CHRONIC OBSTRUCTIVE PULMONARY DISEASE CHRONIC OBSTRUCTIVE PULMONARY DISEASE.
Pulmonary Disease
description
Transcript of Pulmonary Disease
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Pulmonary DiseasePresented by: Bobbie Jo Bennett,
Kristen Franklin,& Lacey McGallion
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Chronic obstructive pulmonary disease (COPD)
A large group of lung diseases characterized by obstruction of air flow that interferes with normal breathing.
2 common typesChronic bronchitisEmphysema
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EtiologyThe primary etiology is use of tobacco and
exposure to occupational and environmental pollutants. Dental hygienists should motivate patients with
COPD using tobacco to begin a smoking cessation program.
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OccurrenceChronic bronchitis
2009- estimated 9.9 million AmericansEmphysema
2009- estimated 4.9 million Americans
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PopulationChronic bronchitis
Race: non-hispanic whiteAge: 45-64 years oldSex: women almost 2x likely Location: South of the United States
Emphysema Race: non-hispanic whiteAge: 65+ years oldSex: men
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TreatmentNo cureMedication intervention Home oxygen therapy Pulmonary rehabilitation Surgery (lung transplant & LVRS)–severe cases onlyPatients are encouraged to…
Stop smoking Adequate nutritionDrink plenty of waterExercise regularlyDecrease exposure to pollutants
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MedicationsPneumonia and influenza vaccinesBronchodilators and other medications
similar to those used for asthmaBeta-agonists Anticholinergics Systemic or inhaled corticosteroids Antibiotics
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Dental ConcernsIndications Contraindications
Nitrous oxide-oxygen analgesia for clients with chronic bronchitis
Use of local anesthesia: without epinephrine
Low-flow supplemental oxygen is helpful
Low dose of oral diazepam if needed to reduce stress
Semiupright/upright chair position to facilitate breathing
Diazepam/Lorazepam Supine chair positionAvoid use of ultrasonic debridementAvoid use of rubber cup and air
polishing Avoid use of rubber damAvoid use of Nitrous oxide-oxygen
analgesia in clients with Emphysema Avoid use of barbiturates and narcotics
because of their respiratory depressant properties
If client is on Theophylline (bronchodilator) avoid use of erythromycin, macrolide antibiotics and ciprofloxacine- it will increase levels of Theophylline
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How will oral health be impacted?
Chronic smokers with COPD have a higher risk of developing:HalitosisNicotine stomatitisPeriodontal infectionsOral cancerExtrinsic tooth stains
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Medical Treatments impact on oral healthThere is no cure for COPD. Encourage patients to:
stop smoking have adequate nutrition drink plenty of water exercise regularly decrease exposure to pollutants.
Medical interventions strategies include: Pneumonia and influenza vaccines. Bronchodilators and other medications similar to those used
for asthma.
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Medications impact on oral healthMedications: Side effects
- B-adrenergic agonists xerostomia- Antiholinergics xerostomia- Bronchodilators:Theophylline xerostomia and bad taste- Corticosteroids xerostomia and candidiasis
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Periodontal Management Interventions that improve oral hygiene and
possibly lower oral inflammation may prove to lower risk of lung infection in susceptible populations.
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Expected/Accepted Treatment OptionsPre-med
No- controversial Patient positioning
Semi-supine or upright chair position to facilitate breathing
Appointment lengthShorter appointments
Ultrasonic useAvoid use- Pathogens may be aspirated into the lungs
Recall intervals Semi-annual appointments- unless other
medical/dental issues involved
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Dental Hygiene CareBefore you begin…
Review medical historyAvoid treating if upper respiratory infection is
presentTreatment may be performed on stable
patients with adequate breathing.Identify patients who may experience
exacerbation of symptoms under emotional stress
May use local anesthesia without epinephrineNitrous oxide-oxygen inhalation sedation
should be avoided with severe COPD and emphysema
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Question #1Dental hygienist should motivate patients
with COPD to…A. Stop smokingB. Drink plenty of waterC. Exercise dailyD. All of the above
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Question #2Chronic smokers with COPD have a higher risk for developing oral cancer. Chronic smokers with COPD have a higher risk for developing periodontal infections. A. Both statements are true.B. Both statements are false.C. The first statement is true, and the second
statement is false.D. The first statement is false, and the second
statement is true.
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Question #3Chronic bronchitis is most commonly seen in
which race? A. HispanicsB. Non-hispanic- whiteC. African AmericansD. Asians
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ReferencesWilkins, E.M. (2009). Clinical Practice of
Dental Hygiene 10th edition. Baltimore, MD Online
http://www.lung.org/finding-cures/our-research/trend-reports/copd-trend-report.pdf
http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/pulmonary/chronic-obstructive-pulmonary-disease/
http://www.fidanoski.ca/dentalhygiene/2011/COPD.htm