RESPIRATORY

DISEASES
MORGAN FOWLER
KARISSA GRADO
BRITTNI GRUSECKI
 OVERVIEW
• THE RESPIRATORY SYSTEM
• UPPER RESPIRATORY TRACT DISEASES
• LOWER RESPIRATORY TRACT DISEASES
• COPD
• BRONCHITIS
• EMPHYSEMA
• PNEUMONIA
• TUBERCULOSIS
• ASTHMA
• CYSTIC FIBROSIS
• ANATOMY: SINUSES, NASAL CAVITY, LARYNX, PHARYNX, TRACHEA, BRONCHI AND LUNGS

• THE RESPIRATORY TRACT FROM THE NASAL CAVITY TO THE LUNGS SERVES AS A PASSAGEWAY
FOR AIR EXCHANGE.
• INHALE FRESH AIR
• EXHALE CARBON DIOXIDE
 UPPER RESPIRATORY TRACT DISEASES
• CAUSED BY INFECTIONS OR ALLERGIC REACTIONS THAT RESULT IN INFLAMMATION
• MODES OF TRANSMISSION:
• INHALATION
• INDIRECTLY BY CONTAMINATED HANDS OR ITEMS

ACUTE DISEASE: NOSE, SINUSES, PHARYNX, OR LARYNX

• RHINITIS (COMMON COLD)
• SINUSITIS
• PHARYNGITIS/TONSILLITIS
• INFLUENZA (FLU)

CHRONIC DISEASE:
• ALLERGIC RHINITIS (HAY FEVER)
 Disease Prevention

• HEALTHCARE PROVIDERS SHOULD OBTAIN IMMUNIZATIONS

• USE STANDARD PRECAUTIONS TO PREVENT TRANSMISSION

• DELAY TREATMENT UNTIL PATIENT IS NO LONGER INFECTIOUS

• TEMPERATURE RETURNS TO NORMAL
LOWER RESPIRATORY DISEASES
 ACUTE BRONCHITIS

• SHORT TERM INFLAMMATION OF THE BRONCHI

• “CHEST COLD”

• TREATMENT: VIRAL SUPPORTIVE BED REST

FLUIDS
INHALED BRONCHODILATORS
COUGH SUPPRESSANT
BACTERIAL ANTIBIOTICS (AMOXICILLIN)

• CAN BE CAUSED FROM BACTERIA OR VIRUSES, BY INHALING IRRITANTS, OR HAVING AN UPPER

RESPIRATORY TRACT INFECTON (FLU)
 DENTAL HYGIENE CARE

• AVOID ULTRASONIC
• EVALUATE SALIVARY FLOW-RISK FOR XEROSTOMIA
• SEMI-SUPINE POSITION
• SHORT APPOINTMENTS
• STRESS REDUCTION
• 6 MONTH RECALL
 PNEUMONIA

• INFECTION AND SUBSEQUANT INFLAMMATION OF THE LUNGS CAUSED BY EITHER VIRUSES,

BACTERIA, FUNGI, MYCOPLASMA, OR PARASITES
• COMMUNITY ACQUIRED
• HEALTHCARE ASSOCIATED (NOSCOMIAL)

• TREATMENT: VIRAL SUPPORTIVE

BED REST
FLUIDS
BACTERIAL ANTIBIOTICS
SULFA DRUGS (FUNGAL)
 DENTAL HYGIENE CARE

• AVOID ULTRASONIC
• BACTERIA FROM ORAL BIOFILM CAN BE ASPIRATED INTO LUNGS
• XEROSTOMIA
• PERIODONTAL DISEASE
• PRE MED: USE 0.12% CHLORHEXIDINE GLUCONATE RINSE BEFORE TREATMENT
• SEMI-SUPINE
• SHORT MORINING APPOINTMENT
• STRESS REDUCTION
• 6 MONTH RECALL
 TUBERCULOSIS

• CHRONIC, INFECTIOUS, AND COMMUNICABLE DISEASE WITH WORLDWIDE PUBLIC HEALTH

SIGNIFICANCE AS A CAUSE OF DISABILITY AND DEATH
• MYOBACTERIUM TUBERCULOSIS
• TREATMENT: CHEST RADIOGRAPH
ANTIBACTERIAL THERAPY
PHYSICAL EXAM
MEDICATIONS: ISONIAZID, RIFAMPIN, ETHAMBUTOL,
PYRAZINAMIDE
 DENTAL HYGIENE CARE
• AVOID ULTRASONIC
• CLASSIC MUCOSAL LESION- PAINFUL, DEEP, IRREGULAR ULCER
• ADEQUATE HOME CARE
• PALLIATIVE TREATMENT FOR ORAL LESIONS
• PRE-MED: VERIFY WITH PHYSICIAN
• SEMI-SUPINE POSITION
• SHORT MORNING APPOINTMENTS
• STRESS REDUCTION
• 6 MONTH RECALL
• POSTPONE NON-EMERGENCY TREATMENT AND REFER TO PHYSICIAN WHEN PATIENT HAS SIGNS
AND SYMPTOMS
 ASTHMA
• CHRONIC, RESPIRATORY DISEASE CONSISTING OF RECURRENT EPISODES OR DYSPNEA, COUGHING, WHEEZING, LEADING TO
BRONCHIAL INFLAMMATION AND MUSCLE CONTRACTION
• EXACT CAUSE IS NOT UNDERSTOOD:
EXTRINSIC (ALLERGIC)
INTRINSIC (NON ALLERGENIC)
DRUG OR FOOD INDUCED
EXERCISE INDUCED
INFECTION INDUCED
• TREATMENT: LONG TERM CONTROL SHORT TERM CONTROL
CORTICOSTEROIDS SHORT ACTING BETA 2 AGONISTS
MAST CELL STABILIZERS ANTICHOLINERGICS
IMMUNOMODULATORS SYSTEMIC CORTICOSTEROIDS
LEUKOTRIENE RECEPTOR ANTAGONIST
LONG ACTING BETA 2 AGONIST
METHYLXANTHINES
 DENTAL HYGIENE CARE

• AVOID ULTRASONIC
• AVOID EPINEPHRINE
• DECREASED SALIVARY FLOW DUE TO MEDICATION
• ORAL CANDIDIASIS
• USE FLUORIDE
• PRE-MED: USE INHALER BEFORE TREATMENT IF NEEDED
• SEMI-SUPINE
• STRESS REDUCTION
• 6 MONTH RECALL
 COPD
• CHRONIC OBSTRUCTIVE PULMONARY DISEASE
• PROGRESSIVE LUNG DISEASE INCLUDING EMPYSEMA, CHRONIC BRONCHITIS, AND
REFRACTORY ASTHMA
• RESULTS FROM LONG TERM EXPOSURE TO LUNG IRRITANTS
• SECONDHAND SMOKE, AIR POLLUTION, CHEMICAL FUMES OR DUST FROM ENVIRONMENT OR
WORKPLACE

• TREATMENT: BRONCHODILATOR (ALBUTEROL, IPRATROPIUM)

STEROID (FLUTICASONE, BUDESONIDE)
• SHORTNESS OF BREATH • CHRONIC COUGH THAT PRODUCES SPUTUM
• WHEEZING
• CHEST TIGHTNESS
• EXCESS MUCOUS IN THE MORNINGS
 DENTAL HYGIENE CARE
• ASSESS SEVERITY
• AVOID STRESS DURING APPOINTMENT
• ENCOURAGE TOBACCO CESSATION
• SEMI-SUPINE POSTITON
• USE ANTIMICROBIAL PRE-RINSE
• AVOID ULTRASONIC AND AIR POLISHER
• ADMINISTER LOCAL ANESTHETIC WITHOUT EPINEPHRINE
• NO OXYGEN INHALATION SEDATION (AVOID WITH SEVERE COPD AND EMPHYSEMA)
• PROMOTE ORAL CARE
• FREQUENT RECALL
 EMPHYSEMA
• ACCUMULATION OF AIR TISSUES IN ORGANS- TERMINAL BRONCHIOLES BECOME PLUGGED
WITH MUCOUS

• TREATMENT: BRONCHODILATORS
STEROIDS (INHALED OR ORAL)
RESCUE INHALER

• SMOKING IS RESPONSIBLE FOR AT LEAST 85% OF CASES, HOWEVER NOT ALL SMOKERS WILL
DEVELOP EMPHYSEMA

• ORAL HEALTH SHOWS CLINICAL ATTACHMENT LOSS, ALVEOLAR BONE LOSS, TISSUE
DESTRUCTION, HALITOSIS, EXTRINSIC TOOTH STAIN, ORAL CANCER, NICOTINE STOMATITIS
 DENTAL HYGIENE CARE
• THERE IS NO CURE
• TO DECREASE EXACERBATIONS: ENCOURAGE TOBACCO CESSATION, ELIMINATE EXPOSURE TO
ENVIRONMENTAL POLLUTANTS, ADEQUATE NUTRTION, DRINK WATER, EXERCISE REGULARLY
• ASSESS SEVERITY
• TREATMENT ONLY ON PATIENTS THAT ARE STABLE
• MONITOR VITALS
• USE ANTIMICROBIAL PRE-RINSE
• AVOID ULTRASONIC
• ADMINISTER LOCAL ANESTHETIC WITHOUT EPINEPHRINE
• SEMI-SUPINE POSITION
• FREQUENT RECALL
 CHRONIC BRONCHITIS
• FORM OF COPD
• INFLAMMATION OF THE BRONCHIAL TUBES- THE AIRWAYS THAT CARRY OXYGEN TO THE LUNGS

• THE BRONCHIAL TUBES PRODUCE MUCOUS

• THE MUCOUS PRODUCTION IS SUFFICIENT ENOUGH TO CAUSE A COUGH WITH EXPECTORATION FOR AT
LEAST 3 MONTHS OF THE YEAR FOR 2 OR MORE YEARS
• TREATMENT: SMOKING CESSATION AND AVOID AIR BORNE BRONCHIAL IRRITANTS
BRONCHODILATORS, STEROIDS, OXYGEN THERAPY

• MEDICATIONS: NSAIDS (IBUPROFEN)

ANALGESIC (ACETAMINOPHEN)
NARCOTIC (CODEINE)
COUGH MEDICATION (DEXTROMETHORPHAN)
 MANAGEMENT
• ASSESS AND MONITOR DISEASE
• REDUCE RISK FACTORS
• MANAGE EXACERBATIONS
DENTAL HYGIENE CARE
• TREATMENT MAY BE PERFORMED ON STABLE CONDITIONS
• PATIENTS WHO USE TOBACCO HAVE AN INCREASED RISK FOR ORAL CANCER, NICOTINE STOMATITIS,
HALITOSIS, PERIO INFECTIONS, AND EXTRINSIS TOOTH STAIN
• MONITOR VITALS
• USE ANTIICROBIAL PRE-RINSE
• AVOID ULTRASONIC
• ADMINISTER LOCAL ANESTHETIC WITHOUT EPINEPHRINE
• ENCOURAGE TOBACCO CESSATION AND PROMOTE ORAL CARE
• SEMI-SUPINE POSITION
• REQUENT RECALL
 CYSTIC FIBROSIS
• AUTOSOMAL RECESSIVE GENE DISORDER THAT AFFECTS MOVEMENT OF SALT AND WATER IN AND OUT
OF EPITHELIAL CELLS IN THE RESPIRATORY TRACT

• TREATMENT: DIETARY SUPPLEMENT

ANTIBIOTICS
COUGH MEDICINE

• TREATMENT MAY EASE SYMPTOMS AND REDUCE COMPLICATIONS. NEWBORN SCREENINGS HELP WITH
EARLY DIAGNOSIS.

• PATIENT SHOULD BE SCREENED FOR ORAL CANDIDIASIS, CARIES, PERIODONTAL DISEASE, NUTRITIONAL
STATUS AND ORAL HYGIENE REGIMEN

• SIGNS AND SYMPTOMS: FAILURE TO THRIVE

PERSISTENT COUGH OR WHEEZING
RECURRENT PNEUMONIA
SALTY SKIN OR SWEAT
EXCESSIVE APPETITE WITH POOR WEIGHT GAIN
 DENTAL HYGIENE CARE
• SHORT MORNING APPOINTMENT
• MAINTAIN CLEAR AIRWAYS OF MUCOUS
• NUTRITIONAL THERAPY
• PRE MED
• STRESS REDUCTION TO AVOID PRECIPITATING FACTORS
• SEMI-SUPINE
• AVOID ULTRASONIC AND AIR POLISHING
• 3 MONTH RECALL
• USE 6 STEPS OF DH CARE: ASSESSMENT IMPLEMENTATION
DH DIAGNOSIS EVALUATION
PLANNING DOCUMENTATION
 SLEEP APNEA SYNDROME
• REPETITIVE NARROWING AND CLOSURE OF THE UPPER AIRWAY DURING SLEEP
• PHARYNGEAL AIRWAY OBSTRUCTION

• SIGNS AND SYMPTOMS: INTERRUPTION IN SLEEP PATTERNS

SNORING
ASSOCIATED WITH COMORBIDITIES, MOTOR ACCIDENTS
AND OCCUPATIONAL ACCIDENTS

• TREATMENT: USE OF CPAP MACHINE

MANDIBULAR ADVANCEMENT DEVICE
WEIGHT LOSS
POSITIONAL THERAPY
SURGERY
 DENTAL HYGIENE CARE
• ASSESS TISSUES AND TMJ
• RECOMMEND NON ALCOHOL BASED MOUTH RINSE
• BRING MANDIBULAR DEVICE AT EACH APPT. FOR EVALUATION
 SOURCES
• KHAN ACADEMY. (2017). HEALTH AND MEDICINE: RESPIRATORY SYSTEM DISEASES.
KHANACADEMY.ORG.
• MCCOLLEY, SUSANNA A. (2015). ADVANCES IN THE MANAGEMENT OF CYSTIC FIBROSIS:A
CLOSER LOOK AT THE ROLES OF CFTR MODULATION THERAPY. JOURNAL OF MANAGED CORE
MEDICINE VOL.20, NO. 3. WWW.NAMCP.ORG.
• WILKINS, ESTHER M. (2017). CLINICAL PRACTICE OF THE DENTAL HYGIENEST (12 EDITION).
BALIMORE, MD: WOLTERS KLUWER