have asthma or think they have asthma. It also had some great questions to ask their doctor.
http://www.ccsd.ca/drip/research/drip14/index.htm This website had interesting research of persons with asthma and comparing those with disabilities versus those without disabilities. It also talked about who is more prone to have asthma.