Dental care for the medically compromised child

Question 1

Medical model

Answer 1

Problem of person identified
Medical care is seen as main issue
Focus on cure and rehab via medical intervention

Question 2

Social model

Answer 2

Society disables people with impairments by its failure to include them

Question 3

Impairment - medical

Answer 3

Loss or abnormality of physiology or anatomical structure or function

Question 4

Impairment - social

Answer 4

Functional limitation within individual caused by physical, mental or sensory loss

Question 5

Disability - medical

Answer 5

Restriction of activity as a consequence of impairment

Question 6

Disability - social

Answer 6

Loss/limitation of opportunities to take part in normal life of the community on an equal level with others due to physical or social barriers

Question 7

Cerebral palsy

Answer 7

Difficulties with muscle control

Fine or general

Question 8

Effects of disability and examples

Answer 8

Makes treatment potentially dangerous

• cardiac lesion
• immunocompromisation
• haemophiliac

More at risk of dental disease

• cleft lips and palate
• down syndrome - - low caries risk due to different salivary composition but high periodontitis risk due to autoimmune response
• cerebral palsy and involuntary movement

Compliance with personnel care

• Autism
• ADHD
• cerebral palsy

Compliance with Tx

• learning delay
• ADHD
• cerebral palsy

Question 9

DBOH

Answer 9

Fluoride
Toothbrushing
Sealants - 48 months 60% caries reduction 
Retention of sealants 52% in 48 months 
Resin best if retained

Question 10

Autistic spectrum disorder
Ratio
Characteristics?

Answer 10

3:1 M:F

Difficulties with social interaction, communication, inflexibility in thinking and behaviour

Question 11

ADHD 
Ratio 
Characteristics 
Association 
Management

Answer 11

3:1 male to female

Hyperactive/inattentive/compulsive

1/3 have another disorder e.g motor, bipolar

medications, behaviour modifications, lifestyle changes and counselling

Question 12

Down Syndrome

Answer 12

Mechanism
Trisomy 21 extra chromosome

Appearance
Upslanting fissure, simian fold, reduced muscle tone
Reduced IQ

Symptoms
congenital heart disease

Gastric reflux

thyroid dysfunction

immune deficiency - increased risk of leukaemia and periodontitis

Joint between C1 C2 is less tight

Oral - less caries, more per, delayed eruption, macroglossia - difficult

Question 13

Cerebral palsy

Ratio
Mechanism
Affects

Answer 13

1:3 male to female
2/1000 births
Damage to motor control centres, abnormal muscle tone, cognition and epilepsy

Question 14

Special needs

Answer 14

Poorer dental health
Problems with access
Complex needs
Dental health one of many priorities

Question 15

S
E
A
M
L
E
S
S

Answer 15

Should have opportunity Education
Access
Multidisciplinary
Linkwork
Empowerment
Special Care Dentistry / Paediatric Dentistry
Service provision