Summary
Samenvatting mondzorgplan
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De lessen die in powerpoint vorm werden gegeven, zijn in dit werk tot een overzichtelijke en gestructureerde samenvatting gebracht. MET casussen en meerkeuzevragen
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By: bellarosamesdary • 8 months ago
By: tatianaraimundo02 • 1 year ago
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MONDZORGPLAN1. Inleiding
2. MZP 1: Gegevensverzameling
3. MZP 2: Analyse
4. MZP 3: Casussen (mondzorgplan en implementatie + verslaggeving)
Bonamie Laurence 1
,Inhoud
1 Inleiding .....................................................................................................................................................................................4
1.1 Individueel ..........................................................................................................................................................................4
1.2 Holistisch ............................................................................................................................................................................4
1.3 Patiëntgericht .....................................................................................................................................................................4
1.4 Mondzorgplan, wat nog? ...................................................................................................................................................5
2 MZP 1: Gegevensverzameling ..................................................................................................................................................5
2.1 Administratieve gegevens .................................................................................................................................................5
2.2 Medische anamnese ..........................................................................................................................................................5
2.2.1 Nieuwe of bestaande patiënt ..................................................................................................................................5
2.2.2 Gemodificeerde ASA ................................................................................................................................................6
2.2.3 Noodzaak van medische anamnese ........................................................................................................................6
2.2.4 Medicatie ................................................................................................................................................................10
2.2.5 Speeksel ..................................................................................................................................................................10
2.2.6 Invloed orale bacteriën op algemene gezondheid ...............................................................................................11
2.2.7 Onderzoek en eliminatie van odontogene infectiehaarden ................................................................................11
2.2.8 AB profylaxe ...........................................................................................................................................................11
2.3 Intakegesprek ...................................................................................................................................................................12
2.4 Klinisch onderzoek ...........................................................................................................................................................12
2.4.1 Extra-oraal onderzoek............................................................................................................................................12
2.4.2 Intra-oraal onderzoek ............................................................................................................................................13
2.4.3 Intra-oraal: status praesens ...................................................................................................................................14
2.4.4 Intra-oraal: specifiek dentaal .................................................................................................................................15
2.4.5 Intra-oraal: specifiek parodontaal .........................................................................................................................23
2.4.6 Intra-oraal: specifiek tand- en kaakstand .............................................................................................................31
2.5 Aanvullende onderzoeken en gegevens .........................................................................................................................36
2.5.1 RX ............................................................................................................................................................................36
2.5.2 Mondhygiëne routine/middelen ...........................................................................................................................37
2.5.3 Gevoeligheidstesten: vitaliteitstesten, percussietest ...........................................................................................37
2.5.4 Voedingsdagboek ...................................................................................................................................................37
2.5.5 Mondgewoonten....................................................................................................................................................37
3 Analyse ....................................................................................................................................................................................38
3.1 Gegevensanalyse..............................................................................................................................................................38
3.2 Tandheelkundige behandelingen ....................................................................................................................................38
3.3 Behandelnoodzaak...........................................................................................................................................................38
3.4 Cariës, curatief versus preventief ....................................................................................................................................39
3.5 Cariës management tools ................................................................................................................................................39
3.6 Erosie beoordeling ...........................................................................................................................................................40
3.6.1 BEWE-index (Basic Erosive Wear) .........................................................................................................................40
3.6.2 Cumulative BEWE scores and management guidelines .......................................................................................40
3.6.3 Toekomst ................................................................................................................................................................40
3.7 Gingivitis risicoprofiel.......................................................................................................................................................41
3.8 Parodontitis risicoprofiel .................................................................................................................................................41
3.9 Orthodontie risicoprofiel .................................................................................................................................................42
Bonamie Laurence 2
,4 Fluoride....................................................................................................................................................................................42
4.1 Internet’weetjes’ over fluoride .......................................................................................................................................42
4.2 Neveneffecten van fluoride .............................................................................................................................................42
4.3 Tandpasta’s zonder fluoride ............................................................................................................................................43
4.4 Historiek ...........................................................................................................................................................................43
4.5 Herhaling tandenwissel....................................................................................................................................................44
4.6 Fluorose ............................................................................................................................................................................45
4.7 Fluoridetabletjes ..............................................................................................................................................................46
4.8 Enkele waarden ................................................................................................................................................................47
4.9 Fluoroserisico bij ons .......................................................................................................................................................47
4.10 Duraphat 5000 ppm tandpasta ..................................................................................................................................48
5 Preventieve adviezen ..............................................................................................................................................................48
5.1 Basis en specifieke preventieadviezen ............................................................................................................................48
5.1.1 Basis preventieaandachtspunten ..........................................................................................................................49
5.1.2 Specifieke preventieadviezen en ‘bijsturing’ basispreventie ...............................................................................51
5.2 Rookstop ...........................................................................................................................................................................52
6 Casussen ..................................................................................................................................................................................53
6.1 Casussen A ........................................................................................................................................................................53
6.2 Casus 1 Lien ......................................................................................................................................................................57
6.3 Casus 2 Arthur ..................................................................................................................................................................58
6.4 Casussen B ........................................................................................................................................................................59
6.5 Casus 3 Bram ....................................................................................................................................................................62
6.6 Casus 4 Caroline ...............................................................................................................................................................63
6.7 Casus 5 Albert ...................................................................................................................................................................64
6.8 Casussen C ........................................................................................................................................................................65
6.9 Casus 6 John ....................................................................................................................................................................69
6.10 Casus 7 Willem ............................................................................................................................................................70
6.11 Casus 8 Sarah...............................................................................................................................................................71
6.12 Casussen D...................................................................................................................................................................72
6.13 Casus 9 Marie ..............................................................................................................................................................75
6.14 Casus 10 Staf ...............................................................................................................................................................76
7 Woordenlijst............................................................................................................................................................................77
Bonamie Laurence 3
, 1 Inleiding
Doel van mondzorgplan = mondzorgtraject om een gezond mondmilieu te verkrijgen, te handhaven en te bevorderen
• Individueel
• Holistisch
• Patiëntgericht
1.1 Individueel
Er zijn verschillende personen en verschillende settings.
Verschillende personen
• Persoonlijkheid, leeftijd
• Zorgvraag, verwachtingen en wensen
• Dentale en medische voorgeschiedenis
• Huidige gebits- gezondheidssituatie
• Mondhygiëne
• Eet- en drinkgewoontes
• Sociaal economische status of achtergrond (kinderen) => respecteer achtergrond van patiënt (financiële situatie,
migratieachtergrond, …)
Verschillende settings
• Algemene tandheelkunde
• Praktijken voor parodontologie, orthodontie
• Verzorging van chronische zieken of kwetsbare ouderen
• Verpleeg- en verzorgingstehuizen
• Woonzorgcentra
• Gehandicaptenzorg
• …
Nadruk zal ander liggen afhankelijk van de setting
1.2 Holistisch
Totaliteit van de persoon:
• Mentaal
• Fysisch
• Emotioneel
• Sociaal
• Spiritueel
• Omgevingsfactoren
• …
1.3 Patiëntgericht
Patiënt staat centraal.
Wordt actief betrokken in de besluitvorming
Keuzes worden gerespecteerd
Draagt medeverantwoordelijkheid voor zijn eigen zorgtraject
Wij zijn niet verantwoordelijk voor wat patiënt wel of niet doet
Informed consent
= geïnformeerde toestemming = patiënt heeft recht op informatie over gezondheidstoestand en voorgestelde behandeling.
Voordelen, alternatieven, mogelijke risico’s worden besproken en de patiënt krijgt de mogelijkheid om vragen te stellen. De
behandeling kan pas starten na toestemming van de patiënt. Indien hij weigert, moet dit gerespecteerd worden.
POWER PATIENT = patiënt en arts moeten samen een juiste behandeling zoeken. De arts kent zijn vak het best. De patiënt
kent zijn lichaam het best.
Voordelen Hoe?
+ Betere behandelresultaten • Mondhygiënist en patiënt zijn een team
+ Minder neveneffecten • Betrek patiënt actief bij de diagnose
+ Grotere gezondheidswinst • Geef uitleg bij de verschillende opties
+ Betere diagnostiek • Kom tot een gemeenschappelijke ‘oplossing’
+ Vermijden van tunnelvisie
+ Minder angst, dus betere therapietrouw => betere
opvolging van adviezen
Bonamie Laurence 4
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