104 Exam 3 (ch 19, 20, 28)

6 Sources for adult motivation

1. Social relationships: Changing behavior to meet people or improve social activities. 2. External expectations: Desire to please someone in authority. 3. Social welfare: Desire to improve society. 4. Personal advancement: Improvement on the job or achievement of a personal goal. 5. Escape stimulation: Avoidance of boredom. 6. Cognitive interest: Learning for the sake of learning.

Second-hand smoke exposes the non-smoker to more chemicals than the smoker. How much worse are these chemicals? 100 fold 125 fold 25 fold 50 fold

100 fold

In regards to smoking/nicotine, when is the most difficult withdrawal time?

2-5 days

How long does the nicotine remain your system?

20-30 mins

Autism stats

3-4/1000 babies have autism. 1 in 110 children diagnosed with autism or other ASD Associated with sleep disorders

What is the success rate of individuals attempting to quit smoking on their own And with medications?

3-5% 30% with meds

What percentage of the children with cerebral palsy have epilepsy? 5% 10% 20% 30%

30%

How long does it take to feel the 1st signs of withdrawal from nicotine/smoking?

4 hours

What percentage of persons with Down syndrome have mitral valve prolapse? 20% 30% 40% 50%

40%

How many toxins and carcinogens can be found in cigarette smoke? 6000 toxins and 40+ carcinogens 8000 toxins and 60+ carcinogens 4000 toxins and 60+ carcinogens 8000 toxins and 40+ carcinogens

4000 toxins and 60+ carcinogens

How long does it take for smoking to effect the brain and release chemicals? What chemicals?

7 seconds Dopamine, seratonine

Smoked tobacco and alcohol use account for approximately _____% of oral cancers each year in the US.

70

The theory of reasoned action is more effective with which of the following? An individual A small group setting A collective community None of the above

A collective community

Stressor

A source of disturbance that upsets a sense of equilibrium. Produces tension, which then has an effect on the individual (becomes sick).

Oligodontia

Absence of one or several teeth.

Which of the following is not considered a symptom associated with nicotine withdrawal? Irritability Restlessness Headache All may be associated with withdrawal

All may be associated with withdrawal

What are common signs and cues indicating a person might have autism? Distant or aloof appearance Lack of response to verbal or social cues Easily frustrated All of the above

All of the above

Which are products that assist patients with nicotine withdrawal? Gum Patches Medications All of the above

All of the above

5 A's model for treating tobacco use and dependence

Ask - do you currently use tobacco? have you ever? Advise - to quit Assess - Are you willing to quit now? Have you recently quit? Any challenges? Assist - Tx, intervention, relapse prevention, encourage continued abstience. Arrange - follow up for those who are quitting (letter, card, call, appt)

What is the first thing you should do prior to sharing information with a patient? Provide background Ask permission Remove personal protective mask Remind patient that you are the authority

Ask permission

Tobacco Dependence Intervention should always include which two of the 5 A's? Ask, Assess Assess, Advise Ask, Advise Advise, Assist

Ask, Advise

Behavioral beliefs

Attitudes held by the individual alone. Based on relative risks, benefits, and possible outcomes.

Which developmental disability impairs communication, and social, behavioral, and intellectual functioning? Down syndrome Mental retardation Autism Cerebral palsy

Autism

Transtheoretical Model

Based on an individual's readiness to adopt a new health behavior. Foundation of MI. 6 stages: -Precontemplation (little, or no interest in changing behavior) -Contemplation (considering making a change within the next 6 months) -Preparation (actively makes plans to change) -Action (change has been adopted) -Maintenance (change has been continuous for at least 6 months) -Termination (change is permanent)

Which habit is harder to break? Behavioral/social dependence to nicotine, or chemical dependence to nicotine?

Behavioral/social

What are referred to as a "poor man's" cigarette and are small hand rolled cigarettes imported from India or Southeast Asia? Hookas Flavored cigarettes Kreteks Bidis

Bidis

An increase in damaging oral habits such as bruxism, biting of ones' lips, and pica may also be found in patients with autism. These habits may be considered a self-coping mechanism, exploration, or one of many repetitive behaviors seen in individuals with autism. Both statements are true. Both statements are false. First statement is true, second statement is false. First statement is false, second statement is true.

Both statements are true.

Smokers have greater probing depths, gingival recession, loss of attachment, and bone loss than non-smokers. Cigarette smoking is a potential contributing factor in necrotizing ulcerative gingivitis. Both statements are true. Both statements are false. First statement is true, second statement is false. First statement is false, second statement is true.

Both statements are true.

In which population is periodontal disease and caries widespread? Down syndrome Cerebral palsy Autism Mental retardation

Cerebral palsy

What is defined as a non-progressive, neuromuscular disorder caused by damage to the immature brain? Down syndrome Cerebral palsy Multiple sclerosis Parkinson's disease

Cerebral palsy

Which of thhe following is true about patient behavior? Changing behavior can be difficult. Patients will always make the best choices. Education is guaranteed to help an individual make good choices

Changing behavior can be difficult.

Fagerstrom Test for Nicotine Dependence (FTND)

Consists of 6 basic questions on smoking behavior and has been widely used to assess the level of dependence. 1. How soon after you wake up do you smoke your first cigarette? (5 mins, 6-30 mins, after 60 mins) 2. How many cigarettes per day do you smoke? (10 or less, 11-20, 21-30, 31 or more) A person who smokes within 30 mins of waking, and/or smokes 21 or more cigarettes per day is considered highly dependent.

Generalized Resistance Resources (GRR)

Coping skill. Help avoid/manage daily stressors. Avoiding danger for good health.

Locus of Control

Deals with perception of personal control over those elements and pertinent health issues. Internal LOC - People think their personal actions determine health status. External LOC - People perceive others as being in control of health decisions and health status (ex. God, fate, chance, luck)

Salutogenesis

Defines health in terms of a continuum of ease to disease and the conditions surrounding the individual that provide coping resources. -Continuum of ease to disease- "dis-ease"

Autism

Describes a number of neuro developmental disorders commonly known as pervasive developmental disorders, which begin before the age of 3 and last throughout a person's lifetime. Affects communication, social/behavioral, and intellectual functioning. Causes/correlations: highly intelligent parents, valproic acid and thalidomide taken during pregnancy. Parents with autism or those with one autistic child are more likely to have other children with it.

Persons with this developmental disability have variable tooth morphology and short roots. Down syndrome Cerebral palsy Autism Mental retardation

Down syndrome

Snuff

Finely ground tobacco sold in 3 forms: moist (fine or long cut), packets or sachets, and dry. Placed in vestibule.

One can of snuff equals approximately what? Two packs of cigarettes Three packs of cigarettes Four packs of cigarettes Five packs of cigarettes

Four packs of cigarettes

Normative beliefs

Held by other people who influence the individual. Beliefs you're raised on - Milk example. Peer pressure is a huge part of this model. Community expectation - more influential to individual

Water pipes

Hookahs, narghile, shisha, or arghile. Originates in Africa and Asia. Becoming popular among college students in US. Contains bowl in which fermented tobacco and flavorings are burned with the use of charcoal. Smoke bubbles through water and is breathed via tubes.

Kreteks, or Clove cigarettes

Imported from Indonesia and contain a mix of tobacco, cloves, and other additives.

Social Learning Theory

Individuals do not learn or change behavior in a linear fashion. They are bidirectionally; environment, information, and behavior all affect one another.

A cognitive disability characterized by a below average intelligence quotient test in addition to limitations in activities of daily living is known as Developmental disability Chromosomal disorder Intellectual disability Pica

Intellectual disability

Side stream smoke

Involuntary, exposure to tobacco smoke, environmental tobacco smoke, or second hand smoke. 100x higher exposure.

Vicarious Learning

Learning through modeled behavior. Allows patient to develop expectations based on others' experiences. Learns poor outcomes without actually experiencing them.

Chew tobacco

Loose leaves, in a twist of tobacco leaves, or in a block of tobacco. Cuts off chunk or "plug" and usually placed in vestibule.

What are the top 3 causes of death due to smoking?

Lung cancer Chronic obstructive pulmonary disease (COPD) Ischemic heart disease.

Pica

Medical disorder characterized by an appetite for substances not fit as food or of no nutritional value.

Sense of Coherence

Method of seeing the world and one's place in it.Focus: How can I be health? NOT how to manage disease.

What focuses on the patients' readiness to learn and change, and helps engage patients to motivate them to progress along the stages of the model? Motivation Motivational interviewing Personal opinion Values

Motivational interviewing

Perseveration

Occurs when a person uncontrollably repeats a particular response, such as a word, phrase, gesture, or movement despite the absence or cessation of a stimulus.

Motivational Interviewing

Patient-centered counseling that helps the patient resolve conflicts and ambivalence. Behavior changes are encouraged by having patient set personal goals.

Health Belief Model

Places high value on the attitudes of the learner and recognized the importance of the learner's readiness to enact meaningful behavior change. (Staged theory) Downside = unpredictable

What is the BEST preventive measure a dental provider can use for a patient with a developmental disability? Regular maintenance visits Sealants Electric toothbrushes Fluoride

Regular maintenance visits

Which of the following is a key point in learning? Relevance Self-efficacy Determination Stressors

Relevance

PHS's 5 R's

Relevance - Tailor specific health info (perio disease, stain, leukoplakia) to patient's health status Risks - Explore whether the patient knows and understands the health risks associated with tobacco use. Rewards - Have the patient identify the benefits of quitting: improved health, better tasting food, saving money, fresher breath, and better smelling clothing and hair. Roadblocks - Have the patient identify possible barriers to quitting: withdrawal symptoms, fear of failure, depression, weight gain, lack of support, and loss of friends. Repetition - Use of the 5 R's and MI techniques each time a tobacco user receives dental Tx - keep intervention short and focused. Actively listen to patient; reflect his/her feelings, frustrations, and goals back to the patient. Allow the patient to choose a realistic quit plan that will work for him/her. Avoid "educating" patient. Stress benefits of quitting.

Which is NOT a source of motivation? Social welfare External expectations Social relationships Religious beliefs

Religious beliefs

What closely examines the role of stressors and tensions as contributing factors for health and disease? Salutogenesis model Generalized resistance resources Sense of coherence Stressor

Salutogenesis model

Social Cognitive Theory

Self-efficacy, main construct of SCT, is the belief that one's personal actions will have an impact on outcome.

Which involves a method of seeing the world and one's place in it? Sense of coherence Sense of self Sensory learning None of the above

Sense of coherence

Main stream smoke

Smoked tobacco inhaled by the consumer.

Approximately 75% of periodontitis cases are attributed to _________.

Smoked tobacco.

Because smoking alters the body's ability to mount a host response; how does periodontal inflammation present itself in a smoker? Smooth tissue with minimal bleeding Red, swollen gingival margins, with profuse bleeding Tight and firm margins with pyramidal papilla Smooth tissue with profuse bleeding

Smooth tissue with minimal bleeding

Smokeless tobacco specific leukoplakia is called Spit Sack Snuff Dipper's Pouch Chew Cancer Smokeless Leukoplakia

Snuff Dipper's Pouch

What theory states that changes take place bidirectional; environment, information, and behavior all affect one another? Locus of control Sense of coherence Social Learning Theory Theory of Reasoned Action

Social Learning Theory

Theory of Reasoned Action

Stresses importance of attitudes and intentions to change a behavior. Most important determinant of behavior is intention. 2 cognitive processes: -belief about what significant others think is important -personal motivation to comply with those significant people. Most effective in communities.

Dose response

The number of cigarettes plus the umber of years smoked. Often an indicator for the level of periodontal destruction.

What is the primary cause of preventable death and disease in the US? Approximately how many premature deaths per year are attributed to this?

Tobacco use. 443,000

First line medications are approved for tobacco cessation but second line medications for tobacco cessation are not FDA approved for that use. True or False?

True

The clinician will increase the likelihood of engaging patients if he/she clearly demonstrates respect for patients and recognizes they are autonomous individuals. True False

True