Clinical practice of the dental hygienist / Esther M. Wilkins.

Format:

Book

Author/Creator:

Wilkins, Esther M.

Language:

English

Subjects (All):

Dental hygiene.

Physical Description:

xvii, 893 pages : illustrations ; 28 cm

Edition:

Seventh edition.

Place of Publication:

Baltimore : Williams & Wilkins, 1994.

Contents:

1. The Professional Dental Hygienist 3

Factors Influencing Clinical Practice 6

Objectives for Practice 6

Factors to Teach the Patient 7

Part II Preparation for Dental Hygiene Appointments

2. Infection Control: Transmissible Diseases 11

Microorganisms of the Oral Cavity 11

The Infectious Process 11

Pathogens Transmissible by the Oral Cavity 16

Tuberculosis 16

Viral Hepatitis 17

Herpesvirus Diseases 25

HIV Infection 29

Factors to Teach the Patient 36

3. Exposure Control: Barriers for Patient and Clinician 41

Personal Protection of the Dental Team 41

Immunizations and Periodic Tests 41

Clinical Attire 42

Use of Face Mask 43

Use of Protective Eyewear 44

Hand Care 45

Technical Hints 50

Factors to Teach the Patient 50

4. Infection Control: Clinical Procedures 52

Treatment Room Features 52

Instrument Management 54

Sterilization 56

Chemical Disinfectants 59

Unit Water Lines 62

Preparation for Appointment 62

Universal Procedures for the Prevention of Disease Transmission 65

Disposal of Waste 67

Technical Hints 67

Factors to Teach the Patient 67

5. Patient Reception and Positioning in the Dental Chair 70

Position of the Clinician 71

Position of the Patient 73

Functional Factors 76

Technical Hints 77

Factors to Teach the Patient 77

Part III Patient Assessment

Diagnostic Workup 80

Examination Procedures 80

Tooth Numbering Systems 81

6. Personal, Medical and Dental Histories 85

History Preparation 85

The Questionnaire 87

The Interview 87

Items Included in the History 92

Review of History 95

Immediate Applications of Patient Histories 95

Prophylactic Premedication 102

Technical Hints 103

Factors to Teach the Patient 103

7. Vital Signs 106

Body Temperature 106

Pulse 109

Respiration 111

Blood Pressure 111

Technical Hints 114

Factors to Teach the Patient 115

8. Extraoral and Intraoral Examination 116

Components of Examination 116

Sequence of Examination 118

Records 119

Description of Observations 121

Oral Cancer 124

Special Applications for the Extraoral and Intraoral Examination 127

Child Abuse and Neglect 127

Substance Abuse 128

Factors to Teach the Patient 130

9. Dental Radiographs 133

Origin and Characteristics of X Ray 133

How X Rays Are Produced 135

Characteristics of an Acceptable Radiograph 136

Factors that Influence the Finished Radiograph 137

Exposure to Radiation 140

Rules for Radiation Protection 142

Procedures for Film Placement and Angulation of Ray 145

Panoramic Radiographs 152

Child Patient Survey 153

Edentulous Survey 154

Paraclinical Procedures 154

Analysis of Completed Radiographs 158

Technical Hints 159

Factors to Teach the Patient 161

10. Study Casts 164

Clinical Preparation 165

The Interocclusal Record (Wax Bite) 166

Preparation of Impression Trays 166

The Impression Material 169

The Mandibular Impression 169

The Maxillary Impression 170

Disinfection of Impressions 171

Paraclinical Procedures 171

Trimming the Casts 173

Technical Hints 177

Factors to Teach the Patient 178

11. The Gingiva 180

The Treatment Area 180

The Gingiva and Related Structures 183

The Recognition of Gingival and Periodontal Diseases 186

The Gingival Examination 187

Factors to Teach the Patient 193

12. Disease Development and Contributing Factors 195

Development of Gingival and Periodontal Infections 195

Gingival and Periodontal Pockets 197

Tooth Surface Pocket Wall 198

Complications of Pocket Formation 200

Contributing Factors in Disease Development 201

Xerostomia 204

Factors to Teach the Patient 205

13. Examination Procedures 207

The Mouth Mirror 207

Instruments for Application of Air 208

Probe 209

Clinical Attachment Level 215

Furcations Examination 216

Mucogingival Examination 217

Periodontal Charting 217

Explorers 219

Mobility Examination 223

Fremitus 224

Radiographic Examination 225

Radiographic Changes in Periodontal Infections 225

Early Periodontal Disease 227

Other Radiographic Findings 227

Technical Hints 228

Factors to Teach the Patient 228

14. The Teeth 231

The Dentitions 231

Dental Caries 231

Enamel Hypoplasia 236

Attrition 237

Erosion 238

Abrasion 238

Fractures of Teeth 238

Clinical Examination of the Teeth 239

Recognition of Carious Lesions 242

Testing for Pulpal Vitality 243

Factors to Teach the Patient 245

15. The Occlusion 248

Static Occlusion 248

Determination of the Classification of Malocclusion 250

Occlusion of the Primary Teeth 253

Functional Occlusion 254

Trauma from Occlusion 255

Technical Hints 256

Factors to Teach the Patient 256

16. Bacterial Plaque and Other Soft Deposits 258

Acquired Pellicle 258

Bacterial Plaque 260

Clinical Aspects 266

Significance of Bacterial Plaque 267

Effect of Diet on Plaque 269

Materia Alba 269

Food Debris 269

Technical Hints 269

Factors to Teach the Patient 270

17. Dental Calculus 272

Classification and Distribution 272

Clinical Characteristics 273

Calculus Formation 275

Significance of Dental Calculus 277

Prevention of Calculus 278

Factors to Teach the Patient 278

18. Dental Stains and Discolorations 280

Extrinsic Stains 281

Endogenous Intrinsic Stains 283

Exogenous Intrinsic Stains 285

Technical Hints 285

Factors to Teach the Patient 285

19. Indices and Scoring Methods 287

Periodontal Screening and Recording (PSR) 289

Plaque Index (PI I) 291

Plaque Control Record 292

Plaque-Free Score 293

Patient Hygiene Performance (PHP) 295

Oral Hygiene Index (OHI) 296

Simplified Oral Hygiene Index (OHI-S) 298

Bleeding Indices 299

Papillary-Marginal-Attached Gingival Index (P-M-A) 301

Gingival Index (GI) 302

The Periodontal Index (PI) 303

The Periodontal Disease Index (PDI) 304

Calculus Score 306

Dental Plaque Score 306

Community Periodontal Index of Treatment Needs (CPITN) 307

Dental Caries Indices 308

Technical Hints 311

Factors to Teach the Patient 312

20. Records and Charting 314

Periodontal Records and Charting 315

Dental Records and Charting 317

Technical Hints 319

Factors to Teach the Patient 319

21. The Dental Hygiene Treatment Plan 320

Preparation of the Treatment Plan 320

Planning the Dental Hygiene Treatment Plan 322

Informed Consent 326

Technical Hints 326

Factors to Teach the Patient 327

Part IV Prevention

Self-Cleansing Mechanisms 330

Steps in a Preventive Program 330

Patient Counseling 331

Factors to Teach the Patient 331

22. Oral Infection Control: Toothbrushes and Toothbrushing 333

Development of Toothbrushes 333

Manual Toothbrushes 334

Toothbrush Selection for the Patient 336

Guidelines for Toothbrushing 337

Methods for Toothbrushing 338

Power-assisted Toothbrushes 344

Supplemental Brushing 345

Toothbrushing for Special Conditions 347

Toothbrush Trauma: The Gingiva 347

Toothbrush Trauma: Dental Abrasion 348

Care of Toothbrushes 349

23. Interdental Care and Chemotherapy 352

The Interdental Area 352

Dental Floss and Tape 353

Tufted Dental Floss 356

Knitting Yarn 357

Gauze Strip 357

Interdental Brushes 358

Single-Tuft Brush (End-Tuft, Unituft) 359

Interdental Tip 359

Pipe Cleaner 360

Toothpick in Holder 360

Wood Interdental Cleaner 360

Chemotherapy 361

Oral Irrigation 361

Mouthrinses 364

Dentifrices 367

American Dental Association Evaluation Programs 370

Technical Hints 370

Factors to Teach the Patient 370

24. Care of Dental Prostheses 376

Orthodontic Appliances 376

Space Maintainers 379

Fixed Partial Dentures 381

Removable Partial Dentures 382

Complete Dentures 384

Complete

Overdenture 389

Technical Hints 390

25. The Patient with Oral Rehabilitation and Implants 393

Characteristics of the Rehabilitated Mouth 394

Self-care for the Rehabilitated Mouth 396

Dental Implants 399

Factors to Teach the Patient 403

26. Disclosing Agents 407

Technical Hints 409

Factors to Teach the Patient 410

27. Disease Control: Helping Patients Learn 411

Planned Patient Learning 411

The Learning Process 412

Individual Patient Planning 413

Presentation, Demonstration, Practice 414

The Preschool Child 417

The Teaching System 419

Evaluation of Teaching Aids 419

28. Diet and Dietary Analysis 422

Oral Relationships 422

Daily Food Requirements 424

Counseling for Dental Caries Control 425

The Dietary Analysis 425

Preparation for Counseling of Patient 429

Counseling Procedures 429

Evaluation of Progress 431

Factors to Teach the Patient 431

29. Fluorides 434

Fluoride Metabolism 434

Fluoride and Tooth Development 435

Tooth Surface Fluoride 436

Fluoride Action 437

Fluoridation 438

Fluorides in Foods 442

Dietary Fluoride Supplements 442

Professional Topical Fluoride Applications 443

Self-applied Fluorides 449

Combined Fluoride Program 453

Fluoride Safety 453

Technical Hints 455

Factors to Teach the Patient 456

30. Sealants 462

Selection of Teeth for Sealant Application 462

Clinical Procedures 463

Penetration of Sealant 466

Retention and Replacement 467

Fluoride and Sealant 467

Technical Hints 468

Factors to Teach the Patient 468

Part V Treatment

31. Principles for Instrumentation 473

Instrument Identification 473

Instrument Parts 474

Instrument Grasp 475

Wrist, Arm, Elbow, Shoulder: Neutral Positions 477

Fulcrum: Finger Rest 477

Adaptation 479

Angulation 479

Lateral Pressure 480

Activation: Stroke 480

Visibility and Accessibility 481

Dexterity Development 481

Prevention of Cumulative Trauma 483

Technical Hints 486

32. Instruments and Sharpening 488

Curets 488

Scalers 490

Specifications for Instruments for Scaling and Root Planing 493

Instrument Sharpening 494

Sharpening Curets and Sickles 496

Moving Flat Stone: Stationary Instrument 496

Stationary Flat Stone: Moving Instrument 498

Sharpening Cone 499

The Neivert Whittler 500

Mandrel Mounted Stones 501

Sharpening the Hoe Scaler 502

Sharpening the Chisel Scaler 503

Sharpening Explorers 503

Care of Sharpening Stones 503

Technical Hints 504

33. Scaling and Root Planing 506

Rationale 506

Preparation for Instrumentation 507

Procedure for Scaling 509

Supragingival Scaling 511

Subgingival Instrumentation 513

Ultrasonic and Sonic Scaling 516

Use of a Topical Anesthetic 519

Technical Hints 521

Factors to Teach the Patient 522

34. Nonsurgical Periodontal Therapy: Postcare and Adjunctive Treatment 525

Immediate Evaluation 525

Patient Instructions after Scaling and Root Planing 526

Effects of Scaling and Root Planing 527

Gingival Curettage 528

Professional Subgingival Irrigation 531

Factors to Teach the Patient 532

35. Acute Gingival Conditions 536

Necrotizing Ulcerative Gingivitis/Periodontitis 536

Periodontal Abscess 541

Technical Hints 543

Factors to Teach the Patient 544

36. Dressings and Sutures 545

Types of Dressings 545

Clinical Application 547

Dressing Removal and Replacement 547

Suture Removal 549

Technical Hints 552

Factors to Teach the Patient 552

37. Hypersensitive Teeth 554

Desensitization 556

Dental Hygiene Care 557

Technical Hints 558

Factors to Teach the Patient 558

38. Extrinsic Stain Removal 561

Effects of Polishing 561

Indications for Stain Removal 563

Clinical Application of Selective Stain Removal 564

Cleaning and Polishing Agents 565

Clinical Applications 566

Procedures for Stain Removal (Coronal Polishing) 567

The Instruments 567

Use of the Prophylaxis Angle 568

Polishing Proximal Surfaces 569

Airbrasive for Polishing 571

Cleaning the Removable Denture 571

Factors to Teach the Patient 573

39. The Porte Polisher 576

Technical Hints 578

Factors to Teach the Patient 579

40. Amalgam Restorations 580

Rationale for Finishing and Polishing 580

The Amalgam Restoration 580

Clinical Management: Mercury Hygiene 584

Finishing Procedures 584

Appointment Planning 585

Margination 587

Polishing 588

Fluoride Application 589

Factors to Teach the Patient 589

41. Debonding 591

Clinical Procedures for Debonding 593

Postdebonding Evaluation 594

Postdebonding Preventive Care 595

Technical Hints 595

Factors to Teach the Patient 595

42. Evaluation and Preventive Maintenance 597

Periodontal Evaluation 597

Follow-up Evaluation 597

The Maintenance Phase 599

Technical Hints 600

Factors to Teach the Patient 601

Part VI Applied Techniques for Patients with Special Needs

Introduction to Patients with Special Needs 604

Special Oral Problems 604

Systemic Diseases 604

Integration of Applications to Special Needs 604

43. The Pregnant Patient and the Infant/Toddler 605

Fetal Development 605

Oral Findings During Pregnancy 608

Aspects of Patient Care 608

Dental Hygiene Care 609

Patient Instruction 610

Infant and Toddler Oral Health 612

44. The Patient with a Cleft Lip and/or Palate 617

Classification of Clefts 617

Etiology 617

Oral Characteristics 618

General Physical Characteristics 619

Personal Factors 620

Treatment 620

Dental Hygiene Care 621

45. Preadolescent to Postmenopausal Patients 624

Puberty and Adolescence 624

Menstruation 628

Hormonal Contraceptives 629

Menopause and Climateric 630

46. The Gerodontic Patient 634

Aging 634

Characteristics of Aging 635

Oral Findings in Aging 637

Personal Factors 639

Dental Hygiene Care 639

Technical Hints 644

47. The Edentulous Patient 646

The Edentulous Mouth 646

Denture-Related Oral Changes 649

Denture-Induced Oral Lesions 649

Prevention and Maintenance 650

Denture Marking for Identification 651

Factors to Teach the Patient 653

48. The Oral and Maxillofacial Surgery Patient 655

Patient Preparation 655

Dental Hygiene Care 657

Patient with Intermaxillary Fixation 659

Treatment of Fractures 660

Dental Hygiene Care 664

Dental Hygiene Care Prior to General Surgery 666

Technical Hints 667

49. The Patient with Oral Cancer 669

Description 669

Preparation for Treatment 670

Surgical Treatment 671

Radiation Therapy 672

Chemotherapy 674

Personal Factors 674

Dental Hygiene Care 675

Technical Hints 677

Factors to Teach the Patient 677

50. Care of Patients with Disabilities 679

Dental and Dental Hygiene Care 679

Barrier-free Environment 682

Patient Reception: The Initial Appointment 684

Wheelchair Transfers 685

Patient Position and Stabilization 687

Clinic Procedures for Assessment of Patient 688

Oral Manifestations 689

Dental Hygiene Treatment Plan 690

Disease Prevention and Control 690

Bacterial Plaque Removal 691

Self-care Aids 692

Instruction for Caregiver 696

Fluorides 698

Pit and Fissure Sealants 698

Diet Instruction 698

Group In-service Education 699

Instrumentation 701

51. The Patient who is Homebound, Bedridden, or Helpless 705

Homebound Patients 705

The Helpless or Unconscious Patient 707

Technical Hints 709

52. The Patient with a Physical Impairment 711

Spinal Cord Dysfunctions 711

Spinal Cord Injury 711

Myelomeningocele 715

Cerebrovascular Accident (Stroke) 717

Muscular Dystrophies 719

Myasthenia Gravis 720

Multiple Sclerosis 721

Cerebral Palsy 722

Bell's Palsy 725

Parkinson's Disease 725

Arthritis 726

Scleroderma (Progressive Systemic Sclerosis) 728

53. The Patient with a Sensory Disability 731

Visual Impairment 731

Hearing Impairment 734

Technical Hints 740

54. The Patient with Epilepsy 741

Description 741

Clinical Manifestations 742

Oral Findings 743

Phenytoin-induced Gingival Enlargement (Overgrowth) 744

Dental Hygiene Care 745

Emergency Care 746

Technical Hints 747

55. The Patient with Mental Retardation 749

Mental Retardation 749

Etiology of

Mental Retardation 751

General Characteristics 752

Dental and Dental Hygiene Care and Instruction 752

Down's Syndrome 752

Autistic Disorder 754

Technical Hints 756

56. The Patient with a Mental Disorder 759

Schizophrenia 759

Mood Disorders 763

Anxiety Disorders 766

Eating Disorders 768

Psychiatric Emergencies 772

57. The Patient with Alcoholism 775

Description 775

Systemic Effects 776

Withdrawal Syndrome 779

Treatment 779

Dental Hygiene Care 780

Patient Instruction 782

Factors to Teach the Patient 782

58. The Patient with a Cardiovascular Disease 784

Congenital Heart Diseases 784

Rheumatic Heart Disease 787

Infective Endocarditis 788

Hypertension 789

Hypertensive Heart Disease 791

Ischemic Heart Disease 791

Angina Pectoris 793

Myocardial Infarction 794

Congestive Heart Failure 795

Sudden Death 796

Cardiac Pacemaker 796

Anticoagulant Therapy 798

Cardiovascular Surgery 799

Technical Hints 800

Factors to Teach the Patient 800

59. The Patient with a Blood Disorder 802

Oral Findings Suggestive of Blood Disorders 802

Normal Blood 802

Anemias 806

Polycythemias 809

White Blood Cells 810

Hemorrhagic Disorders 813

Hemophilias 814

60. The Patient with Diabetes Mellitus 818

The Diabetic Syndrome: Classification 818

Effects of Diabetes 820

Treatment for Diabetes Control 822

Oral Relationships 823

Dental Hygiene Care 824

Prevention of Diabetes 825

61. Emergency Care 828

Prevention of Emergencies 828

Emergency Materials and Preparation 830

Basic Life Support 835

Rescue Breathing 837

External Chest Compression 837

Airway Obstruction 839

Oxygen Administration 841

Specific Emergencies 841

Technical Hints 841

Prefixes, Suffixes, and Combining Forms 851.

Notes:

"A Lea & Febiger book."

Includes bibliographical references and index.

ISBN:

0683062123

OCLC:

29184391