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special care dentistry > Bariatric Care > Flashcards

Bariatric Care Flashcards

1
Q

what is the definition of overweight and obese

A

abnormal or excessive fat accumulation that may impair health

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2
Q

what is a bariatric person

A

an individual of any age who has limitations to health and social care due to physical size, health, mobility and environmental access

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3
Q

what is BMI

A

weight in kilograms divided by square height in metres

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4
Q

what is overweight in BMI

A

> 25

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5
Q

what is obesity in BMI

A

> 30

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6
Q

what are the limitations of BMI

A

does not assess body fat distribution
does not account for factors such as age, sex, ethnicity and muscle mass

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7
Q

what is the cause of obesity

A

energy imbalance between calories consumed and calories expended

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8
Q

what are the contributing factors to obesity

A

underlying health problems
lack of energy
difficulty chewing/swallowing food
medications that can contribute to weight gain
physical limitations
lifestyle factors

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9
Q

is obesity a disability

A

no but conditions associated with it could lead to disability

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10
Q

what is the role of the dental team in bariatric patients

A

identify and diagnose oral health issues
signpost patients to services
beware of co morbidities
appropriate referral
provide emergency care
raise concerns

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11
Q

what do we think about for the patient prior to appointment

A

venue has appropriate facilities for patient care
how are they travelling

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12
Q

what accessibility issues do we consider when the patient has arrived at the practice

A

suitable chair
adequate door widths
toilet facilities
lift/stairs
emergency evacuation procedures

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13
Q

what do we think about when the patient comes into the surgery

A

may require longer for appointment
extra weight on face makes it difficult
may need specialist equipment
longer needles
airway management difficult

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14
Q

what is obesity hypoventilation syndrome

A

result of chronic hypoventilation due to excess weight preventing full expansion of lungs

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15
Q

what do we need to think about in regards to the dental chair

A

weight limit
cant lie people flat if they have extra weight on chest - risk of hypoxaemia

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16
Q

what are the comorbidities associated with obesity

A

hypertension and CVA
diabetes
sleep apnoea
dyspnoea
GORD
osteoarthritis
depression/anxiety
liver and gallbladder
skin conditions - cellulitis and impetigo

17
Q

what issues can arise during treatment of a bariatric patient

A

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

18
Q

what is the relationship between obesity and periodontal disease

A

associative (due to diabetics) but not causative

19
Q

what are the dental implications for bariatric patients

A

caries
wound healing delayed
tooth wear

20
Q

why do bariatric patients have higher caries rate

A

due to interrelated causations (diet high in processed sugars)

21
Q

why do bariatric patients have delayed wound healing

A

reduced immune function

22
Q

why do bariatric patients get tooth wear

A

increased prevalence of GORD so acid erosion

23
Q

what is the first line option for bariatric care

A

domiciliary care

24
Q

what should you do if an emergency appointment is for a bariatric person

A

provide emergency relief of pain treatment only
consider treating in their own wheelchair
arrange future appointment with suitable facilities

25
Q

why do people with learning disabilities often gain weight

A

poorly balanced diet, more sedentary lifestyles, genetic predisposition

26
Q

what is a contraindication to dental sedation for bariatric people

A

risk of sleep apnoea

27
Q

why are bariatric adults not suitable for IV sedation

A

difficulty placing cannula

28
Q

what is the most appropriate form of sedation for bariatric patients

A

inhalation sedation

29
Q

how should you communicate issues about a persons weight to them

A

sensitively and honestly
emphasise safety aspects

30
Q

what are the advantages of bariatric surgery

A

weight loss, improved control of comorbidities, improve self esteem

31
Q

what are the disadvantages of bariatric surgery

A

nutritional deficiencies, eating disorders
periodontal disease, caries, hyposalivation, ulcers, dentine sensitivity, halitosis

32
Q

why is there a high caries risk once someone has bariatric surgery

A

higher frequency and prolonged meal times

33
Q

what advice can we give to patients who have had bariatric surgery

A

healthy balanced diet
adequate oral hygiene
stimulate salivary flow
increase consumption of foods rich in fibre
chew gum
brush tongue
avoid toothwear
drink through straw
fluoride varnish

special care dentistry (15 decks)

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