Children with Special Healthcare Needs

Question 1

dental home

Answer 1

ongoing relationship b/w dentist and pt, inclusive of all aspects of oral health care delivered in a comphrehensive, continuously accessible, coordinated, and family-centered way

Question 2

when should the dental home be establish?

Answer 2

no later than 12 months of age

Question 3

individuals with special health care needs (SHCN)

Answer 3

1. can be developmental or acquired
2. can cause limitations in daily self-maintenance or major life activity
3. requires specialized knowledge, increased awareness, attention, and accommodation

Question 4

what is the most common unmet health care need?

Answer 4

dental care

Question 5

T/F: dental needs are more commonly unmet in low-income families

Answer 5

true

Question 6

when was the Americans with Disability Act enacted?

Answer 6

in 1990

Question 7

what happens if dental office fails to accommodate SHCN pts?

Answer 7

could be considered discrimination and violation of state and federal law

Question 8

what should you specifically ask about when going over medical hx with new pt?

Answer 8

cardiac and neurological status

Question 9

gastronomy tube (G-Tube)

Answer 9

1. common for children with impaired swallow reflex

2. children that cannot sustain nourishment

Question 10

ventriculoperitoneal shunt (VP shunt)

Answer 10

1. drains excess CSF to peritoneal cavity

Question 11

VP shunts are common in children with what?

Answer 11

hydrocephalus

Question 12

tracheostomy

Answer 12

1. need for long term mechanical ventilation

2. allows caregivers to suction the airway

Question 13

central line

Answer 13

catheter places into a large v., usually jugular, subclavian, femoral

Question 14

port-a-cath

Answer 14

internal catheter placed in similar area

Question 15

desensitization

Answer 15

slowly introduce pt to more challenging situations

Question 16

communicative techniques

Answer 16

1. communicate at appropriate developmental level
2. short, direct commands
3. nonverbal techniques
4. tell show do
5. distraction
6. positive reinforcement

Question 17

T/F: do not force any positions on pt especially when using passive restraint

Answer 17

true

Question 18

vac pac

Answer 18

1. keep stable and secure better pt presentation

2. help prevent pressure points

Question 19

T/F: you should check for mobile teeth before inserting mouth prop

Answer 19

true

Question 20

T/F: mouth props should not be used to force open bite

Answer 20

true

Question 21

when taking radiographs, who holds the child’s head?

Answer 21

parents… never dentist or staff

Question 22

what must be used on pts with poor gag reflex/frequent aspiration?

Answer 22

high volume suction

Question 23

recall for SHCN?

Answer 23

3 months

Question 24

you do NOT need to remove calculus on which surface of SHCN pt during prophy?

Answer 24

occlusal surfaces

Question 25

T/F: G-tube children have significantly higher rates of calculus formation

Answer 25

true

Question 26

amount of calculus present in G-tube children are associated with what?

Answer 26

hx of pneumonia

Question 27

T/F: special needs pts are at an increased aspiration risk thus high volume suction is needed when scaling

Answer 27

true

Question 28

SCHN are minimally at what type of risk according to the AAPD caries risk assessment?

Answer 28

moderate risk

Question 29

dental trauma is more common in pts with what?

Answer 29

1. class II malocclusion
2. pts with seizure disorder
3. pts with unstable gait (Down syndrome)
4. pts with frequent intubations

Question 30

T/F: you should trust the parents when they say their SHCN is in pain because they are very perceptive to behavior changes in their children

Answer 30

true

Question 31

T/F: ortho should be ruled out because pt has special needs

Answer 31

false, don’t!

help parents make informed decisions

Question 32

developmental disabilities

Answer 32

1. intellectual disabilities
2. cerebral palsy
3. sensory impairment
4. restricted mobility

Question 33

mild intellectual disability

Answer 33

requires special support in school environment (80% of SHCN)

Question 34

moderate intellectual disability

Answer 34

some education and partial independence as adults

Question 35

severe to profound intellectual disability

Answer 35

1. can achieve success with self-help, leisure and some vocational skills
2. may be able to live in a group home

Question 36

communication with pts with intellectual disability

Answer 36

1. use leveling
2. remove distractions
3. use declarative sentences
4. use open-ended questions
5. provide corrective feedback
6. rephrase questions if needed

Question 37

Down syndrome

Answer 37

inherited associated with intellectual disability

Question 38

complications with Down syndrome

Answer 38

1. increased risk for cardiac anomalies
2. high risk of leukemia
3. axioatlantal instability
4. immunological deficiencies
5. comorbidities of autism and behavior disorders
6. increased risk of perio disease

Question 39

cerebral palsy

Answer 39

1. disordered movement and posture due to injury to brain and motor areas
2. damage is nonprogressive

Question 40

most common form of cerebral palsy

Answer 40

spastic

Question 41

spastic cerebral palsy

Answer 41

muscles appear stiff and tight

Question 42

spastic cerebral palsy arises from damage to what?

Answer 42

motor cortex

Question 43

dyskinetic cerebral palsy

Answer 43

characterized by involuntary movements

Question 44

dyskinetic cerebral palsy arises from damage to what?

Answer 44

basal ganglia

Question 45

ataxic cerebral palsy

Answer 45

1. characterized by shaky movements

2. affects balance and sense of positioning in space

Question 46

ataxic cerebral palsy arises from damage to what?

Answer 46

cerebellum