Dental practitioners take action to minimize the risk of a disease from certain procedures that may allow bacteria from the mouth to enter the bloodstream. Antibiotic premedication therapy is a prophylactic measure that prevents bacteria from being released into the blood stream. The bacteria can infect the heart lining, as well as the valves or blood vessels, causing them to become inflamed. Infective endocarditis (IE), the name for the inflammation, has the potential to be fatal or debilitating. The risk of developing IE can happen from a combi¬nation of high-risk patients and dental procedures. While this is not an issue for most patients, some do require protection. The American Heart Association recommends antibiotic premedication therapy before dental procedures. But only for those whose cardiac conditions as well as a few other conditions are associated with the highest risk of adverse outcome.3
To know who and why a patient will need antibiotic premedication therapy, the hygienist has to keep an accurate and up to date patient history. It is significant because the oral conditions reflect the general health of the patient, common health factors influence response to treatment, and the patients health is constantly changing.1 Preventative antibiotics before a dental procedure are advised for patients with underlying cardiac conditions, a history of IE, and total joint replacements who have suppressed immune systems. Conditions that require premedication include:3
A. Congenital heart disease, but only the following types:
a. Unrepaired Cyanotic Congenital Heart Disease
Cyanotic heart disease is a heart defect, present at birth that results in low blood oxygen levels. With a series of surgeries, this condition is usually tr...
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...ot prescribed for individuals with immediate-type hypersensitivity reaction (urticarial, angioedema, or anaphylaxis) to penicillins or ampicillin.i
As stated above, the risk of developing IE can happen from a combination of high-risk patients and certain dental procedures. Antibiotic premedication therapy is valuable to those who require it. The clinician will work with the patients physician and take a close look at the up-to-date medical history and what kind of dental treatment will be carried out to ensure that the proper safety information can be utilized.
Works Cited
1Wilkins, Esther M. (2013). Clinical Practice of the Dental Hygienist
2American Dental Association
3 American Heart Association (2013) Retrieved from http://www.heart.org/HEARTORG/Conditions/CongenitalHeartDefects/TheImpactofCongenitalHeartDefects/Infective-Endocarditis_UCM_307108_Article.jsp
[7]Similarly they are contraindicated in patients with low caries risk, teeth with shallow self cleansing grooves, patients with good oral hygiene maintenance,
Al-Momany NH, Al-Bakri AG, Makahleh ZM, Wazaify MM (2009) Adherence to international antimicrobial prophylaxis guidelines in cardiac surgery: a Jordanian study demonstrates need for quality improvement. J Manag Care Pharm. 15:262-71.
However, on the a recent visit dated 23/12/13 the patient’s gingival condition had deteriorated, presenting with an increased plaque scores of 34% and bleeding scores to 63%. Intra oral examination also showed generalised oedema and erythema throughout in the mouth in response to this increase in plaque bacteria. The presence of supra-gingival calculus on lower anterior teeth and both sites of upper buccal molars and the patients BPE now reads 212 /121, putting the patients caries risk at a ‘High’ status.
Smith brings his 4-year-old to your office with chief complaints of right ear pain, sneezing, mild cough, and low-grade fever of 100 degrees for the last 72 hours. Today, the child is alert, cooperative, and well hydrated. You note a mildly erythemic throat with no exudate, both ears mild pink tympanic membrane with good movement, lungs clear. You diagnose an acute upper respiratory infection, probably viral in nature. Mr. Smith is states that the family is planning a trip out of town starting tomorrow and would like an antibiotic just in case.
Nurses should take a leading role in reducing the impact of disease on patients and influence the expansion of evidence based infection prevention practice. Antimicrobial resistance prevention must remain a huge priority. In times of opposing priorities concerning patient safety, progress has been made in undertaking these bacteria’s and infections. The outlook of a near future without helpful antibiotics should not be dismissed, and all us in positions of influence should encourage and educate the conscientious use of antimicrobials seriously and do what we can to stop the situation from spreading.
Kleinpell RM, Munro CL, Giuliano KK. Targeting Health Care–Associated Infections: Evidence-Based Strategies. In: Hughes RG, editor. Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Rockville (MD): Agency for Healthcare Research and Quality (US); 2008 Apr. Chapter 42. Available from: http://www.ncbi.nlm.nih.gov/books/NBK2632/
In conclusion, it is important for the dental staff to treat all patients as if they are infected. A patient may or may not choose to disclose any information pertaining to their disease or they may not be aware of it. It is also important for the dental staff to have immunizations done at regular intervals. The hygienist needs to make sure he or she protects him or herself as well as the patient during treatment. Discrimination against someone with a disease is illegal. With that in mind it is the clinician’s duty to be aware of diseases he or she may come into contact with and how to treat the patient.
...of initial dual antibiotic therapy compared with single antibiotic therapy on mortality. Both groups of treatment received the first dose of antibiotic therapy within eight hours of admission. In the single antibiotic therapy group, patient received cefuroxime and for the dual antibiotic therapy group patients either received a Beta-lactam such as ceftriaxone or cefuroxime and macrolide. In the single antibiotic group 21% of the participants were considered immunocompromised whereas 17% of the participants were considered immunocompromised in the dual antibiotic group. The researchers were able to conclude that the single antibiotic therapy group had increase in mortality than the dual therapy group. It was concluded that initial empiric dual therapy with Beta lactam antibiotic and a macrolide decreases mortality in immunocompromised patients diagnosed with CAP.
...f infections acquired during the hospital. Many of these studies have indicated that these infection control interventions will decrease the number of sick or dying patients related to hospital acquired infections and lower the medical cost by decreasing the stay of each patient in the hospital.
Infection control is a central concept to every practice of health care providers. Its main objective is to prevent the transmission of infectious diseases from both patients and health personnel (Martin et al., 2010). In dental clinic, infection control is a continuous concern for its professionals. They have to contact patients routinely and be exposed to their blood, saliva, dental plaque and pus that may contain infectious pathogens. It is important for the dental professionals to treat these fluids as if they are infectious and special precautions must be taken to handle them. In this essay, I will highlight the scope of infection control practices in dental clinics and the ways through which infectious microorganisms are transmitted in the dental clinic. Also, I will talk about some infection control guidelines implemented in dental clinics and how they meet the needs of the patients. Finally, from a personal perspective, I will mention some factors that affect the implantation of infection control guidelines and procedures.
It was hard to listen to one member of our profession speak so ill of another. Regardless if it were true, the patchwork comment resonates with what Kazemian, et al. describe as overtreatment due to fee-for-service systems. As dentists, we are reimbursed based on our coding. This incentive to maximize the amount of codes per appointment creates an alluring opportunity for the provider to perform hasty, albeit slipshod treatment. Unfortunately, this too often leads to gross errors, misdiagnoses, and treatments with poor long-term outcomes. It cannot be emphasized enough that rushing does not equate to efficiency and success. We should always strive to improve the well-being of our patients and their long-term health, and this can only be attained by thorough diagnosis and sound treatment protocols. Ostensibly, speed of treatment may momentarily appeal to patients, but as providers we are held to a higher standard. Ultimately, it is the care we provide to our patients that defines us as
The prevention of periodontitis is straightforward for patients. The first step in prevention is to assure that the patient is brushing twice a day utilising the proper brushing technique. Patients who fear the contraction of periodontitis are not encouraged to brush too much however, as excessive brushing with poor technique can lead to other oral problems such as the reduction of the gums (gingival recession). Brushing at least twice a day help inhibit the growth of unwanted bacteria and prevents plaque, and thus tartar from forming. Patients who wish to prevent periodontitis should also floss daily. Flossing daily includes the spaces between each tooth, as well as behind the last two molars on the mandibular and maxillary arches. Flossing should get in below the gum line to prevent bacteria from congregating just below the surface. The last at home, over-the-counter treatment available for the prevention of periodontitis is the use of an antiseptic mouthwash. While proper use of mouthwash in conjunction with the other techniques can help cure gingivitis, once periodontal disease has elapsed stage 1 of periodontal disease, no amount of mouthwash or brushing can restore attachment lost in the periodontium.
Cappelli, D. P., & Mobley, C. C. (2008). Prevention in clinical oral health care. St. Louis, Mo: Mosby Elsevier.
Infection control in dentistry crucial for the well being of employees as well as the patients. Many precautions must be taken to avoid serious illness or injuries.There are many steps and guidelines to follow in infection prevention but as employees in the dental office we must take the time to ensure no harm is done to the clients or ourselves.
Patients who are already in a poor state of health can become infected more easily. There are several treatments that leave patients vulnerable to infection. For instance, immunosuppression and antacid treatment undermine the body 's defenses. The prolonged use of antibiotics may reduce the effectiveness of a patient 's own immune system. If a hospital warns patients of the risk of infections before the patient begins treatment and gives the patient an opportunity to opt out of the treatment, it can be excused from assuming the responsibility of the