Download Health Assessment Across Lifespan - Oral Health Nursing Education

The OHNEP Interprofessional
Oral Health Faculty Toolkit Psychiatric-Mental Health Nurse
Practitioner Program
CURRICULUM INTEGRATION OF INTERPROFESSIONAL
ORAL HEALTH CORE COMPETENCIES:
Health Assessment across the Lifespan
•  Health Promotion in Children & Adolescents
•  Health Promotion in Adults & Older Adults
•  Resources
• 
© Oral Health Nursing Education and Practice (OHNEP)
INTRODUCTION
S The Oral Health Nursing Education and Practice (OHNEP) program has developed an Interprofessional Oral Health Faculty Tool Kit to provide
you with user friendly curriculum templates and teaching-learning resources to use when integrating oral health and its links to overall health in your
Psychiatric- Mental Health Nurse Practitioner program.
Oral health and its relation to overall health has been identified as an important population health issue. Healthy People 2020 (2011), the IOM
Reports, Advancing Oral Health in America (2011) and Building Workforce Capacity in Oral Health (2011), as well as the IPEC Competencies (2011),
challenged HRSA to develop interprofessional oral health core competencies for primary care providers. Publication of the report, Integrating Oral
Health in Primary Care Practice (2014), reflects those interprofessional oral health competencies that can be used by Psychiatric-Mental Health
Nurse Practitioners for faculty development, curriculum integration and establishment of “best practices” in clinical settings.
The HRSA interprofessional oral health core competencies, the IPEC competencies and the NONPF core competencies provide the framework for the
curriculum templates and resources. Exciting teaching-learning strategies that take students from Exposure to Immersion to Competence can
begin in the classroom, link to simulated or live clinical experiences and involve community-based service learning, advocacy and policy initiatives as
venues you can readily use to integrate oral health into your existing primary care curriculum. The Psychiatric- Mental Health Nurse Practitioner
curriculum template illustrates how oral health can be integrated into health promotion, health assessment and clinical management courses.
The Smiles for Life interprofessional oral health curriculum provides a robust web-based resource for you to use that articulates with the oral health
curriculum template for each course. A good place to begin oral health integration is by transitioning the HEENT component of the history and
physical exam to the HEENOT approach. In that way, you and your students will NOT forget about including oral health in patients encounters.
Research evidence continues to reveal an integral relationship between oral and systemic health. Chronic diseases managed by Psychiatric- Mental
Health Nurse Practitioners, such as diabetes, Celiac, HIV and Kawasaki, are but a few of the health problems that have oral manifestations that can
be treated or referred to our dental colleagues. It is important for nurse practitioners on the frontline of primary care to have the oral health
competencies necessary to recognize both normal and abnormal oral conditions and provide patients with education, prevention, diagnosis,
treatment and referral as needed.
We encourage you and your students to explore the resources in the templates as you “weave” oral health and its links to overall health into your
Psychiatric-Mental Health Nurse Practitioner program. If you need additional technical assistance, please feel free to contact us at [email protected]
PMHNP Curriculum Integration of Interprofessional Oral Health Competencies in Health Assessment Across Lifespan
IPEC Competencies:
Values and Ethics,
Roles and
Responsibilities
Interprofessional
Communication,
Teams & Teamwork
HRSA Oral Health
Competencies:
Oral Health Risk
Assessment, Oral
Health Evaluation,
Oral Health Preventive
Intervention,
Communication
and Education
NONPF
Competencies:
Delivers evidencebased practice for
patients throughout
lifespan
KNOWLEDGE: ORAL CARE OF INFANT,
CHILD AND ADOLESCENT
Goal: Understand oral care of infant,
child and adolescent
E
N
T
R
Y
• Complete Smiles for Life Modules #1,
2, 6
• Submit SFL Certificates of Completion
• Complete SFL Quizzes for Modules #1,
2, 6 (Appendix 1, 2, 3)
KNOWLEDGE: ORAL CARE OF ADULT
Goal: Understand oral care of adult
L
E
V
E
L
A
S
S
E
S
S
M
E
N
T
•
•
•
Complete Smiles for Life Modules
# 3, 5, 7
Submit SFL Certificates of
Completion
Complete SFL Quizzes for
Modules #3, 5, 7 (Appendix 4, 5,
6)
KNOWLEDGE: ORAL CARE OF OLDER
ADULT
Goal: Understand oral care of older adult
•
•
•
Complete Smiles for Life Module #8
Submit SFL Certificates of Completion
Complete SFL Quiz for Module #8
(Appendix 7)
2) IMMERSION: DEVELOPMENT
3) COMPETENCE: ENTRY-TO-PRACTICE
SKILL/BEHAVIOR
Goal: Demonstrate HEENOT in oral health
history, risk assessment and exam for infant,
child and adolescent during simulation lab
SKILL/BEHAVIOR
Goal: Identify oral pathologies in infant, child
and adolescent during clinical experience
•
•
Read
Guideline on Caries Risk Assessment
(AAPD, 2014)
Present one of three pediatric caries
risk assessment tools in class
(Appendix 8)
Identify oral abnormalities in
pediatric photographs (Appendix 9)
•
•
SKILL/BEHAVIOR
Goal: Demonstrate HEENOT in oral health
history, risk assessment and physical exam
in adult during simulation lab
•
Read and discuss Adult Caries Risk
Assessment Tool CAMBRA for patients
over age 6 (Appendix 10)
Identify oral abnormalities in adult
photographs (Appendix 11)
•
SKILL/BEHAVIOR
Goal: Demonstrate HEENOT in oral health
history, risk assessment and physical exam
in older adult during simulation lab
•
•
CONSTRUCTS
© Oral Health Nursing Education and Practice (OHNEP)
Read and discuss
CAMBRA: Best Practices in Dental
Caries Management (Hurlbutt, 2011)
Identify oral abnormalities in geriatric
photographs (Appendix 12)
S
U
M
M
A
T
I
V
E
A
S
S
E
S
S
M
E
N
T
•
Demonstrate oral health history, risk
assessment and HEENOT exam for
infant, child and adolescent during
during pediatric clinic
Read
Putting the Mouth Back in the Head:
HEENT to HEENOT (Haber et al, 2015)
SKILL/BEHAVIOR
Goal: Identify oral pathologies in adult
during clinical experience
•
Demonstrate HEENOT
competency in oral health
history, risk assessment and
physical exam in adult during
adult clinic
SKILL/BEHAVIOR
Goal: Identify oral pathologies in older
adult during clinical experience
•
Demonstrate HEENOT
competency in oral health
history, risk assessment and
physical exam in older adult
during adult clinic
INTER-PROFESSIONAL PARTNERSHIP & COLLABORATIVE PRACTICE FOR
OPTIMIZATION OF CIENT/PATIENT HEALTH OUTCOMES
1) EXPOSURE: INTRODUCTION
HEALTH
ASSESSMENT
ACROSS
LIFESPAN
APPENDIX 1
Health Assessment Across Lifespan
Smiles for Life Module 1 Quiz: The Relationship of Oral to Systemic Health
S 1. What is the most common chronic
disease of childhood?
A.  Asthma
B.  Seasonal allergies
C.  Dental caries
D. Cefuroxime
2. What is a consequence of untreated
dental caries?
A.  Osteonecrosis of alveolar bone
B.  Gingival hyperplasia
C.  Oral mucositis
D. Tooth fractures
3.Which condition is associated with
periodontal disease?
A.  Asthma
B.  Preterm labor
C.  Sinusitis
D. Hypothyroidism
5. What can a primary care clinician do to
promote oral health?
A.  Collaborate with dental and other health
professionals
B. Apply dental sealants
C.  Prescribe oral fluoride supplements to every
patient
D. Apply fluoride varnish to the teeth of all
adults
6. Which of these classes of medications
is NOT generally associated with
decreased salivary flow?
A.  Antihistamines
B.  Antibiotics
C.  Corticosteroids
D. Anticholinergics
E.  Diuretics
7. A patient undergoing chemotherapy for
cancer is at risk for which of these oral
4. Which of the following medications is linked to complications due to the effects of
chemotherapy?
gingival hyperplasia?
A.  Osteonecrosis of alveolar bone
A.  Phenytoin
B.  Gingival hyperplasia
B.  Amoxicillin
C.  Oral mucositis
C.  Digoxin
D. Tooth fractures
D. Coumadin
8. Which of the following infections
is NOT potentially caused by direct
extension from a dental source?
A.  Otitis media
B.  Sinusitis
C.  Brain abscess
D. Facial cellulitis
9. What is the suggested common
pathway linking chronic periodontitis
and conditions such as diabetes,
coronary artery disease and adverse
pregnancy outcomes?
A.  Direct bacterial extension
B.  Poor nutrition
C.  Circulating antibodies
D. Inflammation
10. Which of the following is NOT a
mechanism for inter-relationships
between oral and systemic disease?
A.  Behavioral
B.  Iatrogenic
C.  Neurologic
D. Inflamatory
(Clark et al, 2010)
APPENDIX 2
Health Assessment Across Lifespan
Smiles for Life Module 2 Quiz: Child Oral Health (part I)
S 1.  What are Early Childhood Caries?
A.  Dental decay in children from 2 – 10 years of age
B. An infectious chronic disease
C.  Deformities in a child’s teeth that are caused by excessive
fluoride
D. Dental decay caused by a lack of fluoride in a child’s diet
2.  Oral bacteria and dietary sugars are two of the
three parts of the “Etiology Triad” of Early Childhood Caries.
What is the third part of the triad?
A.  The enamel and dentine of teeth which is vulnerable to demineralization
B.  Bacterial toxins which attach the teeth’s calcium matrix
C.  Saliva which provides a moist environment for the cariogenic oral
bacteria
D. Genetic predisposition to colonization by cariogenic oral bacteria
3.  What is a risk factor for developing Early Childhood Caries?
A.  High fat diet
B. Patient’s age
C.  Excessive levels of fluoride
D. Caries in siblings or caretakers
4. How can primary care clinicians prevent
Early Childhood Caries?
A.  Counsel a child’s caregivers about the child’s diet
B.  Apply dental sealants to the teeth of young
patients
C.  Prescribe fluoride to every young patient
D. Refer children to a dentist at age 5
5. The mother of your 10 month-old patient asks for a prescription for
supplemental fluoride. She reports that the family obtains their water
from a well. What is your best course of action?
A.  Prescribe a dietary fluoride supplement as well water
does not contain fluoride
B.  Test the well’s fluoride level prior to prescribing a dietary
fluoride supplement
C.  Do not prescribe a dietary fluoride supplement as the child
has neither white spots nor caries
D. Obtain the fluoride level in wells near the family’s home from the
local health department before prescribing a dietary fluoride supplement
6. What does this photograph
of a child’s mouth depict?
A.  Fluorosis
B.  White spots
C. Moderate Early Childhood
Caries
D. Iron staining
7. To what is the arrow on
this photograph of a child’s
mouth pointing?
A.  A normal tooth
B.  Fluorosis
C.  White spots
D. Severe Early Childhood
Caries
(Clark et al, 2010)
APPENDIX 2
Health Assessment Across Lifespan
Smiles for Life Module 2 Quiz: Child Oral Health (part II)
S 8. What is the first step in performing a knee-to-knee
oral examination of a child’s mouth?
A.  Have the caregiver hold the child on his or her lap facing the examiner
B.  Have the caregiver hold the child facing him or her in a straddle position
C.  The examiner looks in the child’s mouth
D. Have the caregiver separate the child’s jaws
9. What guidance about teething should a primary
care clinician provide to a toddler’s caregiver?
A.  Teething can cause ear infections and diarrhea
B.  The caregiver should bring the toddler to the office if the child starts to
drool
C.  Teething sometimes causes upper respiratory infections
D. A child who is teething may be fussy
10. The arrow is pointing to a
darkened feature in a child’s mouth.
What is this feature called?
A.  Fluorosis
B.  An avulsed tooth
C.  An eruption hematoma
D. Early childhood caries in an unerupted tooth
(Clark et al, 2010)
APPENDIX 3
Health Assessment Across Lifespan
Smiles for Life Module 6 Quiz: Caries Risk Assessment, Fluoride Varnish and Counseling (part I)
S 1.  The mother of a 9-month old patient asks what causes
Early Childhood Caries (ECC). Which is the most accurate reply?
A.  The majority of ECC results from thin or “weak” tooth enamel
inherited from the parents
B.  Bacteria in the child’s mouth break down dietary sugars into
acids which break down tooth enamel
C.  A lack of protective saliva is the most common cause of ECC
D. A calcium deficiency during the time teeth are formed produces
teeth that lack a sufficiently thick covering of enamel
2. Which of the following factors places a child at the most risk for
developing early childhood caries?
A.  Having a diagnosis of severe asthma
B.  Living with family members who smoke tobacco or drink
excessive amounts of alcohol
C.  Breast feeding for longer than six months
D. Having plaque on the teeth
3.  Which is NOT a mechanism of action for topical fluoride?
A.  It inhibits demineralization of the teeth
B.  It promotes remineralization of the teeth
C.  It inhibits bacterial metabolism
D. It promotes the release of saliva
4.  Which of the following is a benefit of fluoride varnish?
A.  Fluoride varnish permanently seals the pits and fissures of teeth
B.  Fluoride varnish decreases the need for routine dental care
C.  Fluoride varnish can reverse early decay (i.e., the “white spots”)
and slow enamel destruction
D. Fluoride varnish replaces the need to take systemic fluoride supplements
5. While performing an exam on one of
your young patients, you observe the
following (see photograph). Describe what
you see:
A.  The teeth are normal and have no
white spots or tooth decay
B.  The gingiva are pathologically pigmented
C.  The tooth’s enamel is thin, so fluoride
varnish must be applied to strengthen the
enamel
D. The color of the tooth indicates that
the child is at risk for developing
fluorosis
6. What guidance would you provide the mother of your 20 month old
patient who expresses concern about her child developing fluorosis?
The family lives in a town that adds fluoride to the water supply, and
the child has already had 2 cavities:
A.  Tell the mother to use only a small smear of fluoridated
toothpaste when brushing the child’s teeth
B.  Tell the mother to use a non-fluoridated toothpaste
C.  Brush the child’s teeth every other day
D. Only give bottled drinking water to the child
7.  Which children should receive fluoride varnish in the medical office?
A.  All children at high risk for caries
B.  High risk children without a dental home
C.  Low risk children
D. All children
(Clark et al, 2010)
APPENDIX 3
Health Assessment Across Lifespan
Smiles for Life Module 6 Quiz: Caries Risk Assessment, Fluoride Varnish and Counseling (part II)
S 8. While performing an exam on one of your young patients, you
observe the teeth indicated by the yellow arrows. Describe the
tooth’s condition.
A. The teeth are normal and have no visible decay.
B. The brown areas represent caries where loss of overlying enamel has
exposed underlying dentin.
C. The brown areas indicate that the child has chipped his teeth.
D. The brown color indicates that the child has developed fluorosis.
9. While applying fluoride varnish to an infant what is the gauze
used for?
A. The gauze is the vehicle used to apply the flourish varnish to the
teeth.
B. The gauze is used to hold the tongue out of the way.
C. The gauze is used to dry the child’s teeth and to remove gross
plaque.
D. The gauze is shown to the child to stimulate her to open her mouth.
10. What guidance do you give the grandmother of a child who has
just had fluoride varnish applied to his teeth?
A. The child’s teeth will be discolored for about a week.
B. Do not brush the child’s teeth for at least 48 hours.
C. Brush the child’s teeth in about one hour.
D. Avoid giving the child hot or hard food for 24 hours
(Clark et al, 2010)
APPENDIX 4
Health Assessment Across Lifespan
Smiles for Life Module 3 Quiz: Adult Oral Health
S 1. Which dental procedure does NOT require
prophylaxis for individuals at high risk
of bacterial endocarditis?
A.  Dental extractions
B.  Periodontal procedures
C.  Post-operative suture removal
D. Prophylactic cleaning of teeth if
bleeding is anticipated
E.  Re-implantation of avulsed teeth
2. Periodontal disease can be clinically
distinguished from gingivitis in which of
the following ways?
A.  Inflammation of the gums
B.  White discoloration of the permanent
teeth
C.  Enlarged pockets at the gum base
D. Gingival hypertrophy
3. Which of the following is NOT a common
site for oral cancers?
A.  Tongue
B.  Floor of mouth
C.  Hard palate
D. Lower lip
4. Which of the following is most likely to lead
to poorer oral health in the elderly?
A.  Alzheimer’s dementia
B.  Coronary artery disease
C.  Hypothyroidism
D. All of the above
5. Risk factors for adult caries may include all
the following except:
A.  Low socioeconomic status
B.  Existing tooth restoration
C.  Decreased salivary flow
D. A vegetarian diet
E.  Physical disabilities
6. Which of the following patients requires
bacterial endocarditis antibiotic prophylaxis?
A.  A 26 year old woman with mitral valve
prolapse undergoing routine teeth cleaning
with no anticipated bleeding.
B.  A 64 year old man with a prosthetic mitral
valve who is undergoing a tooth extraction.
C. A 16 year old boy with a ventricular septal
defect completely repaired in infancy who
requires extraction of an impacted wisdom
tooth.
D. A 32 year old man who had bacterial
endocarditis 5 years ago who
isundergoing orthodontic appliance
adjustment.
7. Which of the following is not a normal
age-related tooth change?
A.  Gingival recession
B.  Root caries
C.  Yellowing of teeth
D. Wearing away of teeth with exposed
dentin
8. Whichof the following statements,
concerning xerostomia or dry mouth, is
not true?
A.  Xerostomia is caused by a decrease in
the production of saliva
B.  Xerostomia can cause a burning sensation,
change in taste, and difficulty swallowing
C.  Medications can contribute to xerostomia
D. Xerostomia can increase the development of
caries
E.  Xerostomia is rarely a problem for patients
wearing complete dentures
9. Which of the following has been
implicated in the development of recurrent
aphthous ulcers?
A.  Trauma
B.  Vitamin C deficiency
C.  Sickle Cell Anemia
D. Herpes simplex virus infection
10. Which of the following factors is
NOT involved in the development of
“Meth Mouth”:
A.  Poor oral hygiene
B.  Increased carbohydrate
consumption
C.  Nighttime mouth breathing
D. Teeth grinding
E.  Xerostomia
(Clark et al, 2010)
APPENDIX 5
Health Assessment Across Lifespan
Smiles for Life Module 5 Quiz: Oral Health In Pregnancy
S 1. Which of the following is a
FALSE statement?
A.  Gingivitis is very common in pregnancy
B.  Periodontitis is associated with preterm birth
C.  Treatment of periodontitis in pregnancy
decreases the risk of preterm birth
D. Deep root scaling to improve periodontitis
is safe during pregnancy
2. Which of the following is a TRUE statement:
A.  Mothers with caries pass their genetic
predisposition for caries on to their babies
B.  Mother with caries pass caries-causing
bacteria to their babies in utero
C. Mother with caries pass caries-causing bacteria
to their infants early in life via saliva
transmission
D. All of the above
C.  Dental treatment should only be done during the
second trimester for comfort and safety reasons
D. Dental treatment can be done during
any trimester
5. What guidance should you give a pregnant
patient about having dental x-rays during her
pregnancy?
A.  Dental x-rays should be avoided during
pregnancy
B.  Dental x-ray should be limited to only one
film per pregnancy
C.  Dental x-rays should be taken as
necessary to reach a full diagnosis
D. Dental x-rays are rarely needed during
pregnancy
3. A pregnancy granuloma:
A.  Has malignant potential and should be biopsied
B.  Should be excised during pregnancy even if
asymptomatic to avoid complications
C.  Can be observed
D. Is not likely to recur if excised
6. What oral health guidance should
you give a pregnant patient?
A.  Brush twice daily with fluoridated toothpaste
B.  Use chlorhexidene mouthwash three times per
day
C.  Avoid sugary drinks and snacks between meals
D. Take fluoride dietary supplements
E.  A and C only
4. A pregnant patient asks you for guidance
about having dental treatment during her
pregnancy. What would you say?
A.  Dental treatment should only be done
during the second and third trimester
B.  Dental treatment should only be done
during the third trimester because
organogenesis is complete
7. All of the following conditions can cause
worsening gingivitis EXCEPT:
A.  Onset of puberty
B.  Monthly menses
C.  Menopause
D. Use of oral contraceptives
E.  Pregnancy
8. If a pregnant woman has an oral
abscess in the first trimester, what
should she do regarding its
treatment?
A.  Take antibiotics and pain medication
only and wait until her second trimester
to see the dentist
B.  Avoid x-rays for further diagnosis
C.  Have the tooth treated or extracted
under local anesthesia immediately
D. Delay definitive treatment
until after delivering her
baby
9. Amalgam restorations placed during
pregnancy can lead to which negative
outcome in the fetus?
A.  Birth defects
B.  Neurologic sequelae
C.  Spontaneous abortions
D. None of the above
10. What could pregnant women do
after vomiting to reduce the risk of
enamel erosion?
A.  Swish with baking soda and water
B.  Vigorously brush her teeth
C.  Immediately take a dose of a proton
pump inhibitor
D. Immediately take 3-4 antacid tablets
(Clark et al, 2010)
APPENDIX 6
Health Assessment Across Lifespan
Smiles for Life Module 7 Quiz: Oral Examination
S 1.  What constitutes a tooth’s outer layer?
A.  Enamel
B.  Dentin
C.  Pulp
2.  What is a full complement of adult teeth?
A.  26
B.  28
C.  30
D. 32
3. A caregiver asks you how many teeth
her 3 year old child should have. What
would you respond?
A.  20
B.  22
C.  24
D. 28
4. At what age do teeth typically
begin to erupt in children?
A.  3-9 months
B.  9-15 months
C.  15-21 months
D. 21-27 months
5. Oral cancer is most common in which area
of the mouth?
A.  Hard palate
B.  Surface of tongue
C.  Inside of cheek
D. Posterolateral tongue
6. When performing the “knee-to-knee” oral
exam on a young child, in what position
should the child start?
A.  Facing the examiner
B.  Standing up
C.  Sitting on the exam table
D. Facing the caregiver
8. When examining a 9 month old child’s
mouth, what is a reason for an early referral to
a dentist?
A.  The child has only 4 incisors
B.  Developmental tooth defects are present
C.  No molars have erupted
D. No canine teeth have erupted
E.  Counting less than 20 teeth
9. You are performing an oral exam on your
21 year old patient who has been using
smokeless tobacco for 4 years. What part of
this patient’s oral cavity is especially
important for you to examine?
A.  The sun-exposed areas of the patient’s cheeks
B.  The inner aspect of the patient’s lips and cheeks
7. Which of the following is NOT needed by a C.  Any discoloration or pitting of the patient’s teeth
primary care clinician to conduct a thorough D. Any plaque build-up along the patient’s gum line
oral exam?
E.  The patient’s posterior pharynx
A.  An exam light to illuminate key
features in the mouth
10. A complete oral examination includes each
B.  Tongue depressors to lift the lip
of the following EXCEPT:
and retract the cheek
A.  Temporomandibular joint (TMJ) exam
C.  A mouth mirror to view lingual surfaces of
B.  Cervical node exam
teeth
C.  Palpation of the floor of the mouth
D. Dental explorer
D. Sinus exam
E.  Gauze pads to grasp the tongue
E.  Exam of the skin around the mouth
(Clark et al, 2010)
APPENDIX 7
Health Assessment Across Lifespan
Smiles for Life Module 8 Quiz: Geriatric Oral Health (part I)
S 1.  What is the most common site
for caries in the elderly?
A.  Site of a previous restoration
(filling)
B.  On a root that is exposed due to
gingival recession
C.  On coronal surface of tooth
D. On the buccal surface of molars
2. Which of the following is an
absolute contraindication for
placing dental implants?
A.  Diabetes mellitus that is
controlled
B.  Root caries in the teeth that are to
be replaced
C.  Use of IV bisphosphonates
D. Use of medication known to cause
xerostamia
3. What is the adverse intraoral
effect with which calcium channel
blockers are most associated
with?
A.  Stomatitis
B.  Thrush
C.  Gingival hyperplasia
D. Osteonecrosis of mandible
4. Which statement is true regarding
dental prostheses?
A.  Implants are commonly placed in a
jaw to replace teeth lost due to severe
osteoporosis
B.  Dentures should be removed and
cleaned daily
C.  Bridges should be removed daily to
facilitate cleaning of teeth
D. A partial denture is permanently fixed
to adjacent teeth and therefore does
not need to be removed to perform a
complete oral assessment
5. HPV influenced oral cancers have
which of the following
characteristics?
A.  Account for the rise in oral cancers in
younger individuals , age 40-64
B.  Are usually seen in the anterior
portion of the mouth, especially the
buccal mucosa or the lip
C.  Epidemiologically related to exposure
to HPV 18
D. Less likely to be associated with oral
cancer than other sexually
transmitted infections such as syphilis
and gonorrhea
6. What is the most significant reason why complete tooth loss
has declined in the US from 50% to 18% in the last 60 years?
A.  Increased use of dental insurance in the elderly
B.  Increased use of bottled and filtered water products among adults
C.  Addition of fluoride to most community water systems
D.  Increased use of multiple prescription medications in the elderly
7. While performing an oral exam on a 72 year old patient, you
observe the finding in the photograph. How should you manage
this finding?
A.  Refer the patient to an oral surgeon for immediate biopsy of
probable oral cancer
B.  Schedule the patient to return in 2 weeks to reassess the lesion.
If the lesion is still present, you should then refer the patient for
biopsy
C.  Treat the patient with an antifungal solution and reassess in 2
weeks
D.  Document this finding as sublingual varicosities that are normal
in this age group and require no further evaluation
(Clark et al, 2010)
APPENDIX 7
Health Assessment Across Lifespan
Smiles for Life Module 8 Quiz: Geriatric Oral Health (part II)
S 8. Which of the following statements is true
regarding the oral health of elderly patients with
dementia?
A.  Aging alone is the major contributor to poor oral
health of older individuals with dementia
B.  Medications used to treat hypertension,
depression and behavioral disturbances seen in
this population have little effect on their oral
health
C.  Since this population struggles with Activities of
Daily Living (ADLs), they are at high risk for poor
oral health unless caregivers assist with oral care
D.  Reminding these individuals to brush their teeth
each day is adequate to achieve and maintain
good oral health
10. Elderly with poor oral hygiene, missing teeth
and dental pain are at risk for worsening oral
health due to which of the following nutritional
factors?
A.  Lack of foods rich in vitamins such as vitamin C
and beta carotene
B.  Compensating for taste alteration due to
prescribed medication with soft, sugared foods
such as ice cream, pudding and white bread
which can lead to caries in remaining teeth
C.  Use of mints or sweetened beverages to relieve
dry mouth
D.  All of the above
11. Which of the following is an
appropriate use of fluoride in older
adults?
A.  Topical fluoride treatments for
exposed roots
B.  Oral fluoride supplementation for
patients with multiple carious lesions
C.  Oral fluoride supplementation for
patients with multiple carious lesions
D.  Topical fluoride for gingival
hyperplasia caused by phenytoin
therapy
E.  Topical fluoride as a routine
preventive measure in patients with
excellent oral care (no caries or
periodontal disease)
9. After a hip fracture, a 76 year old woman is
admitted to a long-term care facility for
rehabilitation. While examining her mouth
shortly thereafter, you see the condition in the
photograph. What is the most likely cause of
what you see?
A.  The patient developed cellulitis of her palate
during her recent hospital stay
B.  The patient’s palate was damaged during
intubation for anesthesia
C.  The patient’s dentures were improperly cleaned
while she was in the hospital
D.  The patient probably has an oral cancer
(Clark et al, 2010)
APPENDIX 1-7
Health Assessment Across Lifespan
Smiles for Life Answer Key
S Module 1:
1.  C
2.  A
3.  B
4.  A
5.  A
6.  B
7.  C
8.  A
9.  D
10.  C
Module 2:
1.  B
2.  A
3.  D
4.  A
5.  B
6.  C
7.  C
8.  B
9.  D
10.  C
Module 3:
1.  C
2.  C
3.  C
4.  A
5.  D
6.  B
7.  B
8.  E
9.  A
10.  C
Module 5:
1.  C
2.  C
3.  C
4.  D
5.  C
6.  E
7.  C
8.  C
9.  D
10.  A
Module 6:
1.  B
2.  D
3.  D
4.  C
5.  A
6.  A
7.  B
8.  B
9.  C
10.  D
Module 7:
1.  A
2.  D
3.  A
4.  B
5.  D
6.  D
7.  D
8.  B
9.  B
10.  D
Module 8:
1.  A
2.  C
3.  C
4.  B
5.  A
6.  C
7.  D
8.  C
9.  C
10.  D
11.  A
(Clark et al, 2010)
APPENDIX 8
Health Assessment Across Lifespan
American Academy of Pediatrics Oral Health Risk Assessment Tool
S www2.aap.org/oralhealth/docs/RiskAssessmentTool.pdf APPENDIX 8
Health Assessment Across Lifespan
American Dental Association Caries Risk Assessment Form (Age 0-6)
S www.ada.org/~/media/ADA/Public Programs/Files/topics_caries_educational_under6_GKAS.ashx
APPENDIX 8
Health Assessment Across Lifespan
American Academy of Pediatric Dentistry Caries Risk Assessment Tool
S http://www.aapd.org/media/Policies_Guidelines/G_CariesRiskAssessment.pdf
=
APPENDIX 9
Health Assessment Across Lifespan
Pediatric Oral Health Checklist
S Please identify each item:
Decalcification of teeth (A)
Early childhood decay (B)
Mucocele (C)
Enlarged tonsils (D)
Short frenulum (E)
Gingivitis (F)
Plaque accumulation (G)
Images from:
Rangeeth, B. N., Moses, J., & Reddy, V. K. K. (2010). A rare presentation of mucocele and irritation fibroma of the lower lip. Contemporary clinical dentistry, 1(2), 111.
Verma, S. K., Maheshwari, S., Sharma, N. K., & Prabhat, K. C. (2010). Role of oral health professional in pediatric obstructive sleep apnea. National journal of maxillofacial surgery, 1(1), 35.
Chaubal, T. V., & Dixit, M. B. (2011). Ankyloglossia and its management. Journal of Indian Society of Periodontology, 15(3), 270.
Hagan J.F., Shaw J.S., Duncan P.M. (2008). Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents (3rd, Ed).Elk Grove Village, IL: American Academy of Pediatrics.
=
APPENDIX 9
Health Assessment Across Lifespan
Pediatric Oral Health Answer Key
S Answers
Decalcification of teeth (A)
Early childhood decay (B)
Plaque accumulation (C)
Enlarged tonsils (D)
A B Mucocele (E)
Ankyloglossia (tongue-tie) (F)
Gingivitis (G)
D C E F Images from:
Rangeeth, B. N., Moses, J., & Reddy, V. K. K. (2010). A rare presentation of mucocele and irritation fibroma of the lower lip. Contemporary clinical dentistry, 1(2), 111.
Verma, S. K., Maheshwari, S., Sharma, N. K., & Prabhat, K. C. (2010). Role of oral health professional in pediatric obstructive sleep apnea. National journal of maxillofacial surgery, 1(1), 35.
Chaubal, T. V., & Dixit, M. B. (2011). Ankyloglossia and its management. Journal of Indian Society of Periodontology, 15(3), 270.
Hagan J.F., Shaw J.S., Duncan P.M. (2008). Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents (3rd, Ed).Elk Grove Village, IL: American Academy of Pediatrics.
G APPENDIX 10
Health Assessment Across Lifespan
American Dental Association Caries Risk Assessment Form (Ages >6)
S www.ada.org/~/media/ADA/Public Programs/Files/topics_caries_educational_over6.ashx
APPENDIX 11
Health Assessment Across Lifespan
Adult Oral Health Checklist
S Please check as you identify each item:
Strep throat (A)
Periodontal disease (B)
Black hairy tongue (C)
Herpetic lesion (D)
Gingival recession (E)
Canker sore (F)
Angular cheilitis (G)
Tori madibularis (H)
Images from:
CDC public health images library
Gujral, D. M., Bhattacharyya, S., Hargreaves, P., & Middleton, G. W. (2008). Periodontal disease in a patient receiving Bevacizumab: a case report. Journal of medical case reports, 2(1), 47.
Jain, A., & Kabi, D. (2013). Severe periodontitis associated with chronic kidney disease. Journal of Indian Society of Periodontology, 17(1), 128.
Jeong, J. S., Lee, J. Y., Kim, M. K., & Yoon, T. Y. (2011). Black hairy tongue associated with erlotinib treatment in a patient with advanced lung cancer. Annals of dermatology, 23(4), 526-528.
Khuller, N. (2009). Coverage of gingival recession using tunnel connective tissue graft technique. Journal of Indian Society of Periodontology, 13(2), 101.
Kwon, K. H., Lee, D. G., Koo, S. H., Jo, M. S., Shin, H., & Seul, J. H. (2012). Usefulness of vy advancement flap for defects after skin tumor excision. Archives of plastic surgery, 39(6), 619-625.
Lee, K. H., Lee, J. H., & Lee, H. J. (2013). Concurrence of Torus Mandibularis with Multiple Buccal Exostoses. Archives of plastic surgery, 40(4), 466-468.
APPENDIX 11
Health Assessment Across Lifespan
Adult Oral Health Answer Key
S Answers
Strep throat (A)
Periodontal disease (B)
Black hairy tongue (C)
Herpetic lesion (D)
Gingival recession (E)
Canker sore (F)
Angular cheiltis (G)
Tori madibularis (H)
A B C F E D
H G Images from:
CDC public health images library
Gujral, D. M., Bhattacharyya, S., Hargreaves, P., & Middleton, G. W. (2008). Periodontal disease in a patient receiving Bevacizumab: a case report. Journal of medical case reports, 2(1), 47.
Jain, A., & Kabi, D. (2013). Severe periodontitis associated with chronic kidney disease. Journal of Indian Society of Periodontology, 17(1), 128.
Jeong, J. S., Lee, J. Y., Kim, M. K., & Yoon, T. Y. (2011). Black hairy tongue associated with erlotinib treatment in a patient with advanced lung cancer. Annals of dermatology, 23(4), 526-528.
Khuller, N. (2009). Coverage of gingival recession using tunnel connective tissue graft technique. Journal of Indian Society of Periodontology, 13(2), 101.
Kwon, K. H., Lee, D. G., Koo, S. H., Jo, M. S., Shin, H., & Seul, J. H. (2012). Usefulness of vy advancement flap for defects after skin tumor excision. Archives of plastic surgery, 39(6), 619-625.
Lee, K. H., Lee, J. H., & Lee, H. J. (2013). Concurrence of Torus Mandibularis with Multiple Buccal Exostoses. Archives of plastic surgery, 40(4), 466-468.
APPENDIX 12
Health Assessment Across Lifespan
Geriatric Oral Health Checklist
S Please check as you identify each item:
Melanoma (A)
Candidiasis (B)
Denture sores (C)
Denture Stomatitis (D)
Images from
CDC Public Health Images Library
Clark M.B., Douglass A.B., Maier R., Deutchman M., Douglass J.M., Gonsalves W., Silk H., Tysinger J.W., Wrightson A.S., & Quinonez R. (2010). Smiles for life: a national oral health
curriculum. 3rd Edition. Society of Teachers of Family Medicine. Retrieved from smilesforlifeoralhealth.com
APPENDIX 12
Health Assessment Across Lifespan
Geriatric Oral Health Answer Key
S Answers Melanoma (A)
A Candidiasis (B)
Denture sores (C)
Denture Stomatitis (D)
C B Images from
CDC Public Health Images Library
Clark M.B., Douglass A.B., Maier R., Deutchman M., Douglass J.M., Gonsalves W., Silk H., Tysinger J.W., Wrightson A.S., & Quinonez R. (2010). Smiles for life: a national oral health
curriculum. 3rd Edition. Society of Teachers of Family Medicine. Retrieved from smilesforlifeoralhealth.com
D PMHNP Curriculum Integration of Interprofessional Oral Health Competencies in Health Promotion in Children/Adolescents IPEC Competencies:
Values and Ethics,
Roles and
Responsibilities
Interprofessional
Communication,
Teams & Teamwork
HRSA Oral Health
Competencies:
Oral Health Risk
Assessment, Oral
Health Evaluation,
Oral Health Preventive
Intervention,
Communication
and Education
NONPF
Competencies:
Delivers evidencebased practice for
patients throughout
lifespan; Demonstrates
best practices of family
approaches to care;
Plans care to minimize
development of
complications and
promote function and
quality of life
2) IMMERSION: DEVELOPMENT
3) COMPETENCE: ENTRY-TO-PRACTICE
SKILL/BEHAVIOR
KNOWLEDGE: ORAL CARE OF CHILDREN/
Goal: Identify oral-systemic connection in
ADOLESCENTS
Goal: Understand oral care of children/adolescents psychiatric disorders
• Review Smiles for Life Modules #1, 2, 6
•
•
E
N
T
R
Y
L
E
V
E
L
A
S
S
E
S
S
M
E
N
T
Identify oral health conditions of children/
adolescents with psychiatric disorder
commonly encountered in clinical setting
Communicate importance of oral health to
child/adolescent and parents/caregivers in
clinical setting
KNOWLEDGE: DENTAL ANXIETY
SKILL/BEHAVIOR
Goal: Demonstrate interprofessional care of psychiatric
patients with oral health needs
• Review dental anxiety scale (CFSS-DS) in
• Participate in IP clinical experience with dental/dental
A Screening Device: Children at Risk for Dental Fears hygienist students in Head Start, community health
and Management (Cuthbert & Melamed, 1982)
center, preschool, health fairs or school-based clinic
• Read
• DDS/DH to demonstrate oral assessment/
• Behavior Management of an Anxious
fluoride varnish
Child (Gupta et al, 2014)
• NP to administer dental anxiety scale
• Behavior of preschool children receiving
(CFSS-DS) and demonstrate behavioral
fluoride varnish application (Zhou et al,
management
2013)
• Collaborate together on case study of child with dental
anxieties (Appendix 1)
Goal: Understand dental anxiety in children
KNOWLEDGE: ORAL-SYSTEMIC CONNECTION
Goal: Understand oral-systemic connection in
psychiatric disorders
Read:
• Oral Care Behavior After Purging in a
Sample of Women with Bulimia Nervosa
(Conviser et al, 2014)
• Self- Induced Vomiting and Dental Erosion
(Uhlen et al, 2014)
SKILL/BEHAVIOR
Goal: Demonstrate HEENOT competency in oral health
history, risk assessment and physical exam of child/
adolescent with psychiatric disorder
•
S
U
M
M
A
T
I
V
E
A
S
S
E
S
S
M
E
N
T
•
Perform appropriate oral health history, risk
assessment and physical exam of child/adolescent
with psychiatric disorder in clinical setting
Review
Putting the Mouth Back in the Head: HEENT to
HEENOT (Haber et al, 2015)
SKILL/BEHAVIOR
Goal: Demonstrate professionalism in care of child/adolescent
with behavioral disorder during clinical experience
• Read
• Physiological and behavioral stress an
anxiety in children with autism spectrum
disorder (Stein et al, 2014
• Parental attitudes and experiences of dental
care in children and adolescents with ADHD
(Staberg et al, 2014)
• Present oral health care plan and management
strategies to parents/caregivers of child/adolescent with
behavioral disorder
SKILL/BEHAVIOR
Goal: Integrate oral health into care of
adolescent with eating disorder
SKILL/BEHAVIOR
Goal: Present oral health plan for
adolescents with eating disorders
•
•
•
CONSTRUCTS
© Oral Health Nursing Education and Practice (OHNEP)
Collaborate together on Discussion
Board on case study of patient with
bulimia and oral health needs
(Appendix 2)
Following health literacy principles,
develop evidence-based oral health
education program with dental
students for adolescent with bulimia
Prepare and present an evidencebased collaborative case study on
adolescent with eating disorder.
Include oral health issues related to
the disorder
INTER-PROFESSIONAL PARTNERSHIP & COLLABORATIVE PRACTICE FOR
OPTIMIZATION OF CIENT/PATIENT HEALTH OUTCOMES
1) EXPOSURE: INTRODUCTION
HEALTH
PROMOTION IN
CHILDREN/
ADOLESCENTS
APPENDIX 1
Health Promotion of Children/Adolescents
Dental Anxiety Case Study
S A 12 year old boy presented with a history of lack of cooperation and failed
compliance with general anesthetic administration and oral sedation. According to
the boy, he had had a traumatic experience during the administration of local
anesthesia two years previously and since then his dental anxiety had significantly
increased. Dental anxiety assessment revealed diagnostic categories of fear, fear of
specific stimuli and general dental anxiety. Dental examination showed poor plaque
control and caries.
What behavioral treatment plan do you propose?
What preventive behaviors do you recommend?
What is your follow up?
Adapted from Levitt, J, McGoldrick, P, & Evans, D. (2000). The management of severe dental phobia in an adolescent boy: a
case report. International Journal of Paediatric Dentistry, 10(4), 348-353. doi: 11310250.
APPENDIX 2
Health Promotion of Children/Adolescents
Bulimia Case Study
S A15 year-old female was admitted to the clinic. She had a 8-year history of severe bulimia nervosa according to the DSM-IV
criteria. She had previously been treated in 7 eating disorder clinics and had been hospitalized 2 times for cardiac problems that
were related to her disorder.
Much of her life revolved around binge eating and vomiting 10-15 times daily and compulsively exercising 3 hours per day. She
had frequent mood swings and admitted suicidal thoughts but had mot attempted suicide. She was taking 60 mg Prozac daily
and she complained of severe headaches. Her BMI was 14.2 kg/m2 and she had abnormal glucose 60 mg/dL, urea nitrogen (BUN) 6 mg/dL, amylase level 134 units/L,
folate 24.0 ng/mL, PH 9.0, bicarbonate 33 mEq/L. The patient was verbally abusive toward the mother, preventing the mother from caring for her. The mother had given up on a
positive outcome for her daughter, as she had so many treatment failures. The mother accommodated the patient’s eating
behavior by changing her own eating behavior to suit the patient’s needs. The food choices she made and the portion sizes she
chose were precisely aligned with the patient´s rigid eating system. No guests would visit nor were invited to the house, since
the patient vomited in plants, clogged the toilets with her vomit, and hid plastic bags filled with vomit around the house.
What are you checking for?
What treatment will you prescribe?
Where do you refer patient?
What is your follow-up? Adapted from Mando NYC . Treatment for Eating Disorders - Case Study 3. Retrieved from http://www.mandonyc.com/en/
mandometer/case-studies-/case-study-3/1.aspx.
PMHNP Curriculum Integration of Interprofessional Oral Health Competencies in Health Promotion in Adults/Older Adults
IPEC Competencies:
Values and Ethics,
Roles and
Responsibilities
Interprofessional
Communication,
Teams & Teamwork
HRSA Oral Health
Competencies:
Oral Health Risk
Assessment, Oral
Health Evaluation,
Oral Health Preventive
Intervention,
Communication
and Education
NONPF Competencies:
Delivers evidence- based
practice for patients
throughout lifespan;
Assesses impact of acute
and chronic medical
problems on psychiatric
treatment; Ensures patient
safety through appropriate
prescription and
management of
parhamacologic and nonpharmocologic
interventions
CONSTRUCTS
2) IMMERSION: DEVELOPMENT
3) COMPETENCE: ENTRY-TO-PRACTICE
SKILL/BEHAVIOR
KNOWLEDGE: ORAL CARE OF ADULTS
Goal: Understand oral care of adults/older
adults
•
• Review Smiles for Life Modules #1,
3, 5, 7, 8
E
N
T
R
Y
L
E
V
E
L
A
S
S
E
S
S
M
E
N
T
SKILL/BEHAVIOR
Goal: Demonstrate HEENOT competency in oral
health history, risk assessment, physical exam of
adults with psychiatric disorder
Goal: Integrate oral health into care of adults
with psychiatric disorders
•
Identify oral health conditions of adults/
older adults with psychiatric disorders
commonly encountered in clinical setting
Communicate importance of oral health to
psychiatric adults
KNOWLEDGE: MEDICATIONS CAUSING ORAL SKILL/BEHAVIOR
HEALTH PROBLEMS
Goal: Identify psychiatric medications with
oral health effects
Goal: Understand oral health problems
associated with psychiatric medications
• Prepare a presentation on the oral effects
of 5 psychotropic medications your
Read
patients are taking, which have oral
• Psychotropic Induced Dry Mouth (Swager
health effects
& Morgan, 2011)
KNOWLEDGE: ORAL-SYSTEMIC CONNECTION
Goal: Understand oral-systemic connection
between mental illness and oral health
SKILL/BEHAVIOR
Goal: Identify oral-systemic connection of
psychiatric disorders in adults
Read:
• Nothing to smile about (Luca et al, 2014)
• Oral health of psychiatric patients: the
nurse’s perspective (Azodo, 2011)
Choose one of the following disorders and
present the oral-systemic connection in class:
• Anxiety disorder
• Chronic fatigue
• OCD
• Depression
• Mood disorder
• Eating disorder
• Substance abuse
• Psychotic disorder
© Oral Health Nursing Education and Practice (OHNEP)
•
S
U
M
M
A
T
I
V
E
A
S
S
E
S
S
M
E
N
T
•
Perform appropriate oral health history, risk
assessment, and physical exam of adult with
psychiatric disorder in clinical setting
Review
Putting the Mouth Back in the Head: HEENT to
HEENOT (Haber et al, 2015)
SKILL/BEHAVIOR
Goal: Collaborate interprofessionally on psychiatric
disease case with oral health needs
•
•
Read articles from list (Appendix 1)
Prepare and present with dental students an
evidence-based case study of patient with
metabolic syndrome caused by anti-psychotic
medications. Include oral health issues related
to diabetes, hyperlipidemia and obesity
SKILL/BEHAVIOR
Goal: Collaborate interprofessionally on substance abuse case
with oral health needs
• Review Evidence-Based Screening tools (NIDA, 2014
• Alcohol, tobacco, opioid tools (Appendix 2)
• Read:
• Oral Health of Substance-Dependent Individuals
(D’Amore et al, 2011)
• Promoting Smoking Cessation (Larzelere & Williams,
2012)
• Help your Patients Quit Smoking (ADA) (Appendix 3)
• Treatment Approaches to Drug Addiction (NIDA,
2009)
• Prepare and present with dental students an evidence-based
collaborative case study of patient with substance abuse disorder
and oral health needs
INTER-PROFESSIONAL PARTNERSHIP & COLLABORATIVE PRACTICE FOR
OPTIMIZATION OF CIENT/PATIENT HEALTH OUTCOMES
1) EXPOSURE: INTRODUCTION
HEALTH
PROMOTION IN
ADULTS/
OLDER
ADULTS
APPENDIX 1
Health Promotion of Adults/Older Adults Metabolic Syndrome List
S Kobayashi, Y., Niu, K., Guan, L., Momma, H., Guo, H., Cui, Y., & Nagatomi, R. (2012). Oral health behavior and metabolic syndrome
and its components in adults. Journal of dental research, 91(5), 479-484. doi: 10.1177/0022034512440707.
Lasić, D., Bevanda, M., Bošnjak, N., Uglešić, B., Glavina, T., & Franić, T. (2014). Metabolic syndrome and inflammation markers in
patients with schizophrenia and recurrent depressive disorder. Psychiatria Danubina, 26(3), 214-219.PMID: 25191767
Stanley, S., & Laugharne, J. (2014). The Impact of Lifestyle Factors on the Physical Health of People with a Mental Illness: a Brief
Review. International journal of behavioral medicine, 21(2), 275-281. doi: 10.1007/s12529-013-9298-x.
Toalson, P., Ahmed, S., Hardy, T., & Kabinoff, G. (2004). The metabolic syndrome in patients with severe mental illnesses. Primary care
companion to the Journal of clinical psychiatry, 6(4), 152. PMID: 15361918
APPENDIX 2
Health Promotion of Adults/Older Adults Audit-C Alcohol Screen
S http://www.integration.samhsa.gov/images/res/tool_auditc.pdf
(Bush et al, 1998)
APPENDIX 2
Health Promotion of Adults/Older Adults Drug Abuse Screening Test (DAST)- Opioids Screen
S Scoring and interpretation: A score of “1” is
given for each YES response, except for items
4,5, and 7, for which a NO
response is given a score of “1.” Based on data
from a heterogeneous psychiatric patient
population, cutoff scores of 6
through 11 are considered to be optimal for
screening for substance use disorders. Using a
cutoff score of 6 has been found to
provide excellent sensitivity for identifying
patients with substance use disorders as well as
satisfactory specificity (i.e.,
identification of patients who do not have
substance use disorders). Using a cutoff score of
<11 somewhat reduces the
sensitivity for identifying patients with substance
use disorders, but more accurately identifies the
patients who do not have a
substance use disorders. Over 12 is definitely a
substance abuse problem. In a heterogeneous
psychiatric patient population,
most items have been shown to correlate at
least moderately well with the total scale scores.
The items that correlate poorly
with the total scale scores appear to be items
4,7,16,20, and 22.
(Addiction Research Foundation, 1982)
APPENDIX 2
Health Promotion of Adults/Older Adults Fagerstrom – Tobacco Screen
S (Ebbert et al, 2006)
APPENDIX 3
Health Promotion of Adults/Older Adults Help Your Patients Quit (part I)
S Tobacco Cessa*on (American Dental Association)
APPENDIX 3
Health Promotion of Adults/Older Adults
Help Your Patients Quit (part II)
S Pharmacotherapy (American Dental Association)
RESOURCES
S Addiction Research Foundation. (1982). DAST: Drug Addiction Screening Tool.
Retrieved from http://www.bu.edu/bniart/files/2012/04/DAST-10_Institute.pdf
American Academy of Pediatrics. (n.d.). Oral Health Risk Assessment Tool.
Retrieved from http://www2.aap.org/oralhealth/docs/RiskAssessmentTool.pdf
American Academy of Pediatrics. (n.d.). Oral Health Self Management Goals for Parents/Caregivers.
Retrieved from https://www2.aap.org/oralhealth/docs/GoalSheetEnglish.pdf
American Academy of Pediatric Dentistry. Council, O. (2014). Guideline on Caries-risk Assessment and
Management for Infants, Children, and Adolescents.
Retrieved from http://www.aapd.org/media/Policies_Guidelines/G_CariesRiskAssessment.pdf
American Academy on Pediatric Dentistry Clinical Affairs Committee-Behavior Management
Subcommittee, & American Academy on Pediatric Dentistry Council on Clinical Affairs. (2008).
Guideline on behavior guidance for the pediatric dental patient. Pediatric dentistry, 30(7 Suppl), 125.
American Dental Association. (2009). ADA Caries Risk Assessment Form.
Retrieved from http://www.ada.org/en/member-center/oral-health-topics/caries
American Dental Association. Help Your Patients Quit [brochure]. Retrieved from
http://www.ada.org/~/media/ADA/Science%20and%20Research/Files/topics_smoking_cessation_card.ashx
Azodo, C. C., Ezeja, E. B., Omoaregba, J. O., & James, B. O. (2012). Oral health of psychiatric patients: the nurse’s
perspective. International journal of dental hygiene, 10(4), 245-249. doi: 10.1111/j.
1601-5037.2011.00537
Bassiouny, M. A. (2013). Dental erosion due to abuse of illicit drugs and acidic carbonated beverages.
General
dentistry, 61(2), 38.PMID:23454320.
Benowitz, N. L. (2010). Nicotine addiction. The New England journal of medicine, 362(24), 2295. doi:
10.1056/NEJMra0809890.
Botvin, G. J., & Kantor, L. W. (2000). Preventing alcohol and tobacco use through life skills training. Alcohol
research and health, 24(4), 250-257. PMID: 15986720
Bush, K., Kivlahan, D. R., McDonell, M. B., Fihn, S. D., & Bradley, K. A. (1998). The AUDIT alcohol consumption
questions (AUDIT-C): an effective brief screening test for problem drinking. Archives of internal
medicine, 158(16), 1789-1795. PMID: 9738608
Buchanan, H., & Niven, N. (2002). Validation of a Facial Image Scale to assess child dental anxiety. International
Journal of Paediatric Dentistry, 12(1), 47-52. PMID: 11853248
Clark M. & Krol D. (2014). Protecting all children’s teeth (PACT): systemic diseases. Retrieved from
http://www2.aap.org/ORALHEALTH/pact/index-cme.cfm
www.OHNEP.org
www.SmilesforLifeOralHealth.org
National Oral Health Curriculum
www.IPECollaborative.org
Interprofessional Education
Collaborative
O
N
L
I
N
E
R
E
S
O
U
R
C
E
S
www.APTRweb.org/?PHLM_15 Oral
Health Across the Lifespan Module
www.HealthyPeople.gov
10-year national health goals for
Americans
www.IPE.UToronto.ca
University of Toronto’s Centre for
Interprofessional Education
www.ToothWisdom.org
Health Resources for Older Adults
www.HartfordIgn.org
Hartford Institute Geriatric Oral Health
www.UKY.edu/NursingHomeOralHealth
Nursing Home Oral Health
www.DrugAbuse.gov
www.NIAAA.NIH.gov
National Institute on Alcohol
Abuse and Alcoholism
RESOURCES
S Clark, D. B. (2003). Dental care for the patient with bipolar disorder. Journal of the Canadian Dental Association, 69(1). PMID:12556265
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