imaging of patients with special needs Flashcards
what is gagging? what is the gag reflex? where are people with gag reflexes most sensitive?
- gagging: the strong involuntary effort to vomit
- gag reflex: retcing that is elicited by stimhulation of the sensitive tissues of the soft palate region
- areas that are most likely to elicit the gag reflex: soft palate, lateral posterior third of the tongue
2 precipitating factors for the initiation of the gag reflex
- psychogenic stimuli (originating in the mind)
- tactile stimuli (originating from touch)
patient management:
- operator attitude
- patient and equipment preparations
- exposure sequencing
- receptor placement and technique
operator attitude
- the dental radiographer must convey: a confident attitude, patience, tolerance, and understanding
- the dental radiographer should explain the imaging procedure about to be performed
patient and equipment preparations
- every effort should be made to limit the amount of time that a receptor remains in the mouth
- when preparations are completed before receptor placement, valuable time is saved and there is less likelihood of stimulating the gag reflex
exposure sequence for patients with gag reflexes
- start with anterior exposures: with posterior receptor placements, expose the premolar receptor before the molar receptor
- the maxillary molar receptor is most likely to elicit the gag reflex
receptor placement and technique for patients with gag reflexes
- avoid the palate: do not slide the receptor along the palate, firmly bring the receptor into contact with palatal tissues using one decisive motion
- demonstrate receptor placement: rub a finer along the tissues near the intended area of receptor placement, tell the patient, ‘this is where the receptor will be positioned’
what can we do in extreme cases of gag reflex
- if the gag reflex is uncontrollable, the dental radiographer must use extraoral images such as panoramic or lateral jaw images to obtain diagnostic images
helpful hints
- never suggest gagging
- do reassure the patient
- do suggest breathing
- do try to distract the patient
- do try to reduce tactile stimuli
- do use a topical anesthetic
what is a disability?
- a physical or mental impairment that substantially limits one or more of an individual’s major life activities
physical disabilities and how to deal with them
- visual impairment: must communicate using clear verbal explanations
- hearing impairment: ask the patient how he or she prefers to communicate. can ask a caregiver to serve as interpreter
- mobility impairment: ask whether a patient needs assistance
what are developmental disabilities?
- developmental disabilities are ‘a substantial impairment of mental or physical functioning that occurs before the age of 22 and is of indefinite duration’
- may have problems with coordination or comprehension
- in patients who cannot tolerate intraoral receptor exposure, extraoral exposures may be used
patient management helpful hints
- do practice the golden rule
- do not ask personal questions about a disability
- do think before you speak
- do offer assistance
- do talk directly to the person with a disability
what is paediatrics?
- a brand of dentistry dealing with the diagnosis and treatment of dental diseases of children
what must the dental radiographer be aware of in paediatrics?
- tooth eruption sequence
- prescribing of dental images
- recommended techniques
- types of examinations
- digital sensor issues
- patient and equipment preparations
- patient management
prescribing of dental images
- depends not only on the individual needs of the child but also on the age of the child and his or her ability to cooperate with the procedures
- an imaging examination that includes all of the tooth-bearing areas is recommended at the early mixed dentition stage, after the first permanent tooth has erupted
recommended techniques
- imaging techniques are similar to those used in adults
- typical examinations of primary and transitional dentitions use various techniques
types of examinations
- when a paediatric patient is first treated and does not have previous dental images, it is necessary to obtain a baseline series of images that show all tooth-bearing areas
- examinations may include:
- four-image series
- eight-image series
- 12-image series
- 16-image series
digital sensor issues
- paediatric patients may or may not be able to tolerate the use of a wired digital sensor
- using the correct size of a digital sensor is critical
- wireless sensors are preferred over wired sensors in paediatric dentistry
patient and equipment preparations
for a paediatric patient, special attention must be devoted to:
- explanation of the procedure
- lead apron
- exposure factors
- receptor size
patient management helpful hints
- be confident
- show and tell
- reassure the patient
- demonstrate behaviour
- request assistance
- postpone the examination
what is endodontics?
- the branch of dentistry concerned with the diagnosis and treatment of diseases of the dental pulp within the tooth
- the dental image is indispensable during root coronal procedures, a series of exposures is used to evaluate the tooth before, during and after treatment
receptor placement in endodontic patients
- the dental radiographer must modify the receptor placement in the endodontic patient
- the endoray alignment device can be used to aid in positioning the receptor during a root canal procedure
recommended technique for radiographing endodontic patients
- the paralleling technique whenever possible
edentulous patients may require a dental imaging exam to
- detect the presence of root tips, impacted teeth and lesions
- identify objects embedded in bone
- establish the position of normal anatomic landmarks relative to the crest of the alveolar ridge
- observe the quantity of bone that is present
panoramic exams for edentulous patients
- the most common way of evaluating the edentulous jaw
periapical exams for edentulous patients
- used if a panoramic machine is not available
- may be used as a follow-up to the panoramic exam
what other exams can aid for edentulous patients?
occlusal and periapical
