Bariatric Care

Question 1

What percentage of adults in Scotland are overweight or obese?

Answer 1

66% of adults are overweight or obese.

Question 2

How does obesity impact mental health?

Answer 2

Obesity is associated with depression, anxiety, low self-esteem, and reduced quality of life.

Question 3

How is BMI calculated and classified by WHO?

Answer 3

BMI is calculated as weight (kg) divided by height (m²). Overweight is defined as BMI ≥25 kg/m² and obesity as BMI ≥30 kg/m².

Question 4

What are the limitations of BMI?

Answer 4

BMI does not assess fat distribution or account for age, sex, ethnicity, or muscle mass.

Question 6

What are some contributing factors to obesity?

Answer 6

Factors include underlying health conditions (e.g., hypothyroidism), medications, physical limitations, and lifestyle issues such as poor diet and lack of exercise.

Question 7

Does the Equality Act classify obesity as a disability?

Answer 7

No, but conditions associated with obesity may lead to disability, and healthcare professionals must provide reasonable adjustments.

Question 8

What is the role of the dental team in managing bariatric patients?

Answer 8

The team should diagnose oral health issues, refer patients to services, manage comorbidities, and provide emergency care when needed.

Question 9

What should be ensured before a bariatric patient’s appointment?

Answer 9

Facilities should accommodate patient weight and mobility, and transport arrangements should be confirmed.

Question 11

What accessibility features should a dental practice have for bariatric patients?

Answer 11

Features include weight-bearing armless chairs, wheelchair-accessible doorways and toilets, and safe emergency evacuation procedures.

Question 12

What are key safety considerations for bariatric patients in surgery?

Answer 12

Use appropriate equipment (e.g., wider cuffs), position patients semi-supine to prevent hypoxaemia, and prepare for potential airway management challenges.

max chair is 22 stone

Question 13

What common comorbidities are associated with obesity?

Answer 13

Conditions include hypertension, sleep apnoea, diabetes, liver and gallbladder diseases, dyspnoea, skill conditions (cellulitis), GORD, osteoarthritis, and depression.

Question 14

What challenges do bariatric patients pose for dental treatment?

Answer 14

Challenges include access issues due to large cheeks and tongue, difficulties with radiography, and the need for alternative anesthesia techniques.

Question 15

How does obesity affect dental health?

Answer 15

Obesity is associated with periodontitis (though not causative), higher caries rates, delayed wound healing, and increased tooth wear from GORD.

Question 16

When is domiciliary care appropriate for bariatric patients?

Answer 16

It is appropriate when patients are too large or anxious to leave their homes, but treatments are limited to simple procedures.

Question 17

What are the impacts of bariatric surgery on oral health?

Answer 17

Positive impacts include weight loss and self-esteem improvement.

Negative impacts include increased caries, erosion from reflux, and nutritional deficiencies.

Question 18

What sedation methods are suitable for bariatric patients?

Answer 18

Inhalation sedation is preferred, while IV sedation and GA require caution due to airway risks. (sleep apnoea higher risk)

Question 19

How should weight-related issues be discussed with patients?

Answer 19

Address issues sensitively, focus on safety and care quality, and avoid making patients feel embarrassed.