Learning Objectives:

Abstract:

Most odontogenic infections are polymicrobial. The number of isolated strains ranges from 1 to 10 with an average number of approximately 4 isolates per infection.  Ultimately, facultative gram-positive and gram-negative cocci and bacilli; and anaerobic gram-positive and gram-negative cocci and bacilli predominate in all types of odontogenic infections. Most odontogenic infections can be resolved satisfactorily through debridement (primary dental care). When antibacterial chemotherapy is indicated, the drug of choice should be either the most effective drug against the infective pathogens or the least toxic alternative among several available agents.

Outline:

1. Introduction
2. Microbiology of odontogenic infections
3. Pharmacology of antibacterial agents 
4. Therapeutic considerations
   1. Primary line of treatment
   2. Secondary line of treatment
   3. Tertiary line of treatment
   4. Antibacterial prophylaxis
5. Adverse drug events
6. Conclusion

Learning Objectives:

1. List the most common medical emergencies occurring in the dental environment
2. List the 5 components of physical evaluation of dental patients
3. List the 4 vital signs
4. Describe the A.S.A. physical status classification system
5. Provide examples of ASA 1, 2, 3, and 4 medical problems
6. List the 8 components of the Stress Reduction Protocol
7. Define the goal of physical evaluation

Abstract:

Medical emergencies can, and do, happen in the dental environment. Approximately 75% of these can be prevented through physical evaluation of the prospective dental patient, using a systematic review of the patient’s medical history and recording of vital signs. Assigning an ASA Physical Status can help to distinguish those patients who represent greater-than-usual risk during the planned dental treatment. The Stress-Reduction Protocol can then be utilized to minimize this risk.

Outline:

1. Medical emergencies in dentistry
   1. What happens?
   2. When do they happen?
   3. Can they be prevented?
2. Prevention of medical emergencies
   1. Medical History Questionnaire
   2. Dialogue History
   3. Physical evaluation
      1. Vital signs
         1. Blood pressure
         2. Heart rate & rhythm
         3. Respiratory rate
         4. Height
         5. Weight & BMI
         6. Body temperature
   4. Risk Status Classification
      1. American Society of Anesthesiologists Physical Status
   5. Classification System
   6. Stress-reduction protocols

JULY2019

Learning Objectives:

1. Define the legal obligation of a doctor to the victim of a medical emergency
2. List the 4 components of preparation of the office for medical emergencies
3. Describe the victim who is "clinically dead."
4. Describe the difference between "clinical" and "biological" death
5. List and describe the steps in the AHA 2010 cardiac arrest algorithm
6. List and describe the steps in the algorithm for all medical emergencies
7. Explain why survival rates from sudden cardiac arrest are significantly lower in young children than in adults
8. Describe the functions of each member of the In-Office Emergency Team
9. List the 7 drugs in the bare-bones-basic emergency drug kit

Abstract:

Not all medical emergency situations can be prevented. In this section we discuss the preparation of the dental office & staff to (1) prevent, (2) recognize and (3) efficiently manage those medical emergencies that might arise. The importance of basic life support; development of an in-office emergency response team; (3) activation of emergency medical services; and (4) a basic emergency drug kit & equipment will be discussed.

Outline:

Not all medical emergency situations can be prevented. In this section we discuss the preparation of the dental office & staff to (1) prevent, (2) recognize and (3) efficiently manage those medical emergencies that might arise. The importance of basic life support; development of an in-office emergency response team; (3) activation of emergency medical services; and (4) a basic emergency drug kit & equipment will be discussed.

JULY2019

Learning Objectives:

Abstract:

The most common complaint causing a person to seek the services of an oral health care provider is pain. Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage. Proper management of pain requires an understand¬ing of its complexity, an appreciation for the factors that determine its expression in the clinical setting, the implementation of disease-modifying procedures (primary dental care) and sound pharmacological strategies (analgesia) in the postoperative period.

Outline:

1. Introduction
2. Physiology of pain
3. Activation of acute pain pathways
4. Intrinsic modulation of nociception
5. Role of the higher CNS in pain
6. Pharmacology of analgesics
7. Therapeutic considerations
8. NSAIDs
9. Acetaminophen
10. Opioid agonists
11. Adverse drug events
12. Conclusion

JULY2019

Learning Objectives:

Abstract:

In this section the basic management of all medical emergencies is introduced. The algorithm is P-C-A-B-D – Positioning – Circulation – Airway – Breathing – Definitive Care. Each of these steps is described for (1) the conscious patient and (2) the unconscious patient.

Outline:

1. Introduction
   1. Legal obligation of healthcare provider in medical emergency
2. Recognition & diagnosis of emergency situation
   1. By patient
      1. Angina pectoris
      2. Bronchospasm (asthma)
   2. By doctor or dental staff
      1. Diagnosis based on response – or lack of – to emergency treatment
         1. Syncope
         2. Cardiac arrest
         3. Hypoglycemia
   3. Through recognition of presenting signs & symptoms 
3. The basic emergency management algorithm: P – C – A – B – D
   1. P = Positioning of victim
      1. Conscious
      2. Unconscious
   2. C = Circulation
      1. Conscious
      2. Unconscious
   3. A = Airway
      1. Conscious
      2. Unconscious
   4. B = Breathing
      1. Conscious
      2. Unconscious
   5. D = Definitive care
      1. Diagnosis
      2. Drugs
      3. Defibrillation

JULY2019