Bariatric Care Flashcards
what is the definition of overweight and obese
abnormal or excessive fat accumulation that may impair health
what is a bariatric person
an individual of any age who has limitations to health and social care due to physical size, health, mobility and environmental access
what is BMI
weight in kilograms divided by square height in metres
what is overweight in BMI
> 25
what is obesity in BMI
> 30
what are the limitations of BMI
does not assess body fat distribution
does not account for factors such as age, sex, ethnicity and muscle mass
what is the cause of obesity
energy imbalance between calories consumed and calories expended
what are the contributing factors to obesity
underlying health problems
lack of energy
difficulty chewing/swallowing food
medications that can contribute to weight gain
physical limitations
lifestyle factors
is obesity a disability
no but conditions associated with it could lead to disability
what is the role of the dental team in bariatric patients
identify and diagnose oral health issues
signpost patients to services
beware of co morbidities
appropriate referral
provide emergency care
raise concerns
what do we think about for the patient prior to appointment
venue has appropriate facilities for patient care
how are they travelling
what accessibility issues do we consider when the patient has arrived at the practice
suitable chair
adequate door widths
toilet facilities
lift/stairs
emergency evacuation procedures
what do we think about when the patient comes into the surgery
may require longer for appointment
extra weight on face makes it difficult
may need specialist equipment
longer needles
airway management difficult
what is obesity hypoventilation syndrome
result of chronic hypoventilation due to excess weight preventing full expansion of lungs
what do we need to think about in regards to the dental chair
weight limit
cant lie people flat if they have extra weight on chest - risk of hypoxaemia
what are the comorbidities associated with obesity
hypertension and CVA
diabetes
sleep apnoea
dyspnoea
GORD
osteoarthritis
depression/anxiety
liver and gallbladder
skin conditions - cellulitis and impetigo
what issues can arise during treatment of a bariatric patient
loss of anatomical landmarks
need to treat sitting upright
intra oral radiographs challenging
OPT might not be big enough size
long procedures lead to acute leg oedema
coagulation abnormalities
drug absorption
what is the relationship between obesity and periodontal disease
associative (due to diabetics) but not causative
what are the dental implications for bariatric patients
caries
wound healing delayed
tooth wear
why do bariatric patients have higher caries rate
due to interrelated causations (diet high in processed sugars)
why do bariatric patients have delayed wound healing
reduced immune function
why do bariatric patients get tooth wear
increased prevalence of GORD so acid erosion
what is the first line option for bariatric care
domiciliary care
what should you do if an emergency appointment is for a bariatric person
provide emergency relief of pain treatment only
consider treating in their own wheelchair
arrange future appointment with suitable facilities
