Caring For Children With Special Needs, Complex Meical Cnditions And Oral Pathology

Question 0

What are some of the consequences of kids with special needs?

Answer 0

Pain and discomfort
Nutritional intake
Function (no eating)
Failure to thrive (not growing according to norms)
Reduced quality of life and social functioning

Question 1

Whats the definition of a chilD with special needs?

Answer 1

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Question 2

How can oral health influence systemic health in special needs kids?

Answer 2

Bacteraemia with children with congenital heart disease or caners would be a risk for infective endocarditis

Question 3

What are some oral conditions found in kids with special needs?

Answer 3

Crossbites
Abcesses
Gross plaque and calculus
Gross decay
Congenital neuropaenia can cause periodontal issues (affects PDL and bone)
Attrition - can brux a lot
Anomalies in shape, size, number
Anormal tooth eruption (accelerated or delayed)
Trauma (motor and coordination issues)

Question 4

Whats cleinocranial dysplasia and what are the dental implications?

Answer 4

Clavicles not present and sometimes have supernumeries.

Question 5

What to obeserve first for opgs for kids with special needs?

Answer 5

Look around for pathology, not teeth. Then count teeth, then caries , then perio.

Question 6

What conditioins can cause delayed eruption?

Answer 6

Mitochondrial encepathology

Question 7

How to check for alveolar fracture?

Answer 7

Theres a difference in height (step).

Question 8

What are some inherited dental defects?

Answer 8

Amelogenesis impfecta (doesnt normally have systemic relation but can sometimes be kidney related)
Dentinogenesis imperfecta (related to osteogenesis imperfecta which means patient will have weak bones)

Question 9

What are the dental objectives for treatment for SHCN?

Answer 9

1) establish early dental home
- talk about prevention with parents, they need to come in early
2) hstory
- birth history, any other conditiions, other co-morbidities, medications, alleergies
3) consult with physician when necessary (check before you do anything)
- esp. For bleeding and cardiac disorders
4) consider patient needs when scheduling appts
5) prevention
6) consider all treatment options
7) create behaviour guidence plan

Question 10

What should the recall visits be for high risk children?

Answer 10

3 - 6 months

Question 11

What should be included int he preventive program?

Answer 11

1) rltnshp with dental home
2) increase recalls
3) encourage healthy low caries risk foods.
- dont just stop foods, recommend to rinse with water or just brush with toothbrush dipped in water after meals
4) fluoride supplementatikn
- start as early as possible and also can give tooth mousse
5) institute proper home are practice
- brushing techniques very important
- can also recommend electric toothbrush or wrap a toothbrush with a towel
- recommend flossing ASAP

Question 12

What are sopme of the behavioral issues associated with special needs children?

Answer 12

Anxiety, ADHD, preference of limited diet, can ask parents “how does the child respond when you use a vacuum cleaner?”

Question 13

What are some of the characteristics of ADHD children?

Answer 13

Can be quiet and restless or very aggresive.
Extremely impulsive
Black circles undr eyes, normally not sleeping normally

Question 14

What medications are used to treat ADHD?

Answer 14

Ritalin, adderall, straterra

Question 15

How is ADHD managed in the dental setting?

Answer 15

Bhvr managment

• firm instruction - hands on the belly and sit still
• morning appts better especially when taking meds
• short apps
• avoid treatment holidays
• keep distracting OR just keep setting as quiet as possible

Question 16

What is autism?

Answer 16

Its a spectrum in which there are issues pertaining to

• communication
• social interaction
• repititive and stereotypical movements
• acue snesory hypo and/or hypersensitivities

Question 17

How to deal with autism in dental practice?

Answer 17

• need to establish rapport
• need to know what agitates the child. Ask parent and try to avoid these things.
• parental preparatin
• short, morning appts

Question 18

What are some of the causes of cerebral palsy?

Answer 18

Cerebral anoxia
Infection
Severe jaundice
Trauma

Question 19

Oral implicaations of cerebral palsy?

Answer 19

Dysarthia (speech disorder)
Gag reflex
Airway issues
Seizures can happen

Question 20

How can patients with cerebral palsy be managed in the dntal setting?

Answer 20

Wheelchair
Upright position
Bite-block - dont want to lose fingers
Hydrocephalus - can be countered using shunts. Need to give Ab prophylaxis

Question 21

What are the symptoms of a seizure?

Answer 21

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Question 22

How to manage kids with seizures?

Answer 22

Ask parents:
How often does he have it?
what trigges them?
How long to they last?
What medicatiions does he take?
Has he been in a hospital for it before?

When a seizure happens, take everything off and time it. 10 seconds should be normal.

Question 23

What are some comorbidities associat with downs syndrome?

Answer 23

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Question 24

What are some of the oral conditns associated with downs syndrome?

Answer 24

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