QUESTIONS

AND ANSWERS FOR TUTORIAL/SEMINAR

1. If you have a patient who states on their medical history that they have a heart murmur, what will you do?
Ask the patient further on what type of heart murmur they haveinnocent or abnormal (caused by anatomical problem of heart), when do the murmurs usually happen or do they take any medications when experiencing one.

2. If the patient needs antibiotic premedication what will the doctor prescribe?
The doctor will usually recommend a penicillin antibiotic, Amoxicillin. Patient is to consume medication one hour before dental procedure. (If unable to take orally: Ampicillin 1hr before procedure, Allergy to penicillin: Clindamycin 1hr before procedure, Unable to take orally and allergic to penicillin: Clindamycin 30min before procedure)

3. Why do we prescribe medication for this condition?

When a dental procedure is performed on a child, some oral bacteria may get into the bloodstream and travel throughout the body. If there is an abnormal area inside the heart, such as an abnormal opening or a damaged heart valve, these bacteria can attach themselves to these areas, multiply, and cause an infection in the heart lining and muscle, called Subacute Bacterial Endocarditis (SBE).

4. What is the possible consequence of treating a patient without the needed premedication?
Patient may get infected with SBE by bacteriemia.

5. Why else might a patient need premedication before dental treatment?

Patients who have a history of bacterial endocarditis/ congenital heart defect/ heart valve replacement/transplant/ artificial joints. The artificial joint has plenty of free space inside of it that contains interstitial fluid. If bacteria travel into this space, it will be a long distance for the white blood cells to travel, fight and eat without oxygen and then eliminate the bacteria.

QUESTIONS AND ANSWERS FOR TUTORIAL/SEMINAR

6. What are some reasons for referring a patient to a physician? To a specialist?

Full medical evaluation and requests for any additional medical information (on status of disease) to assist dental personnel in managing the patient when he undergoes dental treatment.