Asthma Background Information
Asthma is described as “a chronic inflammatory respiratory disease characterized by an increased responsiveness of the bronchial airways to various stimuli” (Darby & Walsh, 2010)
Mock Case Study: David
Demographics
Race: White
Gender: Male
Age: 30
Height: 5 ft 11 in
Home: San Francisco
Physical Assessment
Patient presents with slight signs of breathlessness
Mental Assessment
Patient appears to be happy
Social Assessment
Patient lives with roommates
Works 3 jobs
Travels around city by means of public transportation
Medical Assessment
Patient states he has had asthma since he was 13
Patient reports smoking 2-3 cigarettes a day
Dental Assessment
Patient discloses that he has not been to the dentist in 3 years
All wisdom teeth have been extracted
#3 MOD
#4 DO
#13 DO
#14MO
#30 O
Suspicious areas on #10, #15 and #18
Localized supragingival calculus on lingual surface of mandibular anteriors
Extra Oral Exam
2mm x 2mm scab on left side of nose, patient reports scraping nose 2 days ago
Nodes are non palpable
Muscles are smooth
TMJ-clicking on right side, asymptomatic
Intra Oral Exam
Marginal redness on lingual surface of mandibular posteriors
Maxillary anterior papillae are bulbous
Consistency of attached gingival is soft and spongy
General texture is smooth
Xerostomia
David’s Appointment
Communication
Me: “What triggers your asthma?”
David: “ Dog dander, pollen and dust.”
Me: “Is there a particular season that your asthma flares us or is it year round?”
David: “It is year round but gets worse in spring time.”
Me: “Is your asthma bothering you now? Any tightness in your chest?”
David: “No, nothing unusual.“
Me: “Do you take any medications to help control your asthma?”
David: “I regularly receive allergy shots, about twice a month, and I have an inhaler that I carry with me.”
Me: “How often do you have to use your inhaler?”
David: “Less than 3 times a week.”
Me: “Have you every been hospitalized from an asthma attack?”
David: “Yes, when I was 17.”
Me: “Do you know what caused the attack?”
David: “It was a windy day and I was outside running around.”
Me: "How long were you hospitalized?"
David: "About a day and a half."
Me: “Do you have any concerns about your appointment today? Any anxiety about the dental office?”
David: “Nope.”
Me: “Great. Could you get your inhaler? I would like to check the expiration date and keep it out on the counter for the duration of your appointment for your safety.
David hands me his inhaler. The prescription is up to date. It is kept on the counter, within reach for the remainder of the appointment.
Appointment Planning
David’s appointment is in the late afternoon, after he gets off work
The appointment is kept short
Client Positioning
David is placed in a supine position that is comfortable for him
Dental Hygiene Procedures
Avoid extra aerosols by not using ultrasonic and/or air polishing
David states that he does not know what type of local anesthesia has been used for his previous work, so if needed, we will use 3% carbocaine without epinephrine
Safety Precautions
Inhaler is placed on counter within reach
Patient is not left alone
Aerosols are limited
Precaution for sensitivity to sodium preservatives
Patient Recommendations
Prescribed fluoride
David is instructed to rinse his mouth with water after the use of his inhaler
David demonstrates his brushing technique, it is modified so that he is positioning the bristles into the sulcus-he adapted to this technique well
David likes to chew gum to help with his smoker’s breath and I recommended gum with Xylitol, like Trident
David is counseled for smoking cessation and we will discuss his progress at his next visit
Personal Reflection
I chose to make a mock case study about asthma because it is common in my family. My brother and I were both diagnosed with asthma when we were younger, but his has always been much more severe than mine. When I was little, I was confused why my brother had to take many medications and I did not, or why he would have to use a nebulizer and I was never required to used one...it just never made sense to me. After learning more information about the disease, I now understand the different types of asthma and why some cases can be more severe, like my brothers, and others more mild, like my own.
Additional Information
Learn more about asthma at the American Lung Association
This short video demonstrates how to use an inhaler
*Pictures from Google Images
Asthma is described as “a chronic inflammatory respiratory disease characterized by an increased responsiveness of the bronchial airways to various stimuli” (Darby & Walsh, 2010)
Mock Case Study: David
Demographics
Race: White
Gender: Male
Age: 30
Height: 5 ft 11 in
Home: San Francisco
Physical Assessment
Patient presents with slight signs of breathlessness
Mental Assessment
Patient appears to be happy
Social Assessment
Patient lives with roommates
Works 3 jobs
Travels around city by means of public transportation
Medical Assessment
Patient states he has had asthma since he was 13
Patient reports smoking 2-3 cigarettes a day
Dental Assessment
Patient discloses that he has not been to the dentist in 3 years
All wisdom teeth have been extracted
#3 MOD
#4 DO
#13 DO
#14MO
#30 O
Suspicious areas on #10, #15 and #18
Localized supragingival calculus on lingual surface of mandibular anteriors
Extra Oral Exam
2mm x 2mm scab on left side of nose, patient reports scraping nose 2 days ago
Nodes are non palpable
Muscles are smooth
TMJ-clicking on right side, asymptomatic
Intra Oral Exam
Marginal redness on lingual surface of mandibular posteriors
Maxillary anterior papillae are bulbous
Consistency of attached gingival is soft and spongy
General texture is smooth
Xerostomia
David’s Appointment
Communication
Me: “What triggers your asthma?”
David: “ Dog dander, pollen and dust.”
Me: “Is there a particular season that your asthma flares us or is it year round?”
David: “It is year round but gets worse in spring time.”
Me: “Is your asthma bothering you now? Any tightness in your chest?”
David: “No, nothing unusual.“
Me: “Do you take any medications to help control your asthma?”
David: “I regularly receive allergy shots, about twice a month, and I have an inhaler that I carry with me.”
Me: “How often do you have to use your inhaler?”
David: “Less than 3 times a week.”
Me: “Have you every been hospitalized from an asthma attack?”
David: “Yes, when I was 17.”
Me: “Do you know what caused the attack?”
David: “It was a windy day and I was outside running around.”
Me: "How long were you hospitalized?"
David: "About a day and a half."
Me: “Do you have any concerns about your appointment today? Any anxiety about the dental office?”
David: “Nope.”
Me: “Great. Could you get your inhaler? I would like to check the expiration date and keep it out on the counter for the duration of your appointment for your safety.
David hands me his inhaler. The prescription is up to date. It is kept on the counter, within reach for the remainder of the appointment.
Appointment Planning
David’s appointment is in the late afternoon, after he gets off work
The appointment is kept short
Client Positioning
David is placed in a supine position that is comfortable for him
Dental Hygiene Procedures
Avoid extra aerosols by not using ultrasonic and/or air polishing
David states that he does not know what type of local anesthesia has been used for his previous work, so if needed, we will use 3% carbocaine without epinephrine
Safety Precautions
Inhaler is placed on counter within reach
Patient is not left alone
Aerosols are limited
Precaution for sensitivity to sodium preservatives
Patient Recommendations
Prescribed fluoride
David is instructed to rinse his mouth with water after the use of his inhaler
David demonstrates his brushing technique, it is modified so that he is positioning the bristles into the sulcus-he adapted to this technique well
David likes to chew gum to help with his smoker’s breath and I recommended gum with Xylitol, like Trident
David is counseled for smoking cessation and we will discuss his progress at his next visit
Personal Reflection
I chose to make a mock case study about asthma because it is common in my family. My brother and I were both diagnosed with asthma when we were younger, but his has always been much more severe than mine. When I was little, I was confused why my brother had to take many medications and I did not, or why he would have to use a nebulizer and I was never required to used one...it just never made sense to me. After learning more information about the disease, I now understand the different types of asthma and why some cases can be more severe, like my brothers, and others more mild, like my own.
Additional Information
Learn more about asthma at the American Lung Association
This short video demonstrates how to use an inhaler
*Pictures from Google Images