Imaging of Special Needs Patients Flashcards
What are three common special needs in the dental setting?
- Patients with gag reflex
- Patients with disabilities
- Patients with specific needs
What is a gag reflex?
Strong involuntary effort to vomit provoked by stimulation of the soft tissues of the soft palate or posterior dorsum of the tongue
What is the purpose of a gag reflex?
Protective mechanism to clear airway obstruction
What is the most common site that may cause a gag reflex?
Near maxillary and mandibular molars
What are three techniques to reduce the gagging reflex?
- Tongue should be relaxed
- Ask patient to swallow just before placement
- Don’t make patient conscious about gag reflex
How should you place the sensor to reduce gagging reflexes?
Should be carried parallel to the occlusal plane, then rotate it based of area of interest, then bring it into contact with the palate/floor of mouth
Can mouth breathing aggravate the gag reflex?
Yes, tell patient to breathe with their nose
In extreme gagging cases, what images can you take?
EO/Pan images
What are some distractors to help reduce a gag reflex?
- Tactile stimuli
- Exercises (wiggling toes)
- Breathe through nose
Can caregivers assist during radiographs to help patients with disabilities?
Yes
What are three things you should do if a patient has a visual impairment? 3 answers.
- Clear verbal communication
- Inform patient about each procedure before preforming
- Never gesture to another person in the room
What are three things you should do if a patient has a hearing impairment? 4 answers.
- Ask caregiver for assistance
- Can use gestures
- Written instructions when needed
- Speaking clearly and slowly if they can read lips
Should the operator hold an image receptor/sensor for the patient?
No, never
What must the caregiver wear if helping hold the radiographs?
Lead apron and thyroid collar
How can you accommodate a patient with upper limb mobility impairment?
If the holder can not be used to stabilize the receptor, the caregiver can assist
How can you accommodate a patient with lower limb mobility impairment?
Chair transfer should be done when possible, if not preform radiographs with patient in the wheel chair
What is a developmental disability?
Substantial impairment of mental or physical functioning which occurs before the age of 22 and is of indefinite duration
How can you accommodate a patient with developmental disabilities?
Mild sedation can be helpful in cases of coordination problems, the caregiver can hold the receptor
What type of receptor should you use on pediatric patients?
Small
Is a lead apron and thyroid collar needed for pediatric patients?
Yes, highly recommended
Are the exposure parameters for pediatric patients compared to adults?
Reduced compared to adults
What radiographs to you take for a primary dentition?
Two anterior occlusal, two posterior bitewings, and up to 4 posterior PAs
What radiographs to you take for a primary dentition?
2 incisor PAs, 4 canine PAs, 4 posterior PAs, and 2-4 posterior bitewings
What procedures needs radiographs?
Endodontic
For multi-rooted teeth that need endodontic treatment, how should you angle the projection to capture different roots?
Alter horizontal angle by 20 degrees in mesial or distal direction
Why are radiographs important for edentulous treatment?
Important to asses bone, residual roots, infection, or bone cyst/tumor like lesion
What type of images are preferred for edentulous patients?
Pans
What can be used to supplement a Pan for edentulous patients to detect changes in the alveolar ridge?
14 PAs
When should radiographs be taken on a pregnant woman?
Should be limited and only done during diagnostic indications/mother’s dental needs
Are intraoral radiographs specifically dangerous to a pregnant woman?
No, is highly collimated to head and neck region only and poses very little radiation dose to fetus
What must be used if a radiograph is taken on a pregnant woman?
Lead apron and thyroid collar
In cases of edema from an infection, what should be adjusted when taking a radiograph?
Exposure time should be increased to compensate for tissue swelling
If oral infections cause the patient to have a hard time opening their mouth, what can be done instead?
Extra-oral or occlusal radiography
