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Abstract
On any given day a patient seen by the dental hygienist has the potential of experiencing a life-threatening medical emergency. All dental hygiene practitioners should be aware of potential risks that a patient may present, take steps to prevent life-threatening events from occurring, and plan for problems in advance of their happening. The primary goal of this course is to help dental hygienists carry out the ethical, moral, legal, and professional obligation owed any patient. The course will review the basics of medical emergencies, with particular emphasis on those that are most likely to occur in the dental office. Discussion will center on general aspects of prevention and preparation, and will focus on the recognition and emergency treatment of specific conditions. Vasodepressor syncope, orthostatic hypotension, acute adrenal insufficiency, hyperventilation, asthma, heart failure and acute pulmonary edema, cerebrovascular accident seizures, hyperglycemia, hypoglycemia, myocardial infarction, angina pectoris, and anaphylaxis will be emphasized.
... Stattdessen sollte der Patient auf eventuelle Verletzungen, Wunden oder Zahnfrakturen untersucht werden, ein Arzt oder der Notarzt sollten zwischenzeitlich gerufen werden. [59,111,119,148,168] 9. dieser Risikofaktoren auszuschalten oder zu reduzieren, erreicht werden. Die Behandlung der Apoplexie gliedert sich in 3 Teile. ...
... Falls bei diesen Patienten eine akute Infektion auftritt, sollte jedoch der behandelnde Arzt hinzugezogen werden. [119,140,148,168,179] Eine sowie die Überweisung zum Internisten eine wichtige Aufgabe des Zahnarztes. Erst danach sollte mit der zahnärztlichen Behandlung angefangen werden. ...
... Auch die oralen Komplikationen wie verspäteter Zahndurchbruch, Okklusionsstörungen, Makroglossie, und verzögerte Skelettentwicklung können bei rechtzeitiger Diagnose und Therapie verhindert werden. [119,140,148,168,179] An Kretinismus leidende Kinder können verdickte Lippen, eine vergrößerte Zunge und eine Dentitio tarda mit resultierenden Okklusionsstörungen aufweisen. Die einzige spezifische orale Veränderung, welche bei Erwachsenen auftritt, ist die Makroglossie. ...
In the course of his professional work the dentist is increasingly confronted with patients who present with numerous medical risk factors because of the rising age pyramid in the general population. In an overview study, based on most recent publications, the common basic diseases, their treatment, the medications used for this purpose, and the major conclusions drawn from such experience for dental treatment are investigated and presented in a comprehensive way. Based on guidelines worked out on the basis of this information, the purpose of the study is to enable the dentist to confidently handle patients at risk. When faced with threatening situations, the dentist should be able to undertake the right actions, based on well-founded and accurate medical knowledge.
... A transient ischemic attack (TIA) has similar symptoms as stroke, but the symptoms last less than eight hours, sometimes only 15-60 minutes (28). The major risk factors for ischemic stroke are hypertension, diabetes, smoking, hypercholesterolemia and atrial fibrillation. ...
... Sudden unilateral weakness and numbness or paralysis of the face, arm or leg are primary symptoms of stroke (28). The patient may have difficulties of formulating words or to understand talk. ...
... This might complicate an appropriate periodontal care of patients with severe general diseases like HF, LVAD and HTx. This could be additionally negatively influenced by the increased risk for complications of these patients during dental therapy [11,19,29,30], which might result in uncertainty of the dentist and thus in waiver of invasive (periodontal) therapy. This gap in periodontal treatment substantiates the demand of special care programs by specialized dentists with an interdisciplinary approach as demanded in literature [8,13,18]. ...
Background:
To assess whether the standardized recommendation of patients with heart failure (HF), left-ventricular assist device (LVAD) and heart transplantation (HTx) to visit their dentist leads to improved oral conditions after 12 months.
Methods:
Patients from the Department of Cardiothoracic Surgery, Leipzig Heart Centre, Germany were examined at baseline and after 12 months. A dental (decayed-, missing-, and filled-teeth index (DMF-T)) and periodontal examination (periodontal probing depth, clinical attachment loss) was performed. At baseline, patients received a standardized recommendation to visit their dentist. At follow-up, a standardized questionnaire regarding the dental consultation was applied.
Results:
Eighty-eight participants (HTx: 31, LVAD: 43, HF: 14) were included. The majority of patients (79.5%) followed the recommendation to visit their dentist. Within the total cohort, periodontal treatment need was significantly reduced from 91% (baseline) to 75% (follow-up; p < 0.01). Only 10% of total cohort stated that they received periodontal treatment. The outcome in periodontal and dental treatment need at follow-up appointment revealed no statistically significant associations to the questionnaire regarding dentist consultation (p > 0.05). Conclusions: The simple recommendation to visit the dentist appears not enough to obtain sufficient dental and periodontal conditions in patients with severe heart diseases. Thereby, a lack in periodontal treatment of patients with HF, HTx and LVAD was identified, making interdisciplinary dental special care programs recommendable.
... [12] The role of dental hygienists in mass accidents has been described especially in the United States. [11,[13][14][15] The aim of the survey was to assess the prevalence of medical emergencies in dental hygienists' practice in Poland and to determine the hygienists' attitudes toward medical emergencies in dental offices. ...
Dental hygienists in Poland work in various settings, including public health care institutions, private dental practices, dental clinics, kindergartens, and schools. They can often face medical emergencies, whose rate is increasing owing to comorbidities and aging of dental patients’ populations. The aim of the study was to assess the prevalence of medical emergencies in dental hygienists’ practice in Poland and the hygienists’ preparedness and attitudes toward emergencies.
A 10-question authors’ own questionnaire was filled in by 613 dental hygienist. It referred to their cardiopulmonary resuscitation training, availability of emergency medical equipment in the workplace, the prevalence of medical emergencies including the need for an emergency medical service (EMS) call, and the management of cardiac arrest.
Overall, 613 dental hygienists working in Poland participated in the study; 38.99% had taken part in basic life support (BLS) training within the previous 12 months and 35.89% within 2 to 5 years; 15.17% had experienced at least 1 emergency situation requiring an EMS call within the previous 12 months. Vasovagal syncope was the most common medical emergency (15.97%), followed by moderate anaphylactic reaction (13.87%), seizures (8.81%), hyperventilation crisis (7.50%), and hypoglycemia (7.34%).
The most common medical emergency in dental hygienists’ practice in Poland is syncope followed by mild anaphylactic reaction. Most of the dental hygienist had participated in a BLS course within the previous 5 years; however, 20% of them have never participated since graduation. Dental hygienists should participate in BLS courses every 2 years to keep the cardiopulmonary resuscitation skills and stay up-to-date with current guidelines. An important part of the study participants declare the lack of availability in their workplaces of life-saving equipment, including self-expanding bag resuscitator, oropharyngeal, and supraglottic airway device and oxygen source. Medical emergency equipment as recommended in the international guidelines should be available in every practice.
Introduction: Medical emergencies during dental treatment are likely to occur. The ability of a dentist to manage medical emergencies requires sufficient knowledge and information. The purpose of this study was to survey the level of knowledge of the undergraduate dental students of Isfahan University of Medical Sciences on medical emergencies. Materials & Methods: In the cross-sectional study in 2019, 60 senior dental students at the University of Medical Sciences of Isfahan were evaluated. A questionnaire was used for data collection with confirmed validity and reliability. Data was analyzed with correlation coefficients and independent t-test with level of significance at 0.05. Results: Participants' overall knowledge scores were 7.53 ± 2.58 out of 12. There wasn’t a significant difference between the knowledge of male and female students (p value = 0.72). Also this study revealed a relative relationship between students' medical emergencies score and their knowledge on emergencies (p value < 0.001, r = 0.48). Conclusion: The knowledge status of senior dental students on medical emergencies was not desirable. It is recommended that more educational content like theoretical classes and practical workshops should be considered for dental students.
Introduction: Fear from dental work and other medical problems in dental patients can cause medical emergencies in dental office. Managing these emergencies depends on dentist’s knowledge and their access to needed equipments. This study was performed to determine the knowledge of dentists about medical emergencies, and available equipments in Isfahan's dental offices. Methods:In this descriptive study performed in 2005, 150 dentists were selected by systematic random sampling. They were asked in person, using a valid and reliable questionnaire containing 10 multiple choice questions about medical emergencies, a list of 8 emergency medications and 5 emergency equipments. Data was analyzed by SPSS software using mean, frequency,and t-test. Results:From 139 dentists who completed the questionnaires, 74.8% were male and the rest were females. The mean score of their knowledge was 5.42 out of 10 and no significant difference was observed between male and female. The mean of available drugs was 5.28 from 8 drugs and the mean of available emergency equipments was 0.74 from 5 equipments. Conclusion: The Dentists’ knowledge was at an average level and they had little access to emergency drugs and equipments. So, the correct management of medical emergencies in dental offices is difficult
Background and purpose: Most of medical emergencies occurring in dental offices could be life – threatening. So, a dentist must have appropriate knowledge for recognizing and management of these emergencies. The aim of this study was to investigate the knowledge of dentists and senior dental students on the management of medical emergencies in dental offices.
Materials and methods: This analytic cross-sectional research was carried out in Sari among 114 dentists and senior dental students in 2016. A validated questionnaire consisting of 20 questions was administered. The questionnaire included demographic information and also 17 questions about knowledge (scores 14-17: excellent, 11-14: good, 8-11: moderate, and less than 8: poor). Data was analyzed using descriptive and analytical tests in SPSS V20 and a significance level of 0.05 was considered.
Results: The levels of knowledge of participants were found to be poor in 16.7%, moderate in 69.3%, good in 13.2%, and excellent in 1%. There was no significant differences in levels of knowledge between dentists and dental students (P = 0.430) and also between men and women (P= 0.630).
Conclusion: Insufficient levels of knowledge in dentists and senior dental students in Sari on diagnosis and management of dental emergencies call for interventions such as workshops and training programs.
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