intellectual impairment PBL Flashcards
asthmatic pt ask
- inhlaers used?
- hospitalisation
- frequency of asthma attacks
- when last had an attack
how to avoid triggering asthma attack?
proper suction, dental dam use
avoid prolonged supone positions
anxiety levels - assess and help manage if risk triggering attack
how can proper suction and use of dental dam prevent asthma attack
limit amount of particles so reduce chance of allergy induced asthma
what is important to check before commencing dental tx on asthma pt
rescue inhaler on hand
3 characteristics of ASD
- social interaction
- social communication
- limited and restricted patterns in bahviour
pain management of broken tooth in ASD pt
ideally smooth off - but unlikely due to compliance issues
chlorohexidine/salt water wash (prevent secondary infection)- assess ability to swallow
traumatic ulcer Tx
hopefully go away after a few weeks
monitor
GA tx consider when
- uncooperative pt
- volume of disease large
- pain and infection
AWI tx needs to be
least invasive option
minimum necessary treatment
pros of GA if ASD, dentally anxious pt with lots of clinical needs
single appointment
less anxiety/stress for them
so pt best interest
lower splint cons
caries risk
erosion risk
ASD connection to bruxist habit
clench/tight gives comfort
bruxism can cause
NCTSL
trauma can result if no occluding teeth
is large volume of extractions and bruxist ASD pt - what tx is worth considering if going for GA
full clearance
prevent future issues
taurodontism
condition found in molar teeth whereby the body of the tooth and pulp chamber is enlarged verically at the expense of the roots
causing the floor of the pulp and furcation of the tooth to be moved apically done the root
Kilnefelter syndrome
males are born with an extra copy of X chromosome (XXY)
male sex chromosomes
XY
females X chromosome
XX
effect of Kilnefelter syndrome
XXY
x chromosome interferes with sexual development meaning that the individual will produce less testosterone (the male sex hormone) than usual
is Kilnefelter syndrome inherited
not directly inherited
equal chance mother and father having extra X chromosome
sperm or egg having extra X chromosome is random
prevalence of Kilnefelter syndrome
1 in 660 males (quite common)
higher risk is mother over 35 years old
when is Kilnefelter syndrome usually found
aren’t any early symptoms usually
so found when man goes for fertility test
symptoms of Kilnefelter’s
- shy and low self confidence
- literacy and attention problems (dyslexia, dyspraxia)
- low energy levels
- socialising and expressing feelings difficulties
- puberty changes later and different from usual
- INFERTILITY - tx to help
majority have normal and healthy lives
health problems associated with Kilnefelters
increased risk of
- type 2 diabetes
- osteoporosis
- obesity
- CVD and blood clots
- lupus and autoimmune diseases
- hypothyroidism
- anxiety, depression, learning difficulties
tx for Kilnefelters
no cure
- testosterone replacement therapy
- fertility tx
- breast reduction surgery to remove excess tisssue
- occupational therapy
- physio therapy
- speech and language theraoy
pre contemplative
no intention of change behaviour (smoking)
may be unaware of consequences
issues with smoking
- inc risk oral cancer
- inc risk caries
- stained teeth
- systemic risks - lung cancer
- cost
bleeding gums impact on OH
pt may not like taste of blood in mouth so may avoid that area
not good - worsen gum condition
encourage brushing in that area
ulcer causes
- trauma
- malignant lesions
- inflammatory conditions
- nutient deficiency
- adverse drug reaction
traumatic causes of ulcers inc
biting cheek or tongue
brushing harshly
poorly fitting denture
fractured tooth/ restoration
what to do if ulcer presists 3 weeks +
if ulcer presits 3 weeks+ and unexplained cause
refer pt to urgent care for further investigation/biopsy to exclude oral cancer
3 key signs of oral ulcer
pain in the lips/oral cavity
inflammation and redness
abnormal appearance
traumatic ulcer tx
tx cause of tx (e.g. fractured tooth - smooth sharp edges)
arrange review appoinment 4-7 days
should see some resolution in ulcer
soothe ulcers
saline rinse (1 tsp salt in warm water)
chlorohexidine mouthwash is pain limiting OH (0.2% 10ml 2x day until resolved)
analgesics
topical corticosteroids (hydrocortisone oromucosal tablets - dissolved at site of lesion)
topical anaesthetics (benzydamine mouthwash or oromucosal spray)
oral cancer classic presentation
deep ulceration
rolled margins
red and white patches of mucosa
