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Special Care Dentistry > Intellectual Impairment > Flashcards

Intellectual Impairment Flashcards

1
Q

what does intellectual ability involve problems with

A

intellectual functioning and adaptive functioning

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2
Q

what occurred in lennox castle hospital

A

people with learning disabilities were locked up and hidden from the community

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3
Q

what led to closure of long-stay institutions

A

concept of normalisation reinforced by Department of Health legislation

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4
Q

what is an impairment

A

any loss or abnormality of psychological, physiological or anatomical structure or function
occurs at level of organ or system function

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5
Q

what is disability

A

any restriction or lack of ability to perform an activity in the manner or within the range considered normal for a human being

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6
Q

what is activity limitation

A

difficulty encountered by an individual in executing a task or action

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7
Q

what is participation restriction

A

problem experienced by an individual in involvement in life situations

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8
Q

what does the social model say about disability

A

it is caused by the way society is organised rather than by a persons impairment or difference

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9
Q

what does the medical model say about disability

A

people are disabled by their impairments or differences

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10
Q

what is a social model

A

social organisation that takes little or no account of people who have impairments and/or social organisation that creates segregated and second-rate provision

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11
Q

what are the barriers to a social model

A

segregated social provision
inflexible organisational procedures and practices
inaccessible information
inaccessible buildings
inaccessible transport
negative cultural representations

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12
Q

what are the causes of learning disability

A

genotype
maternal health
infection
prematurity
trauma
toxic agents
sensory social deprivation

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13
Q

name 3 syndromes associated with a learning disability

A

down syndrome
prader willi syndrome
autism spectrum syndrome

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14
Q

what is downs syndrome

A

neurodevelopmental disorder of genetic origin affecting chromosome 21

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15
Q

what is the greatest risk factor for down syndrome

A

advanced maternal age

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16
Q

what are the medical features of down syndrome

A

congenital heart defects
alzheimers dementia
epilepsy
leukaemia
hearing impairment
diabetes mellitus
coeliac disease
thyroid disease
intellectual impairment

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17
Q

how does down syndrome impact on periodontal disease

A

oral hygiene issues
oral function
impaired migration of gingival fibroblasts
saliva quality
periodontal pathogens
impaired immune system

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18
Q

what manifestations does prader willi syndrome have

A

constant desire to eat food
restricted growth - short stature
reduce muscle tone
learning difficulty
lack of sexual development
behaviour problems

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19
Q

what is ASD

A

complex developmental condition including range of possible developmental impairments in social interactions and communication

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20
Q

what feature of ASD poses as a barrier to dental treatment

A

sensory atypia

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21
Q

what is cerebral palsy

A

neurological condition that affects movement and co-ordination

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22
Q

what does cerebral paly present as

A

muscle stiffness or floppiness, muscle weakness, random and uncontrolled movements, balance and co-ordination problems

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23
Q

who is in the learning disability team

A

medical doctor
psychiatry
social work
specialist nurse
occupational therapy
nutrition/dietician
SLT

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24
Q

how should dental services be provided

A

recognises everyone as an individual
recognises that everyone has a right to participate in decisions that affect their lives
provides amount of support necessary to enable everyday living

25
what are the barriers to oral healthcare with learning disabilities
access individual characteristics pain recognition attitudes, skills and knowledge of staff transition
26
what are some individual characteristic barriers with oral healthcare
cognitive, physical and behavioural difficulties dependence on family/carers anxiety
27
what are some access barriers with oral healthcare
not having regular dentist cost referral systems transport issues
28
how is pain recognition and response a barrier to oral healthcare
people with learning disabilities find it difficult to communicate that they are in pain
29
how is transition a barrier to oral healthcare
transition between children and adult health services can be tricky for learning disabled people
30
what works to overcome individual barriers to healthcare
reducing anxiety building good relationship
31
what works to overcome service barriers to healthcare
training and education collaboration service availability population needs
32
what might getting to the surgery look like for someone with an intellectual impairment
preparation social stories health passport pre-visit multiple visits with slow progress liaise with community disability nurse
33
how would you time the appointment for an intellectually impaired person
dont run late give lots of time ask what time is best for the patient limit time spent in waiting room
34
what are some signs and symptoms that someone might be in pain
aggression towards themselves or others changes to how person holds or moves their body altered facial expression changes to mobility or balance change in behaviour changes to appetite confusion restlessness or sleep pattern changes
35
how would you verbally communicate with someone
speak naturally and clearly ask yes or no questions dont lead patient responses allow time to communicate dont interrupt or finish sentences
36
what are some adjuncts to communication
makaton picture boards letter boards talking mats draw write
37
what helps to create the right atmosphere
non-threatening environment friendly acclimatise consider augmentive techniques - music singing
38
what should you expect on the first visit
trust and relationship building
39
what helps for a good examination
access to mouth bedi shield open wide mouth rests toothbrush mirror good light head support
40
when should a clinical holding take place
considered if failure of other techniques patient consents no capacity and is deemed benefit unplanned emergencies
41
what is important to find out with social history
living arrangements support transport likes/dislikes
42
what kind of oral disease experience do intellectually impaired people have
more filled teeth, fewer extractions, more untreated active decay depends on their ability to comprehend
43
what are risk factors for people with learning disabilities in relation to oral disease
frequent sugar intake GORD lower income and education difficulty in access non-oral feeders reduced dexterity poor motor control medications
44
what oral diseases do learning disabled people get
high levels of periodontal disease gingival inflammation high numbers of missing teeth increased toothlessness rate higher plaque levels greater unmet oral health needs poorer access to dental services
45
what should treatment planning be
individual co-operation holistic oral health risk factors complexity of treatment provided may be influenced by severity of learning disability realistic
46
how do we give toothbrushing advice
explain first good time of day wear gloves stand behind person keep systematic
47
what conditions can be linked to self-injurious behaviour
cerebral palsy autism tourettes
48
what treatment strategies can we use
symptomatic relief reassurance for patients and parents pharmacological treatment behavioural psychology construction of oral appliances extraction of specific teeth orthognathic surgery to create open bite and prevent biting
49
why do people have a problem with drooling
abnormalities swallowing and moving it to the back of the throat poor mouth closure jaw instability tongue thrusting
50
what can we do for drooling patients
nonpharmacological and non-surgical methods posture improving methods
51
what can give NCTSL
grinding reflux medications drinks
52
what can we give for erosion
fluoride mouthwashes toothpaste brushing delayed for an hour after consuming acidic foods and drinks fluoride varnish sugar free gum after acidic meal
53
what can be used for dry mouth
saliva replacements sugar free chewing gum fluoride rinses
54
what is recommended for people who have feeding problems
good OH intensive regime low foaming toothpaste suction toothbrush
55
what do we need to watch out for when people are nil by mouth
thickeners and tasters
56
what are some risks associated with GA
brain damage, nausea, vomiting, lethargy, shivering, bladder problems, dizziness, sore throat, waking up during operation
57
when is GA the best way to provide care
significant volume of treatment patient uncooperative significant medical complexity
58
when do you refer for GA
pain and swelling where no alternatives exist obvious dental disease when no alternative treatment is possible number of years since reasonable examination in presence of poor oral hygiene
59
what is the role of the dental practitioner in adult protection
recognise respond record

Special Care Dentistry (15 decks)

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