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Behavioral Science > Lecture 6 > Flashcards

Lecture 6 Flashcards

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1
Q

T/F treating patients is still considered prevention

A

TRUE

- just referred to as secondary prevention

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2
Q

ID/DD patient usually presents how to the dental office?

A

with EMERGENCY treatment needs

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3
Q

reaction to ‘I treat every patient the same..’

A

a skilled provider often learn to make adjustments to the treatment and care for individuals with disabilities

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4
Q

T/F oral diseases for individuals with disabilities differ from those of individuals without disabilities

A

FALSE

- oral diseases for individuals with disabilities DO NOT differ from those of individuals without disabilities

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5
Q

how is one able to treat most DDD’s within the office?

A

by understanding what modifications that you must make to YOUR routines (not the patients)

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6
Q

DDD stand for

A

developmental disabilities / disorders

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7
Q

T/F most patients with DDD will require re-positioning of the chair?

A

YES -most require up right positioning

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8
Q

CODA

A

commission of dental accredidation

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9
Q

CODA

commission of dental accredidation standard 2-24?

A

graduates MUST BE COMPETENT ON ASSESSING the treatment needs for patients with special needs

*says nothing about actually treating them!!!

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10
Q

T/F dental issues relevant to the aging population are not equal to those aging WITH disabilities

A

TRUE

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11
Q

percentage that reported disability of the non-institutionalized

A

12%
then doubles if you age 65+
then to over 50% when add older too

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12
Q

use epinephrine with this patient population?

A

NO - do NOT use vasoconstrictors
- unknown adverse effects could occur

  • meds have not been titered
  • dictated by common sense not necessarily scientific data
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13
Q

recommendations for tx for ID/DD patients based on?

A

pediatric population

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14
Q

T/F medical care is more improtant than dental care for the DDD? implication

A

true

  • why often they present later on in life to you with more serious conditions
  • will likley present to you with HIGHER LEVELS OF ANXIETY as a result of developing feat and unsuccesful attempts to find a dentist
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15
Q

rule of thumb with treatment and prevefntion with the special needs patiens

A

if the (special needs) patient presents with no disease (rare) the recommended approach is do more now to PREVENT in order to do less treatment later

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16
Q

primary principles for behavioral support for dentistry have origins where? what are the goals

A

origins in pediatric approach – it is a behavioral approach

goals are to create a means so communicate, limit patient anxiety, and build a trusting attitude towards dentistry while providing quality dental treatment

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17
Q

intent of CODA standard 2-24

A

provide the patient pool - have this available to provide experiences that may include patients whose medical, physical, psychological or social situations make it necessary to consider a wide range of assessment and care options

ASSESSMENT SHOULD EMPHASIZE THE IMPORTANCE OF NON-DENTAL CONSIDERATIONS

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18
Q

T/F the assessments of CODA standard 2-24 should emphasize the importance of NON-DENTAL considerations

A

TRUE

19
Q

Clinical instruction and experience with the patients with special needs should include instruction in??

A

proper communication techniques and assessing the treatment needs compatible with the special need

nothing to do with providing treatment but providing them with what treatment they need

20
Q

common differences encountered in the oral cavity

A

some with ID’s like down syndrome there is an altered erruption pattern of teeth and is usually due to over-retained primary teeth or even the malformation of an individuals teeth (atypical anatomy)

21
Q

tooth replacement sequence he recommends to start with?

A

maryland bridge

  • because it requieres no temperization and minimal tooth preparation
  • and he orders two sets per patient

removable partials (last option)

22
Q

examples of adaptive aids used for this patient population

A

large tooth brush handles, addition of tennis ball to them,mouth rinses, oral lubricants

*can help improve discomfort with oral tissue discomfort and better manual dexterity

23
Q

who do we get the informed consent from

A

find out who care taker is

- legal guardian

24
Q

DO nothing as a tx plan?

A

have to consider this as an option

25
Q

T/F ID and DD patients are quite adapt at sensing the mood of others during interactions

A

TRUE

  • be aware of you communication approaches
  • verbal and non verbal
26
Q

define voice control

A

describes alterations of vocal volume, pace, and intonation to gain patients attention and influence behavioral direction

27
Q

Non-verbal communication

A

ID/DD patietns may be even more aware or sensative to touch, body language and facial expression than if just spoken to alone

  • remove mask, smile
  • touch lip to facilitate jaw opening
  • establish eye contact
  • calm, reassuring confident actions
28
Q

Positive reinforcement

A

can provide beneficial to these pateints
- rewarding acceptable or desired behavior with verbal praise, expression, touch, or tokens

token can be soft drink, favoritre show, etc

29
Q

contingent escape and non contingent escape

A

Contingent escape

  • positive reinforcment which is a rest period from the stimuli (procedure)
  • it is ‘earned’

NON-Contingent escape
-give reward / break in procedure which is not contingent or dependent upon the patients actions / compliance

30
Q

the keys to stimulus and escape

A

are TIMING AND HONESTY

practitioner must judge how much care / stimulus can be completed before offering the rest period (escape)

31
Q

distraction

A

a method of deriving a patients mental focus to positive thoughts, favorable environmental stimuli, or other stimulating sensory images in an effort to override unpleasant procedures or as REDIRECTION from negative behavior

32
Q

flexibility

A

may need to alter office environment to successfully support patient behavior

WE HAVE TO BE THE ONES THAT ARE FLEXIBLE

33
Q

DESENSITIZATION

A

occurs when there is a gradual exposure to the feared object or situation with the concurrent training of and reinforcment of relaxation as a response incompataible with anxiety or fear

34
Q

what may be biggest barrier to access to oral health care for people with ID/DD?

A

dentistry’s lack of proficiency with behavioral support techniques (only available for pediatric patients)

35
Q

what is at the CENTER for every phase of dentistry for this population?

A

BEHAVIORAL MANAGMENT

MODIFY TREATMENT BASED ON DISABILITY

36
Q

what to keep in mind for treatment planning for this patient population

A

think BIG PICTURE and have behavior managment at center and in mind always (could change appt. to appt.)

  • emergencies happen so keep this in mind when treatment planning
  • give you and your staff MORE TIME
37
Q

Medication these pt’s are usually on

A

sugar content high in LIQUID medications

medications have 4-6 times MORE SUGAR THAN A CAN OF COKE

38
Q

techniques for behavior management in regards to opening the mouth
DO AND DONT

A

DO NOT – put fingers into bottom vestibule or fold over bottom lip over teeth and press down and would make them open

pinch nose, etc all ABUSE

YOU CAN USE MOUTH PROP
-always attach floss to them

39
Q

MIPS stands for?

A

Medical immobilization / protective stabilization

40
Q

use of MIPS?

A

treat normally w/ or w/out

pre-medicad/sedation w/ or w/out MIPS

use these words INSTEAD OF RESTRAINED
- must only be used limited to use during the procedure

41
Q

when do you use MIPS?

A

in the hierarchy of behavioral management/ support technique when BASIC SUPPORT TECHNIQUES ARE UNSUCCESSFUL – this is the next step

42
Q

purpose of MIPS

A
  1. to facilitate the comfort and cooperation of the individual receiving services
  2. to prevent injury
  3. to protect the health and safety of the indiviudal and/or providers
43
Q

can you use word retarded

A

no

- but they have a condition of being mental retardation

44
Q

rule about reporting abuse to this pt. populatino

A

written report

follow up phone call within 48 hours of the written report

Behavioral Science (6 decks)

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