Download Case Studies 4 - 80 min. sessions

UNIVERSITY OF LOUISIANA AT MONROE
Course:
DHYG 4034
Title:
Clock Hours: 3
Time: 10:00 – 11:20 T Th
Program: Dental Hygiene
Dental Management of the
Medically Compromised Patient
Credits:
3
Level/Sem./Yr: Sr/Fall/16
Office Hours: M,W,F 9-11:00a.m.
and by appointment
I.
INSTRUCTOR
II.
COURSE DESCRIPTION The dental assessment and management of the
medically compromised patient.
III.
COURSE PREREQUISITES/COREQUISITES
Prerequisites: DHYG: 4015, 4016, 4017
Corequisites: Registration in DHYG: 4014, 4021, 4022
IV.
COURSE OBJECTIVES AND COMPETENCIES
Competencies
Sharon C. Chaney, R.D.H., M.P.S.
Course Objectives
With respect to the following list of medically compromising
conditions and diseases, the student will be able to
*, 6.1, 6.3, 6.4, 6.5,
6.7
*, 6.3, 6.4, 6.5, 6.7
1. Describe the characteristics, signs and symptoms that patients
with each condition present.
2. Summarize medical, surgical or pharmacological treatment that
is normally provided for each condition and state how those
treatments would influence dental treatment.
6.2, 6.6, 6.7
3. Identify the assessment tools appropriate for the patient
*, 6.3, 6.4, 6.5, 11.1, 4. Select treatment modifications and adaptations that might be
11.2, 11.3
necessary to assess and treat compromised individuals and
explain the rationale for such
7.2, 8.1, 8.2
5. State the elements to be included for appropriate patient
education for each condition and the rationale for inclusion
6.3, 10.2
6. State any necessary consultations, referrals, additional
treatment or education that would be recommended.
*, 10.1
7. State possible modifications of expectations of treatment due to
the condition/disease
10.3
8. Select and justify an appropriate maintenance/recall interval
for the patient.
Infective endocarditis and associated conditions
Hypertenstion
Ischemic heart disease
Cardiac arrhythmias
Congestive heart failure
Pulmonary Diseases: COPD; asthma; tuberculosis
Diabetes mellitus
Chronic renal disease; ESRD; dialysis
Liver disease: Hepatitis; alcohol related disorder
Gastrointestinal disease: Peptic Ulcer, Inflammatory Bowel Disease,
Pseudomembranous colitis
Sexually transmitted diseases
HIV; AIDS and related conditions
Adrenal insufficiency
Thyroid disease
Pregnancy and breastfeeding; relation to infant/toddler
Hormonal imbalances: adolescence; menopause
Allergy
Bleeding disorders,
Disorders of the red and white blood cells
Cancer; Oral Cancer
Neurological disorders: epilepsy; cerebrovascular accident
Behavioral / psychiatric disorders
Rheumatologic and Connective Tissue Disorders: osteoarthritis; rheumatoid; lupus
Organ and Bone Marrow Transplants
V.
COURSE TOPICS
See attached Session Topic Schedule
VI.
INSTRUCTIONAL METHODS AND ACTIVITIES
Reading Assignments
Lecture
Discussion in large and small groups
Group activities
Specific medical/ dental equipment/ models
Handouts
Aids: Videos, Power point presentations, handouts, online resources/research
VII
EVALUATION AND GRADE ASSIGNMENT
Exams There will be four examinations given during the semester. Make-up
examinations will not be given unless the student has an excused absence and has
notified the instructor in advance. Missed exams are calculated as “0” when
computing the final course grade. A comprehensive final examination will be
given on the scheduled date. There will be no exemptions from the final
examination. Examinations are pencil and paper using scantrons. Questions are a
variety of multiple choice types similar to those used on the national board
examination.
Participation is expected during class sessions and will be evaluated by the
instructor and members of the peer groups. Evaluation will be based on
observation, and peer evaluation according to the criteria listed on the
form posted on Moodle.
Reading Assignments
Assigned material must be read before class in order to
participate in the discussion or activities for that day. Quizzes will test
for understanding of this information.
Class assignments/activities (both individual and group) will be utilized regularly.
Activities will be utilized to help the student organize, process, and
integrate the material. This will assist the student in transferring the
information to the clinical setting and utilizing it in patient treatment.
Quizzes are typically given at the beginning of each session. They will evaluate
understanding of previously assigned readings and/or application to
patient situations. Regular quizzes will be given throughout the course
covering the reading assignments. Quizzes missed during an excused
absence will be made up the day of the final examination. Students may
take their group grade or opt to take the quiz if they miss a quiz while at
VA. Missed quizzes are calculated as a “0” when computing the final
grade.
Group Activities / Presentations
Each group will be assigned cases or portions of a case involving a
moderate periodontally involved patient with a specific disease or
condition that is compromising. Groups are to develop the case or aspect
of the case according to the following criteria. The group will present their
portion of the case or the entire care to the class. The class will be allowed
to ask questions following the presentation. Evaluation of the
presentations will be based on the following criteria as per the assignment:
Content: 75%
 Exemplified the signs and symptoms typically found in
patients with the disease or condition considered.
 Addressed any medical treatment that might be currently
utilized for this patient.
 Considered pharmacological considerations for the patient
and any possible interactions with dental drugs or
treatment.
 Selected and utilized appropriate assessment data
 Developed a treatment plan, including patient education,
appropriate to the patients’ needs
 Included modifications for assessment, treatment, patient
education and expectations
Presentation: 25%
 The case was presented in an organized, interesting and
informative manner.
Mid-Term Grades will be posted on-line for students to view via Banner. Midterm grades indicate a student's status at mid-semester only and do not
indicate the final performance outcome of a student.
Criteria for the final grade
Quizzes
Examinations (4)
Final Exam
Attendance/Participation/Peer Evaluation
25%
40%
30%
5%
100%
Grading Scale
The grading scale for the Dental Hygiene Program is as follows:
A
93-100
B
85-92
C
77-84
D
70-76
F
Below 70
VIII.
CLASS POLICIES AND PROCEDURES
Required Texts:
Little, et. al. Dental Management of the Medically Compromised
Patient 8th ed.
ULM, Dental Hygiene Clinic Manual 2015 ed.
Wilkins Esther, Clinical Practice of the Dental Hygienist, 11th ed.
Wynn, LexiComp Online Drug Information latest ed.
References:
Physician’s Desk Reference , latest ed.
Mosby’s Dental Dictionary latest ed.
Journal Articles
Moodle Resources
Attendance:
Recognizing that a dental hygiene student will soon be obligated to meet the
needs and demands of the profession of dental hygiene, there are stricter
attendance requirements than those imposed by other academic curricula.
Attendance is required at all clinical courses, laboratories, clinics, and external
rotations as scheduled.
Penalties for tardies and absences are as follows:
1. First tardy – no penalty, If a quiz is in progress, you must stay in the back
of the room until the quiz is over. You will not be allowed to make up the
quiz and a zero will be recorded.
2. Second tardy – 1 point deducted from the final course grade. Policy
regarding quizzes is the same as mentioned above.
3. Subsequent tardies – two points deducted from the final course grade for
each tardy. Policy regarding quizzes is the same as mentioned above.
4. First absence – no penalty if time and/or missed work in all subject areas
missed is made up. The student must contact the course director the day
the student returns to school to make arrangements for the missed work,
assignments. If arrangements are not made, you will not be allowed to
make up the work, assignment; and a zero will be recorded. In addition, 2
points will be deducted from your final course grade. See course
evaluation section for make-up examination policy.
5. Second absence – 2 points will be deducted from the final course grade.
Policy regarding missed work is the same as mentioned in #4.
6. Subsequent absences – for each day of absence, five points will be
deducted from the final course grade in all subject areas missed. Policy
regarding missed work is the same as mentioned in #4.
7. If you are ill, notify
A. your patients
B. dental hygiene receptionist/secretary &/or Clinic Lecture Instructor
C. clinical coordinator
A student may appeal the grade penalty to the Dental Hygiene Admissions and
Academic Standards Committee by personal appearance or written application if
the following two conditions exist and can be demonstrated:
1. there is sufficient documented evidence to support a genuine need for the
absence
2. that missed course work, laboratory work or clinical work can be
overcome
The committee will determine the merit of the appeal and decide what action will
be taken.
For VA rotation – Absences resulting from VA rotation will not be counted
against the student. The student is responsible for all course work missed. If a test
and or quiz is missed, it must be taken the Friday at 8:00 a.m. that the student
returns to school, unless prior arrangements have been made with the course
director. Notes and work missed will be in the VA box in Caldwell 210. It is the
student’s responsibility to pick up this information.
For satellite clinic rotations: students assigned to outside satellite clinics on class
days will be allowed to leave class at 11:00a.m. in order to prepare for and
begin treatment at clinic site on time.
Make-up exams will not be given unless it was an official university excused
absence and the instructor has been notified in advance. It is the student’s
responsibility to contact the instructor within 24 hours of the absence to schedule
a make-up exam. Missed exams will be recorded as a zero when computing the
final grade.
Academic Integrity
Students and faculty must adhere to the ULM published policies on academic
cheating, plagiarism and other forms of academic dishonesty. Infractions of any
of these policies will result in being called before the Dental Hygiene Admissions
and Academic Standards Committee. The committee will determine the
seriousness of the infraction and will determine the penalty or remediation.
Students may appeal any decision of this committee as allowed in the ULM
Student Policy Manual.
Social Media Use Policy
Students who want to communicate about patients via social media must use only
ULM email; wherein, specific patients may be referred to only by initials, not by
either first or last name. No communication about patients, parents, clinic, or the
department is allowed in any other communications via social media (except
ULM warhawks email). These include Facebook, blogs, text-messaging,
personal mail, etc. Official Facebook postings about departmental activities can
only be made by students with approval of the Department Head or Clinical
Coordinator. While faculty cannot stop students from doing so, it is not in the
students’ best interest to speak negatively about him/herself, faculty, the program,
college or university on Facebook or elsewhere. If a student’s public
communication is interpreted in a slanderous and/or non-beneficent
manner, then the student can and will be held ethically and/or legally
responsible. Furthermore, students should be aware that Facebook is viewable
and viewed by faculty, patients, parents of patients, students at other
universities, potential students, and future employers. Before a Facebook post
is made, students should ask themselves, “What will a future employer
(patient, patient’s parent, etc.) think when he/she sees this post? Faculty
(including off- campus supervisors) are not allowed to befriend on Facebook any
current student of the program, patient or parent of a patient. Social relationships
with faculty are inappropriate.
IX.
Student Services: The University of Louisiana at Monroe strives to serve students
with special needs through compliance with Sections 504 of the Rehabilitation
Act of 1973 and the Americans with Disabilities Act. These laws mandate that
postsecondary institutions provide equal access to programs and services for
students with disabilities without creating changes to the essential elements
of the curriculum. While students with special needs are expected to meet our
institution's academic standards, they are given the opportunity to fulfill learner
outcomes in alternative ways. Examples of accommodations may include, but are
not limited to, testing accommodations (oral testing, extended time for exams),
interpreters, relocation of inaccessible classrooms, permission to audiotape
lectures, note-taking assistance, and course substitutions.
Information about ULM student services can be found via these links:





Student Success Center: http://www.ulm.edu/studentsuccess/
Counseling Center http://www.ulm.edu/counselingcenter/
Special Needs at http://www.ulm.edu/studentaffairs/
Library http://www.ulm.edu/library/reference.html
Computing Center Help Desk http://www.ulm.edu/computingcenter/helpdesk

Students with disabilities Current college’s policies on serving students with
disabilities can be obtained on the ULM website:
http://ulm.edu/counselingcenter/
If you need accommodation because of a known or suspected disability, you
should contact the Director for Disabled Student Services at:
Voice phone: 318-342-5220
Fax: 318-342-5228
Walk-In: ULM Counseling Center, 1140 University Avenue (this building
and room are handicapped accessible).
 Mental Wellness on the ULM Campus:
If you are having any emotional, behavioral, or social problems and would like to
talk with a caring, concerned professional, please call one of the following
numbers:
 The ULM Counseling Center: 318-342-5220
 The Marriage and Family Therapy Clinic: 318- 342-9797
 The Community Counseling Center: 318-342-1263
Remember that all services are offered free to students, and all are strictly confidential.
If you have special needs that I need to be made aware of, you should contact me
within the first two days of class.
Sexual Harassment or Gender-Based Discrimination:
Title IX of the Education Amendments of 1972 prohibits sex discrimination against any
participant in an educational program or activity that receives federal funds, including
federal loans and grants. Furthermore, Title IX prohibits sex discrimination to include
sexual misconduct, sexual violence, sexual harassment and retaliation. If you encounter
sexual harassment or gender-based discrimination, please contact the Title IX
Coordinator at 318-342-1004; you may also file a complaint online, 24 hours a day, at:
www.ulm.edu/titleix.
SESSION OBJECTIVES
By the end of each session, the student will be able to:
Interrelationships of Medicine and Dentistry
25 min.
1. State the interrelationships of medicine and dentistry
2. Summarize the health characteristics of the general population
3. State the percentage and types of medically compromised patients in an
average dental practice
4. Compare the dental treatment of medically compromised patients 40 years
ago and today
Infective Endocarditis and Related Conditions
25 min.
1. State the etiology of endocarditis and conditions associated with it
2. Describe the characteristics, diagnostic tests and markers, course,
prognosis and sequelae of the disease
3. Describe the medical management and pharmacologic treatment of the
disease
4. Describe concerns, modifications and precautions for dental and dental
hygiene assessment, diagnosis and treatment of a patient who is
susceptible to, at risk for or has had this disease
5. State the current AHA protocols for various dental and dental hygiene
procedures for patients susceptible to IE
6. List and briefly describe the conditions placing a patient a high, and
moderate risk for infective endocarditis
7. State the protocol for treating patients with high, moderate and low
conditions
8. Describe congenital heart conditions, treatments and relation to
dental treatment and IE
Hypertension
50 min.
1. State the types and etiology of hypertension
2. Summarize the pathophysiology of hypertension
3. Describe the signs, symptoms and significant laboratory findings for
patients with hypertension
4. Describe the medical and pharmacologic management of hypertension
5. Categorize and compare the various types of anti-hypertensive drugs in
terms of mode of action, side effects, oral manifestations and
vasoconstrictor interaction
6. Describe the dental management of hypertensive patients
7. Describe the interactions and considerations of local anesthetics with
hypertensive patients and those on anti-hypertensive medications
Ischemic Heart Disease
50 min.
1. State the incidence, prevalence and etiology of ischemic heart
disease(IHD)
2. Summarize the pathophysiology and complications of IHD
3. Compare and contrast the signs, symptoms, laboratory findings of angina
pectoris and myocardial infarction
4. Describe the medical and pharmacologic management of angina pectoris
and myocardial infarction
5. Identify the drugs commonly used to treat angina pectoris and myocardial
infarction and describe their actions, side effects, vasoconstrictor
interactions and oral manifestations
6. Identify those patients who are at major, intermediate or low risk of a
cardiac perioperative complication
7. Describe the dental management of IHD patients
8. List any oral complications or manifestations of IHD
Cardiac Arrhythmias
30 min.
1. Define and describe pathophysiology and complications of the major
classifications of cardiac arrhythmias
2. State the etiology of cardiac arrhythmias
3. Describe the clinical presentation, (signs, symptoms and laboratory tests),
of cardiac arrhythmias
4. Describe the medical and pharmacologic management of cardiac
arrhythmias
5. Identify the drugs commonly used to treat cardiac arrhythmias and list
their actions, side effects, and oral manifestations
6. Describe the use of pacemakers and cardioverters for arrhythmias
7. Describe the dental management of and prevention of medical
complications of patients who have cardiac arrhythmias
Heart Failure
50 min.
1. Define congestive heart failure and describe its etiology, pathophysiology
and complications
2. Describe the clinical presentation of CHF
3. Describe the medical and pharmacologic management of CHF
4. Identify and classify the drugs used to treat CHF and list the classifications
modes of action, vasoconstrictor interactions, side effects and oral
manifestations
5. Describe the dental management of CHF patients
Pulmonary Disease
Chronic Obstructive Pulmonary Disease
30 min.
1. Define and describe the pathophysiology and complications of the two
major types of COPD
2. State the etiology of COPD
3. Compare and contrast the clinical presentation of bronchitis and
emphysema
4. Describe the medical and pharmacologic management of COPD
5. Describe the dental management of patients with COPD
Asthma
25 min.
1. Define and describe the etiology, pathophysiology and complications of
asthma
2. Describe the clinical presentation of asthma
3. List and describe the classifications of asthma
4. Describe the medical and pharmacologic management of asthma
5. Discuss the dental management of patients with asthma
6. Describe the emergency treatment of patients experiencing an asthma
attack
7. Describe the oral complications and manifestations of asthma or its
medications and how these can be prevented or treated
Tuberculosis
25 min.
1. Define and describe the incidence, prevalence, etiology, pathophysiology
and complications of tuberculosis
2. Describe the clinical presentation of tuberculosis
3. Describe the medical and pharmacologic management of tuberculosis and
the relevance of multi drug resistant strains
4. Describe the actions, side and adverse effects and dental considerations of
antituberculosis drugs
5. Describe the dental management of patients with tuberculosis
6. Describe the oral and perioral manifestations of tuberculosis
7. Discuss government regulations regarding tuberculosis
Diabetes and Chronic Renal Failure and Dialysis
100 min.
1. Define diabetes and state its incidence, prevalence and etiology
2. Briefly summarize the pathophysiology and complications of diabetes
3. Compare and contrast Type 1 and Type 2 diabetes in terms of clinical
presentation
4. Describe the medical and pharmacologic management of diabetes
5. Describe insulin reaction or hypoglycemic reaction and describe the
appropriate treatment for each stage of this reaction
6. Discuss the proper dental management of various categories of diabetic
patients
7. Describe oral manifestations and complications of diabetes
8. List appropriate treatment and appointment modifications typically used
for patients with diabetes
9. Define end-stage renal disease and describe its etiology and prevalence
10. Summarize the pathophysiology and complications of ESRD
11. Describe the clinical presentation or ESRD
12. Discuss the medical and pharmacologic management of ESRD
13. Describe dental management of the ESRD patient including any treatment
planning modifications
14. Describe any oral manifestations of ESRD
15. Identify nephrotoxic drugs and state the adjustment of dosage for others
for ESRD patients
Liver Disease
Hepatitis
50 min.
1. Define hepatitis and describe the five major types in terms of etiology,
incubation, transmission, diagnostic markers, chronic carrier state,
complications, immunizations
2. Briefly summarize the pathophysiology and complications of hepatitis
3. Describe the clinical presentation of hepatitis
4. Describe the medical management of hepatitis
5. Summarize the recommendations following exposure to hepatitis infected
blood
6. Describe the dental management of patients with hepatitis
7. Identify hepatotoxic drugs and those to be used limitedly in carriers or
those with compromised liver function
8. Describe oral manifestations and complications of hepatitis patients
Alcoholic Liver Disease
50 min.
1. Define alcoholism, alcohol dependence and alcohol abuse
2. State the etiology and describe the pathophysiology and complications of
alcoholic liver disease
3. Describe the clinical presentation of alcoholic liver disease including oral
and perioral manifestations
4. Describe the dental management of alcoholic liver disease patients
Gastrointestinal Diseases
50 min.
1. Define Peptic Ulcer Disease, Inflammatory Bowel Disease and
Pseudomembranous Colitis
2. Summarize the etiology, pathophysiology and complications of each
3. Describe the clinical presentation of each and any oral / perioral
manifestations
4. Describe the medical and pharmacologic management of each
5. Describe the dental management of patients with each disease specifying
any treatment modifications
Sexually Transmitted Diseases
50 min.
1. State the definition, etiology and of : gonorrhea, syphilis, genital herpes,
infectious mononucleosis and human papillomavirus
2. Describe the pathophysiology of: : gonorrhea, syphilis, genital herpes,
infectious mononucleosis and human papillomavirus
3. Describe the clinical (including any oral manifestations) presentation of :
gonorrhea, syphilis, genital herpes, infectious mononucleosis and human
papillomavirus
4. State the medical and pharmacologic management of: : gonorrhea,
syphilis, genital herpes, infectious mononucleosis and human
papillomavirus
5. Describe the dental management of patients with : gonorrhea, syphilis,
genital herpes, infectious mononucleosis and human papillomavirus
AIDS and Related Conditions
50 min.
1. Define and state the incidence, prevalence and etiology of AIDS
2. Describe the pathophysiology and complications of AIDS
3. Describe the clinical presentation of AIDS
4. Summarize the medical and pharmacologic management of AIDS
5. Describe the dental management of AIDS including any treatment
modifications
6. Describe oral complications and manifestations of AIDS
Adrenal Insufficiency
30 min.
1. Summarize the anatomy and physiology of the adrenal glands
2. Define categorize and describe the pathophysiology and complications of
primary and secondary adrenal insufficiency
3. Describe the clinical presentation (including oral manifestations) of
adrenal insufficiency
4. Summarize the medical and pharmacologic management of adrenal
insufficiency
5. Describe the dental management of and treatment modifications for
adrenal insufficiency
Thyroid Disease
30 min.
1. Describe the thyroid gland, its location and function
2. Summarize the activity of the thyroid gland and hypothalamic-pituitarythyroid axis as it is involved in the control of thyroid secretion
3. Define, state the etiology of and describe the pathophysiology and clinical
presentation of thyrotoxicosis (hyperthyroidism)
4. Summarize the medical and pharmacologic management of thyrotoxicosis
5. Define, describe and state the medical management of thyrotoxic crisis
6. Briefly define, describe and state the clinical presentation and medical and
pharmacologic management of thyroiditis
7. Define, state the etiology of and describe the clinical presentation of
hypothyroidism.
8. Describe the medical and pharmacologic management of hypothyroidism
9. Describe the clinical presentation of thyroid cancer
10. Describe the dental management, medical considerations and oral
manifestations of thyrotoxicosis, thyroiditis, thyroid cancer and
hypothyroidism.
Pregnancy and Breastfeeding
50 min.
1. Define and describe the physiology and complications of pregnancy
2. Describe the dental management of a pregnant patient
3. Discuss the advantages and disadvantages of dental radiographs, specific
drugs and classifications of drugs during pregnancy
4. Describe the implications of drugs during breastfeeding
5. Describe treatment modifications for dental and dental hygiene treatment
during pregnancy
6. List any treatment modifications for a breastfeeding patient
Allergy
50 min.
1. Define, categorize and describe the etiology of various types of allergies
2. Summarize the pathophysiology and complications of allergic reactions
3. Describe the clinical presentations of the different types of allergic
responses
4. Describe the medical and pharmacologic management of allergic
responses
5. Discuss the relevance of allergy to local anesthetics, antibiotics, analgesics
and dental materials and products in the practice of dentistry
6. Describe the oral manifestations of allergic responses
7. Describe the emergency management of severe Type I hypersentsitivity
reactions
Bleeding Disorders
50 min.
1. Define, state the general etiology of and classify the major types of
bleeding disorders
2. Summarize the pathophysiology of the vascular, platelet, coagulation and
fibrinolytic phases of hemostasis
3. Describe the clinical presentation (signs, symptoms and laboratory tests)
of bleeding
4. Describe the medical and pharmacologic management of bleeding
disorders
5. Describe and classify specific bleeding disorders by etiology
6. Describe the dental management of and treatment modifications for
patients with bleeding disorders
7. Describe the oral manifestations and complications of bleeding disorders
Disorders of Red and White Blood Cells
50 min.
1. Define anemia and differentiate between iron deficiency anemia,
pernicious anemia, glucose-60phosphate dehydrogenase deficiency, sickle
cell anemia and renal disease anemia in terms of etiology
2. Describe the clinical presentation and pathophysiology of the major forms
of anemia
3. State the medical management of the major types of anemia
4. State dental management and treatment modifications of patients with
major forms of anemia
5. Define and differentiate between white blood cell disorders: leukocytosis,
leucopenia, leukemia and lymphoma
6. Describe the clinical presentation and pathophysiology of and note the
treatment and prognoses of the major forms of acute and chronic
leukemia
7. Define and describe the etiology of lymphomas: Hodgkin’s disease, NonHodgkin’s Lymphoma, Burkitts Lymphoma; and Multiple Myeloma
8. Describe the medical considerations, dental management and treatment
modifications for patients with anemias and white blood cell disorders
9. Describe the oral manifestations of anemias and white blood cell disorders
Cancer
1.
2.
3.
4.
5.
6.
50 min.
Define, state the etiology and prevention of and describe the
pathophysiology and complications of cancer
Describe the clinical presentation of cancer including staging
Summarize the occurrence, types and medical treatments used for various
types of cancer
List and describe the major types of cancer that occur orally
Describe the dental management of oral cancer patients
Describe the general and oral considerations and complications of
radiation and chemotherapy and describe the management of each
Neurologic Disorders
50 min.
1. Define and describe the pathophysiology and complications of epilepsy
2. Describe the clinical presentation ( including oral manifestations of the
disease and treatment) of epilepsy
3. Summarize the medical and pharmacologic management of epilepsy
4. Describe the dental management of an epileptic patient
5. Define, state the etiology of and describe the pathophysiology of
cerebrovascular accident
6. Differentiate between a TIA, a RIND, a stroke in evolution and a
completed stroke
7. Differentiate between right and left sided brain damage according to signs
and symptoms
8. Summarize the medical management both immediately and long term
9. Describe the dental management of and treatment modifications for a
CVA patient
Behavioral and Pcychiatric Disorders
50 min.
1. Define, state the etiology of and list examples of: : anxiety disorders,
mood disorders, somatoform disorders, factitious disorders, substance
abuse disorders and eating disorders
2.
3.
4.
5.
6.
7.
Describe the clinical presentation and medical and pharmacologic
management of : anxiety disorders, mood disorders, somatoform
disorders, factitious disorders, substance abuse disorders and eating
disorders
Define, state the etiology , clinical presentation and medical and
pharmacologic management of schizophrenia
Define, state the etiology of, describe the clinical presentation of and
medical and pharmacologic management of cognitive disorders
List and describe the medical action, side effects and interactions with
other drugs of the major classifications of psychiatric drugs
Describe the dental management and treatment modifications of patients
with psychiatric, drug abuse, eating and cognitive disorders
List and describe any oral manifestations or complications of psychiatric,
drug abuse, eating and cognitive disorders
Rheumatologic and Connective Tissue Disorders
50 min.
1. Define and describe the etiology and pathophysiology and complications
of arthritis
2. Describe the clinical presentation of arthritis
3. Summarize the medical and pharmacologic management of arthritis
4. Describe the oral manifestations and considerations of arthritic patients
5. Describe the dental management of and treatment modifications for
arthritic patients
6. Define, state etiology and describe the pathophysiology, complications,
medical and pharmacologic management and dental management of lime
disease
7. Define, state etiology and describe the pathophysiology, complications,
medical and pharmacologic management and dental management of
Sjogren’s Syndrome.
Organ and Bone Marrow Transplantation
50 min.
1. Define and differentiate between the types of transplants in terms of
histocompatibility
2. List the typical indications for transplantations
3. Summarize the medical management of pre, surgical and post
transplantation
4. List and describe the effects and symptoms of overdose of drugs used for
transplant patients and note which drugs should be avoided or minimized
in post-transplant patients of specific organs
5. List and describe complications of pre and post transplant patients and
their management
6. Describe oral manifestations and complications found in transplant
patients and how best to prevent or manage them
Case Studies
4 - 60 min. sessions
1. Develop a patient profile for a scenario of a patient with an assigned
condition or disease. The profile will include clinical presentation, medical
and pharmacologic management, oral manifestations, and medical
considerations.
2. Develop a dental hygiene treatment plan for this patient based on
moderate periodontal disease including any necessary modifications.
3. Present a summary of the case to the class.
DHYG 4034
Dental Management of the Medically Compromised Patient
Fall 2016 Schedule
Date
Assignment/Topic
8/25
Th
Introduction, L: Ch.1 Interrelationships of Medicine and Dentistry
W: pp. 739-741
L:Ch.2 Infective Endocarditis and Related Conditions
W: Ch. 66; pp 1007-1012
9/1
Th
L:Ch. 3 Hypertension
W: Ch. 66; pp. 1012-1014
L:Ch. 4 Ischemic Heart Disease
W: Ch. 66; pp. 1014-1017
L:Ch. 5 Cardiac Arrhythmias
W: Ch. 66; pp.1045-1048
9/8
Th
L:Ch. 6 Heart Failure
W: Ch. 66; pp. 1017-1023
L:Ch.7 Pulmonary Disease
W: Ch. 65 p.1016-1030
Review
9/15
Th Exam I
L:Ch. 14 Diabetes
W: Ch. 68 The Patient with Diabetes Mellitus
L:Ch. 12 Chronic Kidney Disease and Dialysis
9/22
Th
Ch. 10 Liver Disease
W: The Patient with a Substance-Related Disorder p.971
L:Ch. 11 Gastrointestinal Disease
L:Ch. 17 Pregnancy and Breast-Feeding
W: Ch. 48 The Pregnant Patient
9/29
Th
L:Ch. 15 Adrenal Insufficiency
L:Ch. 16 Thyroid Disease
W: pp 785-787
10/6
Th
Exam II
L:Ch. 13 Sexually Transmitted Diseases
L:Ch. 18 AIDS and Related Conditions
Date
10/13
Th
Assignment/Topic
L:Ch. 19 Allergy
L: Ch 22 Disorders of Red Blood Cells
L: Ch. 23 Disorders of White Blood Cells
W: Ch. 67 The Patient with a Blood Disorder
10/20
Th
Fall Holiday
10/27
Th
L: Ch. 24 Acquired Bleeding and Hypercoagulable Disorders
L: Ch. 25 Congenital Bleeding and Hypercoagulable Disorders
W: pp. 1036-1039
11/3
Th Exam III
L:Ch. 20 Rheumatologic and Connective Tissue Disorders
W: Arthritis & Scleroderma p. 902-906
L:Ch 21 Organ and Bone Marrow Transplantation
W: pp.840-842, 844
11/10
Th
L:Ch. 26 Cancer
W: Ch. 55 The Patient with Cancer
L: Ch. 27 Neurologic Disorders
W: Ch. 62 The Patient with a Seizure Disorder
Ch. 58 CVA 886-892
11/17
Th
L:Ch. 28, 29, 30 Behavioral and Psychiatric Disorders
W: Ch 60, 63, 64 The Patient with a Psychiatric Disorder
11/24
Th
THANKSGIVING HOLIDAY
12/1
Th
Exam IV
Review for Final
Friday
Dec. 9
10:00 11:50a.m.
Final Examination
The class schedule may be changed during the semester due to unexpected
situations.
Students will be notified as soon as possible of any changes.