Exam Paper 1 Flashcards
Briefly describe the age profile of contemporary Britain (4 marks)
- Females live longer than their male counterparts
- Ageing population as life expectancy increases because better healthcare
- The proportion of young people to old people is uneven (more older people than 16+)
Describe TWO general health and TWO dental problems that people in Mrs White’s age group are likely to face. (8 marks)
- Joints stiffen, bones become lighter and calcium decreases leading to more rheumatological disorders such as arthritis
- Heart muscle strength decreases, arteries shrink and harden
- Xerostomia because of polypharmacy
- Perio disease and root caries due to lack of manual dexterity and thus improper brushing
- According to the ADHS 2009 there is a lot more people retaining their teeth which means more complex diseases and treatment plans needed.
Give TWO examples of sociological research the elderly face
- Dental age-related effects – dry mouth, caries, pocketing, denture candidiasis etc. (National diet and nutrition survey 2006)
- Poor pensioners are more likely to become sick or disabled than richer pensioners and, if they become ill, poor pensioners are more likely to die younger (Arber and Ginn, 1993).
What implications might ageism have for her dental care now and in the future? (4 marks)
- Not enough dentist for the number of elderly patients there are, there also might be a lack of knowledge as to how to manage older patients as we have never had that before
- Complex procedures due to the - retention of teeth and presence of other conditions e.g. arthritis, patient will take bisphosphonates which can increase risk of osteonecrosis of jaw
What do you understand by the term ageism? (2 marks)
Prejudice on the ground of someone’s age, some dentists find it dissatisfying to treat older people and have a negative attitude towards edentulous patients
Briefly describe the ways psychological theory understands the acquisition of fears (6 marks)
- Fear is a painful emotion excited by danger or the apprehension of danger
- Acquisition of fear can develop through:
- Classical conditioning: associating an involuntary response (being scared or not opening mouth etc) and a stimulus (being in the dental chair), so here being in the dental chair is a neutral stimulus but because one develops an unconditioned response it becomes a conditioned stimulus where you always will have a conditioned response to in the future.
- Can develop phobia/fear without direct experience from parents/siblings, peers/media.
- Social modelling is another way: if parent does something you tend to follow it
- Pathways to acquisition of anxiety/fear: Direct exposure, Social learning, Vicarious learning (social learning theory/ operant conditioning 🡪 avoidance)
- Operant conditioning can be divided into reinforcement and punishment which can be further divided into positive and negative
What FOUR signs might you notice that would indicate that a patient is anxious (4 marks).
- Behavioural: fidgeting
- Cognitive: coping mechanisms, poor ability to comprehend information
- Subjective: what you tell the dentist/ your mood
- Physiological: sweating
Discuss three ways in which you might use your understanding of psychology to help a patient to feel less anxious. (6 marks) and illustrate your answer with TWO examples from psychological research. (4 marks)
- Assess the level of anxiety and act accordingly because if she. is too anxious you might want to consider CBT, analgesics, GA but if her level of anxiety is low to moderate then proper communication of information, rapport building, distractions (Arntz et al 1991) etc (Newton et al 2012)
- Enhance sense of control because study of (Thrash et al 1982) suggested that when patients have more sense of control, they experience less discomfort (traffic light system)
- Other techniques to be considered are chairside techniques such as quasi-relaxation techniques e.g. guided imagery.
State the THREE professional duties of care that you have towards a patient (6 marks), and describe ONE way in which you could be in breach of each of these duties (6 marks).
To protect patients’ health and life to an acceptable professional standard (do good and no harm) – not sticking to infection control procedures e.g. PPE
To respect autonomy – not giving all treatment options as part of informed consent
To act justly and fairly – being discriminative to someone with HIV
List TWO measures that you would take to ensure that you have been just and fair to a patient (4 marks).
Do not discriminate against the patient just because of her age (ageism)
Distribute resources fairly, if the patient needs a crown, they get it.
Describe TWO moral reasons why being just and fair is so important in dental care. (2 marks)
- Deontological theory of ethics states that it is the patient’s right to be treated fairly, the deontological theory is absolute and states one must stick to the moral rule book thus we should honour that and treat her fairly
- Utilitarianism is greatest happiness for the greatest number which directly relates to the fair distribution of resources within the NHS.
Which recent case law has impacted on consent and communication of risk? (2 marks)
Montgomery v Lanarkshire Health Board 2015
Describe FOUR challenges that you might face in communicating with a patient (4 marks) and how would you overcome each of these challenges? (8 marks)
- Move closer to the person to increase loudness of sound addressing them directly
- Talk face to face, speak at eye level, do not cover your mouth with a mask when you’re asking the patient questions or giving instructions
- Write down explanations to treatments as visual aids may help patient understanding
- Speak slowly and clearly (there is no need to raise your voice – never shout at a person who is hard of hearing)
- Ask the patient about their hearing impairment, as one ear may be worse than the other, and speak into the better ear if so
- Make sure the person fully understands what you said as they may be embarrassed by their hearing loss, simply ask the person to repeat what you said
- The use of hearing loupes in practice may also help assist the patient
- The patient might also be anxious which will be another barrier to communications: therefore, be empathetic and explore the cause of anxiety, we know from the scenario that she had a bad childhood experience so be sure to be empathetic about that and reassure her that her experience will not be the same.
What do you understand by the word empathy? (4 marks)
- Putting yourself in somebody else’s shoes, it is not sympathy because you should not feel sorry for them but instead understand their struggles and reassure them.
- The ability to understand and feel for another.
What would be an empathetic response to a patient when he/she tells you that they are so nervous?
- It is ok to be nervous; I understand, would you like to talk about it more and tell me why you feel nervous?
- Ensure you speak in a calm manner, an appropriate tone of voice and volume
- If the patient tells you more about why, empathise with them and relate your own experience and reassure them and try your best to make them feel at an ease
