Dental care for the medically compromised child Flashcards
Health
“ a complete state of physical, mental and
social well-being, and not merely the
absence of disease or infirmity”
Rights of disabled people
‘Disabled people, whatever the origin,
nature & seriousness of their handicaps
and disabilities have the same fundamental
rights as their fellow citizens of the same
age, which implies first & foremost the right to enjoy a decent life, as normal & full as possible
Medical model
A problem of the person
-she is disabled because she has epilepsy
Medical care/ treatment is seen as the main issue
The focus is on cure and rehabilitation through medical intervention
‘The personal tragedy theory of disability’
Social model
It is society which disables people with impairment
by its failure to include them
Impairment: medical model
loss or abnormality of physiology or anatomical
structure or function
Impairment: social model
the functional limitation within the individual
caused by physical, mental or sensory loss
Disability: medical model
restriction of activity as a consequence of
impairment
Disability: social model
the loss or limitation of opportunities to take part in
the normal life of the community on an equal level
with others due to physical or social barriers
Functional limitations caused by physical impairments
There are 8.7 million physically
disabled people in the UK
8% people with physical disability
are wheelchair 20 users
20 people for every 1,000 have mild or moderate learning disability
3-4 people for every 1,000 have profound or multiple or multiple disability
25% of people with learning disabilities have carer aged 65 or over
20% `have 2 carers aged 70 or over
11% have only one aged 70 or over
Challenging behaviour
behaviour of such an intensity, frequency or duration that the physical safety of
the person or others is likely to be
placed in serious jeopardy, or behaviour
that is likely to seriously limit or deny access to the use of ordinary community facilities
Dental aspects
Makes treatment potentially dangerous
More at risk of dental disease
Compliance with personnel care
Compliance with treatment
Makes treatment potentially dangerous
Cardiac lesion
Immuno-compromised
Bleeding tendency
More at risk of dental disease
Cleft lip and palate
Down syndrome
Cerebral Palsy
Compliance with personnel care
Autism
ADHD
Cerebral palsy
Compliance with treatment
Learning delay
ADHD
Cerebral palsy
Treatment need
The need for oral health care is the most prevalent unmet health care need among U.S.
children and adolescents with Special
Healthcare Needs (SHCN), just as it is for all U.S.
children and adolescents
Children and adolescents with SHCN are almost
2x as likely to have unmet oral healthcare needs as their peers without SHCN across all
income levels
What can affect access to care?
Socio-economic
Racial
Cultural
DBOH
Learn
Advice should be
Three Ps:
Personal
Practical
Positive
Autistic spectrum disorder epidemiology
31-47 per 10,000
3:1 males:females
Autistic spectrum disorder: difficulties with
Social interaction
Communication
Inflexibility in thinking and behaviour
ADHD
Attention deficit hyperactivity disorder (ADHD)
Hyperactive/ inattentive/ compulsive
ADHD epidemiology
3:1 male : female
1/3 have another disorder (motor, defiant, bipolar disorder
ADHD management
Medications, behaviour modifications, lifestyle changes, and counselling
Down syndrome typical appearance
Upslanting palpebral fissure
Simian fold
Reduced muscle tone
Down syndrome symptoms/ cause
Trisomy 21 Reduced IQ Congenital heart disease Gastric reflux Thyroid dysfunction Immune deficiency, > risk of leukaemia Atlanto-axial instability
Down syndrome - oral
Less caries
More perio disease
Delayed eruption
Macroglossia
Cerebral palsy epidemiology
1.3:1 male: female
2 in 1,000 births
Cerebral palsy
Damage to motor control centres Abnormal muscle tone -i.e. slouching over, reflexes, motor development, coordination Sometimes cognition Sometimes epilepsy
SEAMLESS
Should have opportunity Education Access Multidisciplinary Linkwork Empowerment Special Care Dentistry / Paediatric Dentistry Service provision
Special needs
Poorer dental health
Problems with access
Complex needs
Dental health one of many priorities
