Dental Nursing Surgical Risk Calculator

Question: Describe about the Dental Nursing for Surgical Risk Calculator. Answer: Introduction: Dental nursing requires a complete knowledge about teeth and various associated parts; disease involved and their care. A vast knowledge about the treatment and medication is required by a professional to handle patient. So the following report contains a broad perspective of dental nursing and its various applications and activities: Organisational and legal requirements: A dental nurse must be well accustomed to the various styles of practices of the dentists and physicians besides maintaining a curriculum of activities. The General Dental Council or GDC of professional dental support a complete documentation about an individual patient including the description of the issues, entire information about the duration of his treatment, health care record and medications provided. The nurses should also maintain the record of the continuous revival of the patient, evaluate his problem and maintain the quality of the care that should be provided. A detailed documental record should be maintained. A professional needs to entirely follow NHS policies for safe nursing. The information about the patients is very confidential and should be strictly maintained under Data Protection Act. Nurses should maintain such confidentiality and should only discuss the issues only when the duty demands so or as required due to relevant law or legislation (Pierce 2014). Importance of informed consent: The patient should be completely informed about the pros and cons of the treatment to be followed and should be given entire privilege to decide for himself. It is only after the patient's consent that the treatment or test would be conducted ( Bilimoria et al. 2013). There is a legal angle behind this. Under certain conditions, the patient might complain of being misled. This might simply arise from a miscommunication between either of the stakeholders. Under such case, the patient might file complaints indicating that the entire situation arose because of treachery from the nurses side which may charge the nurse for physical assault and would be punishable. So detailed discussion should be conducted, and everything should be clarified before the patient gives consent. Hence obtaining consent after a detailed discussion is necessary. Policy and procedure of handling complaint: A nurse who is handling the complaint section must try to resolve the problem of the patient at the hospital level only and should not try to linger it too long. This would result in the patient to seek for bigger governing bodies like Parliamentary and Health Service Ombudsman, Citizens Advice Bureau, etc. that would demean the image of hospitals. The policy of the complaint should be followed thoroughly and discussed with the patient. The complaints should be managed according to national frameworks, and the discussion should be clear and less defensive (Young 2016). The entire process should be easy, well publicized and transparent. It should have a rapid but easy procedure and should be followed by the authority for their betterment. Methods of oral health assessment: A Mouth mirror is the most common instrument that is used by dental professional to assess the inside view of the mouth. It might be flat, concave or round shaped with or without the light that helps to visualize those parts, which are difficult to view. Besides, it also helps to retract the tongue or the cheek muscles to complete a complex surgery or any other procedures. Dental explorers are probes, which are used by professionals to view over the surface of teeth for considering any decays there or behind previous fillings or other restorative works. Probes are also used during surgery of root canal and help in viewing any cracks on the ceiling of the pulp portion. Periodontal probes help in measuring the distance between teeth and gums. Fiber optic illuminations are extensively used because professionals find it easier to find more enamel as well as dentinal lesions. It can be used in other caries diagnosis as well. Radiographic Assessment like the use of Orthopantogram is a kind of X-ray that helps in scanning the jaws. They observe anatomical structures such as bony structures, air shadows, soft tissue parts as well as the walls and floor of maxillary antrum. Maxilla and temporal bones are also observed for any abnormality. Various study models help in assessing the oral health of a population when dental examination becomes expensive, unworkable and time-consuming. It involves a step by step approach that involves large scale consensus building a program for dental professionals and practitioners. It involves identification of stakeholders, planning a program with self-assessment, collecting primary and secondary data and evaluating the assessment after collection of the data. Types of chart used in oral health assessment: BPE is Basic Periodontal Examination which is a tool that is not used directly in diagnosing but is required to determine the level of importance required. A casual guidance can then be provided. Full periodontal charting ponders over the overall dental health and gives guidelines to maintain a natural set of teeth. It involves the location of gingival margin as well as furcating or mobility (WHO 2013). The other parameter includes clinical attachment loss or CAL. It then recommends care based on this diagnosis. FDI or Federation Dentaire International charting is an internationally accepted charting that gives information about the position of a particular tooth. Here the chart gives the view of a dentist where the dentists left points the patients right. Importance of taking dental images Radiographs: Dental X-rays become important because visual examination may not provide the professionals with the root of origin of the problems. If after the tests, one does not find any cavities or growth issues then the individual may be sure of the situation (Corea et al. 2014). Photographs: Dental photographs have various uses which include the abnormalities of the mouth cavity that helps the physician with the treatment. It also helps in teaching the students as well as the patients of the various complications, forming case studies and making documentations on them. Materials used in oral health assessment: Alginate is an elastic and hydrocolloid material, which is irreversible and provides an impression. They are of immense use in dental care because they form sports mouth guard, indirect restorations, various models in orthodontics and bleaching trays. Silicone has more or less similar function and activity like alginate. This material used in dental impressions is costlier than the previous (Joiner et al. 2014). The elastomer is also a synthetic compound used extensively in providing impressions for dental treatment. It includes polysulphide and polyether. Methods of measuring pulp vitality, its advantage and disadvantage: The pulp vitality testing helps in diagnosing the condition of the dental pulp after a critical surgery. The two old method even used extensively is the thermal method and electric pulp testing. These tests depend on the innervations levels. So it does not provide a correct result. Nowadays researchers are working on them extensively. To determine the condition of pulpal circulation, these tests are conducted (Katatoka et al. 2016) Modern technologies like oximetries are developed to give a better insight of the pulpal depths that would help further in the pulp vitality testing. Morphology and anatomy of structure of primary and second dentition: Primary dentition: The crowns are short, constricted with thin enamel and dentine. The roots are narrow, longer and more slender. The pulps are relatively longer. The mandibular incisors are central and flat. Maxillary incisor is the only tooth that has a greater width in comparison. Maxillary first molar is unique. Secondary maxillary molar is similar to permanent counterpart but smaller (Brand et al. 2013). Mandibular first molar has four cusps. Mandibular second molar resembles the permanent counterpart. Canines are long and sharp. Secondary Dentition: The secondary dentition consists of about 32 teeth with four incisors, two canines, two premolars and three molars in each jaw. Usually the last molars of each jaw are normally not present and may eject later in age giving a painful feeling. It consists of a normal crown, root, and pulp structure with the supporting tissues and muscles. Structure and function of periodontium: The periodontium is a special set of tissues, which are mainly responsible for holding the teeth in its position in the mandibular and the maxillary zones. It has four important parts such as the gum (gingiva), cementum (covering of tooth), alveolar bone and periodontal ligament (Goncalves et al. 2015). Each of them has a distinct location, structure, and function that help them to adapt to the surrounding for a lifetime. Gum is mainly responsible for holding the teeth in its place firmly. It is strongly attached to the underlying bone and prevents any shock to deeper tissues. Cementum is a calcified material that covers the root and binds the teeth with the alveolar bone with the help of periodontal ligament. The alveolar bone consists of the sockets where the teeth remain attached. The periodontal ligament is the connecting medium between the cementum and the alveolar bone. Location and function of salivary gland and muscles of mastication: Salivary gland: The largest salivary gland called the parotid gland is situated anterior to the temporal bone and posterior to the mandible. They are responsible for secretion of saliva and production of salivary amylase that helps breaking down of starch (Raz et al. 2013). The other pair is the submandibular glands, which is present below the lower jaws and helps in producing the maximum amount of saliva. The pair of sublingual glands are present beneath the tongue and produces saliva. Muscles of mastication: Primary muscles include masseter, temporal, lateral Pterygoid and medial Pterygoid. Accessory muscles include digastrics, stylohyoid and mylohyoid and geniohyoid. Infrahyoid muscles involve sternohyoid, thyrohyoid and omohyoid. All of them help in mastication processes by their movement. Structure of maxilla and mandible: Maxilla: The upper jaw bone is called the maxilla.it is made up of two maxillary bone joined at the intermaxillary suture. It includes the palate of the mouth. Mandible: Mandible is the lower jaw, which is immovable (Lindhe et al. 2013). The bone is formed at the mandibular symphysis, which is a ridge present more or less in the midline of the anterior part. Movement of the temporomandibular joint: The temporomandibular joint contains three surface articulation the head of the mandible, the articular tubercle, and mandibular fossa. They remain separated by articular disc. Fibrocartilage covers the articular disk. The extracapsular ligaments help in the stabilisation of the joints (Reddy et al. 2014). The lateral pterygoid muscle guides protrusion. Geniohyoid and digastrics muscles maintain retraction. The lower part helps in opening and closing the mouth permitted by elevation and depression. Nerve and blood supply to teeth: The maxillary artery arises from the carotid artery and supplies blood to the maxilla and mandibular teeth. The teeth, bone, and periodontium receives sensory innervations from both the left and right trigeminal nerves. Medical conditions affecting oral tissues: Oral cancer occurs mainly occurs above age 40 mainly in mouth, salivary gland, tonsils or back of the throat. People suffering from diabetes might have periodontal disease, gum inflammation, oral candidiasis because of high level of glucose in blood. HIV results in cavities or dry mouth. STD causes sores inside mouth. Anorexia results in osteoporosis resulting in weakening of jaw bones (Neville et al. 2015). Bulimia results in stomach acids that erode tooth enamel, tooth erosion, and sensitivity. Besides hepatitis, leukoplakia, mental illness, xerostomia may lead to various abnormalities in tooth condition. Effects of aging on oral tissues: Periodontitis is present by 70% in people above 60 to 70 years. Factors involve unhealthy social, behavioral, economic practices. Loss of periodontal assessment along with biomolecular changes in the associated cells mainly results from aging. Alteration of endocrine secretion and differentiation of osteoblasts or osteoclasts are the main reasons. Medical conditions guiding treatment planning: A toothache and swelling and pus around teeth require quick attendance. Stained teeth require whitening Where the doctor uses whitening agent and a special light. It might also be bleached. Cavities in teeth need sealing by professionals. In case of chipped teeth, the nurse will bind a strong resin kind of substance to teeth and if pulp is affected root canal is done by dentists. Cracks in teeth may be treated with sealing, a root canal or may be pulled out depending upon the extent of the crack. Commonness of oral diseases: Prevention: Brushing twice a day after meal and regularly visiting dentists is the primary step towards prevention. One should floss daily and change the toothbrush after every three months. Fluoride treatments are of immense help. One should lead a healthy lifestyle to avoid problems (Bourgeois et al. 2015). Various disease is having side effects on teeth should be treated immediately. Diagnosis of oral disease; Professionals should immediately diagnose any abnormality in the teeth, gum or any parts of the mouth before the conditions worsen and surgery is required. Various diseases have different treatment that is discussed by doctors after thorough examinations (Regezi et al. 2013). These might include root canal, /bleaching, Scaling or uprooting the tooth or simple medication. Management of oral disease: Oral diseases may be controlled and managed by proper diagnosis and treatment. Instructions of professional, if followed properly will protect the teeth from further damage and better condition can be sustained. Main classes of drugs and uses: Analgesics: Ibuprofen, acetaminophen, aspirin, corticosteroids, codeine and hydrocodone helps in relieving pain and redness from mouth. Fever can be treated as well. Anesthetics: 2% lidocaine hydrochloride and 2% mepivacaine are examples of anesthetics that can be used to reduce pain from pain-sensing nerves and help during surgery. Antibiotics: Penicillin and amoxicillin are used for different infections. Clindamycin helps in treatment of harmful bacteria in serious cases (Kozma et al. 2016) Antifungal, antiseptics and benzodiazepines are used in this field as well. Storing of drugs in dental setting: Dental medicines should be differentiated and stocked separately into solid preparation and liquid preparation. This reduces the risk of choosing the wrong ones (Lden et al. 2013). Stock control and order should be verified. Oral medicines which follow non oral route administration must be kept separately. Function of respiratory and circulatory system: Respiratory system helps in production of energy by the breakdown of glucose in the cells after carrying oxygen to the cells through complex biological reactions. Circulatory system: The blood circulatory system and the lymphatic system mainly helps in circulation. Blood carries deoxygenated blood from different parts of the body to heart and oxygenated blood from heart to different parts of body (Kolettas et al. 2014). Changes leading to medical emergency: Shortness of breath requires a quick medical emergency. Chronic Obstructive Pulmonary Disease, Bronchitis, and Emphysema require treatment. Myocardial infarction, cardiac necrosis, chest discomfort and pain requires immediate attention and treatment Pulmonary Embolism is also dangerous. Signs and Symptoms of medical emergencies: Difficulty in breathing, speaking, feeling of weakness, dizziness and fainting, chest or upper abdominal pain, shortness of breath and asthma, severe pain, uncontrollable bleeding, vomiting and diarrhea all result in immediate medical emergencies. Response to medical emergency: Professionals in case of handling medical emergency follow a three steps procedure. It includes prevention, preparation, and action. The professional should have a quick glimpse of the history of the patient with immediate observation with the exact symptoms he is facing (Visser et al. 2014). After the thorough analysis if one can handle the situation alone, then he must immediately plan up the process of treatment and start immediate medical treatment. Otherwise, he should consult with colleagues and take necessary steps. 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