Adult/Caregiver Handouts
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Health History
Health History Patient Name ___________________________________________ Date of Birth _______________ Reason for visit ____________________________________________________________________________________________ Past Medical History Have you ever had the following? (Mark all that apply) ☐ Alcoholism ☐ Cancer ☐ Endocarditis ☐ MRSA/VRE ☐ Allergies ☐ Cardiac Arrest ☐ Gallbladder disease ☐ Myocardial infarction ☐ Anemia ☐ Cardiac dysrhythmias ☐ GERD ☐ Osteoarthritis ☐ Angina ☐ Cardiac valvular disease ☐ Hemoglobinopathy ☐ Osteoporosis ☐ Anxiety ☐ Cerebrovascular accident ☐ Hepatitis C ☐ Peptic ulcer disease ☐ Arthritis ☐ COPD ☐ HIV/AIDS ☐ Psychosis ☐ Asthma ☐ Coronary artery disease ☐ Hyperlipidemia ☐ Pulmonary fibrosis ☐ Atrial fibrillation ☐ Crohn’s disease ☐ Hypertension ☐ Radiation ☐ Benign prostatic hypertrophy ☐ Dementia ☐ Inflammatory bowel disease ☐ Renal disease ☐ Bleeding disorder ☐ Depression ☐ Liver disease ☐ Seizure disorder ☐ Blood clots ☐ Diabetes ☐ Malignant hyperthermia ☐ Sleep apnea ☐ Blood transfusion ☐ DVT ☐ Migraine headaches ☐ Thyroid disease Previous Hospitalizations/Surgeries/Serious Illnesses Have you ever had the following? (Mark all that apply and specify dates) Date Date Date Date ☐ AICD Insertion ☐ Cyst/lipoma removal ☐ Pacemaker ☐ Mastectomy ☐ Angioplasty ☐ ESWL ☐ Pilonidal cyst removal ☐ Myomectomy ☐ Angio w/ stent ☐ Gender reassignment ☐ Small bowel resection ☐ Penile implant ☐ Appendectomy ☐ Hemorrhoidectomy ☐ Thyroidectomy ☐ Prostate biopsy ☐ Arthroscopy knee ☐ Hernia surgery ☐ TIF ☐ TAH/BSO ☐ Bariatric surgery -
Guideline # 18 ORAL HEALTH
Guideline # 18 ORAL HEALTH RATIONALE Dental caries, commonly referred to as “tooth decay” or “cavities,” is the most prevalent chronic health problem of children in California, and the largest single unmet health need afflicting children in the United States. A 2006 statewide oral health needs assessment of California kindergarten and third grade children conducted by the Dental Health Foundation (now called the Center for Oral Health) found that 54 percent of kindergartners and 71 percent of third graders had experienced dental caries, and that 28 percent and 29 percent, respectively, had untreated caries. Dental caries can affect children’s growth, lead to malocclusion, exacerbate certain systemic diseases, and result in significant pain and potentially life-threatening infections. Caries can impact a child’s speech development, learning ability (attention deficit due to pain), school attendance, social development, and self-esteem as well.1 Multiple studies have consistently shown that children with low socioeconomic status (SES) are at increased risk for dental caries.2,3,4 Child Health Disability and Prevention (CHDP) Program children are classified as low socioeconomic status and are likely at high risk for caries. With regular professional dental care and daily homecare, most oral disease is preventable. Almost one-half of the low-income population does not obtain regular dental care at least annually.5 California children covered by Medicaid (Medi-Cal), ages 1-20, rank 41 out of all 50 states and the District of Columbia in receiving any preventive dental service in FY2011.6 Dental examinations, oral prophylaxis, professional topical fluoride applications, and restorative treatment can help maintain oral health. -
Nutrition Intake History
NUTRITION INTAKE HISTORY Date Patient Information Patient Address Apt. Age Sex: M F City State Zip Home # Work # Ext. Birthdate Cell Phone # Patient SS# E-Mail Single Married Separated Divorced Widowed Best time and place to reach you IN CASE OF EMERGENCY, CONTACT Name Relationship Home Phone Work Phone Ext. Whom may we thank for referring you? Work Information Occupation Phone Ext. Company Address Spouse Information Name SS# Birthdate Occupation Employer I verify that all information within these pages is true and accurate. _____________________________________ _________________________________________ _____________________ Patient's Signature Patient's Name - Please print Date Health History Height Weight Number of Children Are you recovering from a cold or flu? Are you pregnant? Reason for office visit: Date started: Date of last physical exam Practitioner name & contact Laboratory procedures performed (e.g., stool analysis, blood and urine chemistries, hair analysis, saliva, bone density): Outcome What types of therapy have you tried for this problem(s)? Diet modification Medical Vitamins/minerals Herbs Homeopathy Chiropractic Acupunture Conventional drugs Physical therapy Other List current health problems for which you are being treated: Current medications (prescription and/or over-the-counter): Major hospitalizations, surgeries, injuries. Please list all procedures, complications (if any) and dates: Year Surgery, illness, injury Outcome Circle the level of stress you are experiencing on a scale of 1 to 10 (1 being the lowest): -
Tooth Decay Information
ToothMasters Information on Tooth Decay Definition: Tooth decay is the destruction of the enamel (outer surface) of a tooth. Tooth decay is also known as dental cavities or dental caries. Decay is caused by bacteria that collect on tooth enamel. The bacteria live in a sticky, white film called plaque (pronounced PLAK). Bacteria obtain their food from sugar and starch in a person's diet. When they eat those foods, the bacteria create an acid that attacks tooth enamel and causes decay. Tooth decay is the second most common health problem after the common cold (see common cold entry). By some estimates, more than 90 percent of people in the United States have at least one cavity; about 75 percent of people get their first cavity by the age of five. Description: Anyone can get tooth decay. However, children and the elderly are the two groups at highest risk. Other high-risk groups include people who eat a lot of starch and sugary foods; people who live in areas without fluoridated water (water with fluoride added to it); and people who already have other tooth problems. Tooth decay is also often a problem in young babies. If a baby is given a bottle containing a sweet liquid before going to bed, or if parents soak the baby's pacifier in sugar, honey, or another sweet substance, bacteria may grow on the baby's teeth and cause tooth decay. Causes: Tooth decay occurs when three factors are present: bacteria, sugar, and a weak tooth surface. The sugar often comes from sweet foods such as sugar or honey. -
Msnewsletter 201809 E.Pdf
SEPTEMBER 2018 Volume 24, Issue 3 HEALTHY A newsletter for the members of Central California Alliance for Health YOU AND YOUR HEALTH are important to us. Please call us at 1-800- 700-3874 (TTY: 1-800- 735-2929 or 7-1-1) if you have questions, need help or have concerns about your care as an Alliance member. We’re here to help! Service with a smile! Have you ever wondered who is on the ● Answer questions about your ● Send you a new Alliance ID card if other end of the phone when you call benefits you lose yours Member Services? ● Explain how you can get medical ● Assist you with concerns or Our representatives are caring, care and services complaints dedicated professionals. They are here ● Let you know which doctors and We have representatives in Santa to answer your calls Monday through clinics you can go to Cruz, Monterey and Merced counties. Friday from 8 a.m. to 5:30 p.m. ● Help you choose or change your They live and work in the communities Our representatives are ready to: Primary Care Provider we serve. What they have in common ● Help you understand how your ● Offer interpreter services if you do is that they care about our members health plan works not speak English, Spanish or Hmong and are here to help. Important notice Member Services will not be available on the following dates and times due to companywide or departmental meetings: ● November 7, all day Permit No. 1186 No. Permit ● CA Merced, December 13, from 10:45 a.m. -
Oral Health Toolkit for Athletes
EASTMAN DENTAL INSTITUTE CENTRE FOR ORAL HEALTH AND PERFORMANCE wwwwwww Oral Health Toolkit for Athletes 1 Contents Introduction ..................................................................................................................................... 3 How to use the toolkit ..................................................................................................................... 4 Oral health drills .............................................................................................................................. 5 Preventing dental decay ................................................................................................................. 6 Preventing gum disease ................................................................................................................. 7 Preventing dental erosion ............................................................................................................... 8 Preventing problems with wisdom teeth ......................................................................................... 9 Additional preventative methods .................................................................................................. 10 Dental check-ups .......................................................................................................................... 11 Common dental diseases ............................................................................................................. 12 References ................................................................................................................................... -
Asthma, Allergic Rhinitis, and Tooth Decay
EARN This course was written for dentists, 3 CE dental hygienists, CREDITS and dental assistants. Dreamstime.com | Kaspars Grinvalds © Asthma, allergic rhinitis, and tooth decay A peer-reviewed continuing education course written by Erinne Kennedy, DMD, MMSc, MPH PUBLICATION DATE: DECEMBER 2020 EXPIRATION DATE: NOVEMBER 2023 SUPPLEMENT TO ENDEAVOR PUBLICATIONS EARN 3 CE CREDITS This continuing education (CE) activity was developed by Endeavor Business Media with no commercial support. This course was written for dentists, dental hygienists, and dental assistants, from novice to skilled. Educational methods: This course is a self-instructional journal and web activity. Provider disclosure: Endeavor Business Media neither has a leadership position nor a commercial interest in any products or services discussed or shared in this educational activity. No manufacturer or third party had any input in the development of the course content. Requirements for successful completion: To obtain three (3) CE credits for this educational activity, you must pay the required fee, review the material, complete the course evaluation, and obtain an exam score of 70% or higher. CE planner disclosure: Laura Winfield, Endeavor Business Media dental group CE coordinator, neither has a leadership nor commercial interest with the products or services discussed in this educational activity. Ms. Winfield can be reached at Asthma, allergic rhinitis, [email protected]. Educational disclaimer: Completing a single continuing and tooth decay education course does not provide enough information to result in the participant being an expert in the field related to the course topic. It is a combination of many educational courses and clinical experience that allows the participant to develop ABSTRACT skills and expertise. -
Third Molar (Wisdom) Teeth
Third molar (wisdom) teeth This information leaflet is for patients who may need to have their third molar (wisdom) teeth removed. It explains why they may need to be removed, what is involved and any risks or complications that there may be. Please take the opportunity to read this leaflet before seeing the surgeon for consultation. The surgeon will explain what treatment is required for you and how these issues may affect you. They will also answer any of your questions. What are wisdom teeth? Third molar (wisdom) teeth are the last teeth to erupt into the mouth. People will normally develop four wisdom teeth: two on each side of the mouth, one on the bottom jaw and one on the top jaw. These would normally erupt between the ages of 18-24 years. Some people can develop less than four wisdom teeth and, occasionally, others can develop more than four. A wisdom tooth can fail to erupt properly into the mouth and can become stuck, either under the gum, or as it pushes through the gum – this is referred to as an impacted wisdom tooth. Sometimes the wisdom tooth will not become impacted and will erupt and function normally. Both impacted and non-impacted wisdom teeth can cause problems for people. Some of these problems can cause symptoms such as pain & swelling, however other wisdom teeth may have no symptoms at all but will still cause problems in the mouth. People often develop problems soon after their wisdom teeth erupt but others may not cause problems until later on in life. -
What Every Transplant Patient Needs to Know About Dental Care
What Every Transplant Patient Needs to Know About Dental Care International Transplant Nurses Society Should patients have that still need to be done. Taking gums each day because they don’t feel a dental exam before care of your teeth and gums (oral well. So some patients already have hygiene) is important for everyone. dental problems before they receive having a transplant? For people who are waiting for an a transplant. After transplant, you Transplant candidates should have a organ transplant and for those who may have been more concerned about dental check-up as part of the pre- have received organ transplants, problems like rejection, infection, transplant evaluation. It is helpful to maintaining healthy teeth and gums is or side effects of your medications. have an examination by your dentist an essential area of care. This booklet Because you are now taking medicines when you are being evaluated for will discuss many issues about dental to suppress your immune system, you transplant to check the health of your care and the best ways to take care of could have an increased risk of dental teeth and gums. This is important your teeth and gums. health problems. All of these factors because some medications that you can add to dental problems following take after transplant may cause you Why could I have transplant. to develop infections more easily. problems with my teeth Maintaining your dental health as best What are the most as you can while waiting for an organ and gums? will help you do better after your There are several reasons why you common dental transplant. -
Medical Terminology
MEDICAL TERMINOLOGY THE GASTROINTESTINAL SYSTEM MATCHING EXERCISES ANATOMICAL TERMS 1. uvula a. little grapelike structure hanging above root 2. esophagus of tongue 3. cardiac sphincter b. tube carrying food from pharynx to stomach 4. jejunum c. cul de sac first part of large intestine 5. cecum d. empty second portion of small intestine e. lower esophageal circular muscle 1. ileum a. lower gateway of stomach that opens onto 2. ilium duodenum 3. appendix b. jarlike dilation of rectum just before anal 4. rectal ampulla canal 5. pyloric sphincter c. worm-shaped attachment at blind end of cecum d. bone on flank of pelvis e. lowest part of small intestine 1. peritoneum a. serous membrane stretched around 2. omentum abdominal cavity 3. duodenum b. inner layer of peritoneum 4. parietal peritoneum c. outer layer of peritoneum 5. visceral peritoneum d. first part of small intestine (12 fingers) e. double fold of peritoneum attached to stomach 1. sigmoid colon a. below the ribs' cartilage 2. bucca b. cheek 3. hypochondriac c. s-shaped lowest part of large intestine 4. hypogastric above rectum 5. colon d. below the stomach e. large intestine from cecum to anal canal SYMPTOMATIC AND DIAGNOSTIC TERMS 1. anorexia a. bad breath 2. aphagia b. inflamed liver 3. hepatomegaly c. inability to swallow 4. hepatitis d. enlarged liver 5. halitosis e. loss of appetite 1. eructation a. excess reddish pigment in blood 2. icterus b. liquid stools 3. hyperbilirubinemia c. vomiting blood MEDICAL TERMINOLOGY 4. hematemesis d. belching 5. diarrhea e. jaundice 1. steatorrhea a. narrowing of orifice between stomach and 2. -
Signs and Symptoms of Oral Cancer
Signs and Symptoms of Oral Cancer l A sore in the mouth that does not heal l A white or red patch on the gums, tongue, tonsils or lining of the mouth l Pain, tenderness or numbness anywhere in your mouth or lip that does not go away l Trouble chewing or swallowing Quitting all forms of tobacco use is critical for good oral health and the prevention of serious or deadly diseases. Call the Mississippi Tobacco Quitline for free assistance to help you quit. 1-800-QUIT-NOW (1-800-784-8669) www.quitlinems.com MISSISSIPPI STATE DEPARTMENT OF HEALTH 5271 Revised 11-30-17 Tobacco doesn’t just stain your teeth and give you bad breath. Smoking and using spit tobacco are closely connected to tooth MOUTH – There is a strong link between cancer loss and cancer of the head and neck. Your risk of oral and of the mouth and tobacco use. About 75% of people throat cancer may be even greater if you use tobacco and with cancer of the mouth are tobacco users. drink alcohol frequently. TEETH – Spit tobacco use stains the teeth and may cause Any tobacco use can cause infections and diseases tooth pain and tooth loss. Spit tobacco is high in sugar in the mouth. Tobacco includes: and can also cause cavities. l Cigarettes LIPS – Spit tobacco use can cause sores and cancer l Cigars, pipes on the lip. l Little cigars, cigarillos l Snuff, dip, chew CHEEKS – Spit tobacco can cause white sores l E-cigarettes, vaping products on the inner lining of the mouth and tongue, which may turn to cancer. -
Eating Disorders
From the office of: D. Young Pham, DDS 1415 Ridgeback Rd Ste 23 Chula Vista, CA 91910-6990 (619) 421-2155 I Fact Sheet Eating Disorders I Eating Disorders Eating disorders are real, complex, and often devastating condi- tions that can have serious consequences on your overall health and oral health. Telltale early signs of eating disorders often ap- pear in and around the mouth. A dentist may be the first person to notice the symptoms of an eating disorder and to encourage his or her patient to get help. What are the different types of eating disorders? • Anorexia nervosa is a serious, potentially life-threatening eating disorder characterized by self-starvation and excessive weight loss. • Bulimia nervosa is a serious, potentially life-threatening eating disorder characterized by a cycle of bingeing and compensatory behaviors (i.e., self-induced vomiting, use of laxatives, diuretics, or enemas) designed to undo or compensate for the effects of binge eating. • Binge eating is an eating disorder characterized by recurrent episodes of uncontrollable eating without the regular use of compensatory measures to counter the effects of excessive eating. Binge eating may occur on its own or in the context of other eating disorders. • Pica is an eating disorder that is described as “the hunger or craving for non-food substances.” It involves a person per- sistently mouthing and/or ingesting non-nutritive substances (i.e., coal, laundry starch, plaster, pencil erasers, and so forth) for at least a period of one month at an age when this behav- ior is considered developmentally inappropriate. How do eating disorders affect health? Eating disorders can rob the body of adequate minerals, vita- mins, proteins, and other nutrients needed for good health.