Dentistry for Children with Disabilities

Question 1

what are the classifications of disability

Answer 1

intellectual/behavioural
physical
sensory
medically compromised

Question 2

what to people with a learning disability have

Answer 2

reduced intellectual ability and difficulty in everyday activities
takes longer to learn

Question 3

what is autism spectrum disorder

Answer 3

describe a lifelong developmental disorder which affects how people communicate and interact with world

Question 4

what does autism spectrum disorder affect

Answer 4

social communication
social interaction
repetitive behaviour
over or under sensitivity to light/sound etc
extreme anxiety
meltdowns or shutdowns

Question 5

what are the clinical implications of ASD

Answer 5

use preferred mode of communication
avoid jokes and be direct
avoid body language without verbal instruction
explain clearly what is happening
check understanding
make it a routine
note interests in records
work out sensory issues
make first appointment of day

Question 6

what does downs syndrome present with

Answer 6

large tongue
mid face hypoplasia
learning difficulty
cardiac defects/leukaemia/epilepsy

Question 7

what are the dental features of down syndrome

Answer 7

maxillary hypoplasia
class 3 occlusion
macroglossia
anterior open bite
hypodontia
predisposition to periodontal disease

Question 8

what is cerebral palsy

Answer 8

non-progressive lesion of motor pathways in developing brain caused by brain damage in fetal life or during birth

Question 9

what can cerebral palsy cause

Answer 9

abnormalities of movement and posture
delay in motor skills development

Question 10

what other issues come with cerebral palsy

Answer 10

learning difficulties
epilepsy
visual/hearing impairment
joint contractures/scoliosis
reflux

Question 11

what are the 3 types of cerebral palsy

Answer 11

spastic
ataxic
dyskinetic

Question 12

what is spastic cerebral palsy

Answer 12

increased muscle tone so stiff muscles and awkward movements
described by what body parts affected

Question 13

what is ataxic cerebral palsy

Answer 13

problems with balance and coordination, quick movements and controlled movements

Question 14

what is dyskinetic cerebral palsy

Answer 14

problems with controlling movements of limbs making it hard to sit and walk
uncontrollable and slow or rapid

Question 15

what are the dental considerations with cerebral palsy

Answer 15

difficulty tolerating
increased rate of malocclusion
increased risk of trauma
bruxism
drooling
poor OH
biting
peg fed
periodontal disease
hyperplastic gingivitis
self mutilation
unsafe swallow

Question 16

what are the types of sensory impairments

Answer 16

visual
hearing
ASD

Question 17

what is leukaemia

Answer 17

cancer of WBC where WBC production gets out of control and cells continue to divide in bone marrow but do not mature

Question 18

what can leukaemia affect

Answer 18

lymphocytes
myeloid cells

Question 19

what does leukaemia present with

Answer 19

pallor
increased bleeding/bruising
infection

Question 20

what are the oral manifestations of leukaemia

Answer 20

gingival swelling
ulceration
spontaneous gingival bleeding
unusual mobility of teeth
petechiae
mucosal pallor
herpetic infections
candidosis

Question 21

what cancer treatment do children receive

Answer 21

surgery
chemotherapy
radiotherapy
bone marrow transplant

Question 22

what is chemotherapy

Answer 22

cytotoxic drugs with selective toxicity to rapidly dividing cancer cells

Question 23

what are short term effects of chemo

Answer 23

mucositis
increased infection and bleeding risk

Question 24

what is the long term effect of chemo

Answer 24

enamel hypoplasia/microdontia/thin roots

Question 25

what are short term effects of radiotherapy

Answer 25

mucositis
salivary flow decreased
caries
taste disturbance
infection

Question 26

what are the long term effects of radiotherapy

Answer 26

malocclusion
increased risk of soft tissue neoplasm
risk of ORN
hypodontia/microdontia/enamel hypoplasia

Question 27

what are the implications of childhood cancer on the dental team

Answer 27

dental assessment prior to commencement of treatment
infectious dental foci removed before cancer therapy
optimal OH important
management of mucositis

Question 28

what is cyanotic cardaic defect

Answer 28

deoxygenated blood enter systemic circulation

Question 29

what is acyanotic cardiac defect

Answer 29

normal levels of oxyhaemoglobin in systemic circulation

Question 30

what are the dental implications of congenital cardiac defects

Answer 30

medications increase bleeding
higher risk of GA
careful use of adrenaline
increased enamel hypoplasia
risk of IE

Question 31

what must patients at risk of IE have

Answer 31

optimal oral hygiene
avoid dental infection
more radical treatment plans to ensure mouth kept free from any oral sources of infection

Question 32

what are the dental implications of bleeding disorders

Answer 32

enhanced dental caries prevention
dental treatment within hospital setting
liaise with haematologist
haemostatic cover requirements vary

Question 33

what are the impacts of dental disease in children with disabilities

Answer 33

increased risk of dental caries
delayed diagnosis
delayed management
need for multidisciplinary planning
pain/infection difficult to manage
health risk posed by dental infection

Question 34

what are the dental findings like with children with disabilities

Answer 34

anomalies of tooth number
anomalies of tooth size
dental trauma
periodontal disease
calculus accumulation
grinding

Question 35

why are children with special needs at increased risk of decay

Answer 35

risk infection would pose
sugar containing medicine
limited diet/difficulty with OH
difficulty managing caries