Patients With Respiratory Diseases
Jana, Samantha, and Courtney
Respiratory System
Upper Respiratory Diseases
• Most common disorders are caused by
infections or allergic reactions that result in
inflammation.
• Modes of Transmissions
– Inhalation of airborne droplets
– Contamination from hands or soiled mask with
discharge from the nose or throat.
Upper Respiratory Diseases
• Acute
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Rhinitis(common cold)
Sinusitis
Pharyngitis/tonsillitis
Influenza(flu)
• Seasonal
• viral
• Chronic
– Allergic rhinitis (hay
fever)
Dental Hygiene Care
• Disease Prevention
– Healthcare professionals need to stay up to date on
immunizations
– Prevent the transmission of pathogens from patient to
clinician.
• Appointment Management
– Delay treatment until the patient is no longer infectious
• Bacterial Resistance to Antibiotics
– Bacteria can become resistant to antibiotics within 14 days
Lower Respiratory Diseases
• Acute
– Acute Bronchitis
– Pneumonia
• Chronic
– Tuberculosis
– Asthma
– Chronic Obstructive
Pulmonary Disease
(COPD)
• Chronic Bronchitis
• Emphysema
– Cystic Fibrosis
Acute Bronchitis
• Acute Bronchitis
– Involves trachea and bronchi
– Symptoms: cough with or without phlegm, may
last up to three weeks
Pneumonia
• An infection and inflammations in the lungs caused by
viruses, bacteria, fungi, mycoplasma, or parasites.
• Etiology
– Viral and bacterial
– Fungal
• Categories
– Community- Acquired Pneumonia
• Person-to-person
– Healthcare- Associated Pneumonia
• Main cause of death in hospitalized patients
• Bacteria from the periodontal pocket can cause an infection in the
lungs when aspirated by saliva.
Dental Hygiene Care
• Control oral diseases and periodontal diseases
especially in patients in nursing homes and
hospitals.
Tuberculosis
• Etiology
• Tr
Asthma
• Chronic respiratory disease
• Recurrent episodes of:
– Dyspnea
– Coughing
– Wheezing
• All leading to bronchial inflammation and
muscle constriction.
Etiology
• Extrinsic (Allergic)
– Most common
– Inflammatory response
triggered by: dust,
pollen, tobacco, smoke,
mold, dust mites, or
animal dander.
– Allergic reactions leads
to activation of airway
epithelial mast cells
• Intrinsic (Non-Allergic)
– Triggers: emotional
stress, gastroesophageal
reflux disease (GERD)
– Triggers can be
unidentified
– Usually seen in adults
Etiology Continue
• Drug or Food-Induced
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Aspirin
NSAIDS
Beta-Blockers
Foods: nuts, shellfish, milk, and strawberries
Tartrazine (yellow food dye).
Metabisulfite preservative in food: wine, beer, shrimp, dried fruit
Metabisulfite preservative in drugs: local anesthetic with epinephrine
• Excerise- Induced
– Vigorous physical activity
– Thermal changes cold air can provoke mucosal irritation and airway
hyperactivity
• Infection-Induced
– Lung infections caused by viruses, bacteria, or fungal may provoke
asthmatic symptoms.
Signs and Symptoms
• Chest tightness, sense of
suffocation
• Ineffectiveness of
bronchodilator to relieve
dyspnea
• Wheezing, coughing
• Flushed appearance, sweating
• Confusion due to lack of
oxygen
• Dilated pupils
• Inability to complete a
sentence in one breath
• Tachypnea
• Tachycardia
• Emergency Care
– Recognize signs and symptoms
– Stop dental hygiene treatment
– Rule out foreign body
obstruction
– Use patients inhaler
– Administer oxygen
– Injection or inhalation of
epinephrine
– Monitor vital signs
– Call EMS
Oral Manifestations
• Beta-2 agonist inhalers
– Causes a decrease in salivary flow and dental
biofilm pH.
• Increase in (GERD) when using a beta-2
agonist and theophylline, can cause enamel
erosion.
• Oral candidiasis can occur with high dosage
use of frequency of inhaled corticosteroids.
Dental Hygiene Care
• Before treatment
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Remind patient to bring their inhaler
Review medical dental history
Evaluate symptoms
Review medications
Schedule morning appointments
Have a inhaler and oxygen on hand
Medical consultation if patient has unstable or severe
acute asthma
– Stress free environment
Dental Hygiene Care
• During treatment
– Prevent triggering a hypersenstive airway
– Use local anesthetic without sulfites
• After treatment
– Home care instructions the patient to rinse the
mouth water after using their inhaler.
Chronic Obstructive Pulmonary
Disease (COPD)
• COPD is used to describe pulmonary disorders
that obstruct air flow.
• Two of the most common diseases are chronic
Bronchitis and Emphysema.
• Etiology
– Inhaling tobacco smoke with occupational and
environmental pollutants as contributing factors
Chronic Bronchitis
• Etiology
– Excessive respiratory tract
mucus production
sufficient to cause a cough
with expectoration for at
least 3 months of the year
for 2 or more years.
– Obstruction caused by
narrowing of small airways,
increased sputum, and
mucus plugging.
– Difficulty breathing present
on inspiration and
expiration.
• Signs and Symptoms
– Chronic cough
– Copious sputum
– Chest radiographs
abnormalities
– Sedentary, overweight,
cyanotic, edematous,
breathless, leading to the
term “blue bloater”
Emphysema
• Etiology
– Emphysema is a
distension of the air
spaces distal to terminal
bronchioles due to
destruction of alveolar
walls.
– Smoke injures alveolar
epithelium destroying
alveolar walls and
creating large air spaces.
• Signs and Symptoms
– Difficulty breathing only
on expiration
– Dry cough
– Enlarged chest walls
– Weight loss
– Chest radiograph
abnormalities
– Purse lips to forcibly
expel air, leading to the
term “pink puffer”
Oral Manifestations
• Similar to asthma patients
• Patients who use tobacco have the risk of:
– Oral cancer
– Nicotine stomatitis
– Halitosis
– Periodontal infections
– Extrinsic tooth stain
Dental Hygiene Care
• Before Treatment
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Precautions are needed when concurrent cardiovascular disease is present.
Assess severity of COPD
Treament can be done on stable patients with adequate breathing
Identify patients who may experience exacerbation of symptoms under
emotional stress.
– Monitor vitals
– Short appointments
– Supine position
• During Treatment
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Use antimicrobial preprocedural rinse
Avoid using a power driving scaler and air polisher
Local anesthesia without epinephrine
Nitrous oxide-oxygen sedation: avoid with severe COPD and emphysema
Patient Education
• Encourage patients to stop smoking
• Promote oral care and oral health knowledge
in prevention and treatment of COPD.
• Discuss the link between periodontitis and
COPD
• Schedule frequent periodontal and
maintenance visits.