Management Strategies

Question 1

name 4 behavioural management techniques

Answer 1

acclimitisation
desensitisation
relaxation
structured time
enhanced control

Question 2

why may inhalation sedation not be appropriate for people with learning difficulties despite it carrying the least risk of all sedation options

Answer 2

patient is required to understand that they need to breath in and out through their nose throughout the treatment

Question 3

what medical conditions may see a particular benefit to using IV sedation and why

Answer 3

significant benefit with muscle relaxation and decreased involuntary movement - parkinsons, cerebral palsy, huntingtons disease

Question 4

what are the 5 main categories of barriers to dental care in the elderly

Answer 4

• cost and fear of cost
• fear (dental anxiety)
• accessibility
• availability
• characteristics of dentist (personality, polite, professional)

Question 5

barriers to oral hygiene for older people who are dependent

Answer 5

• patient refusing care
• lack of time
• unclear responsibility of oral care
• ack of knowledge

Question 6

barriers to dental care for ASD patients

Answer 6

behavioural - ability to comply with OH and dental appointments
inhibited social and communication skills - lack of cooperation with personal care, lack of understanding re personal care
parental dependence - low prioritisation of oral care, often dont ask for additional support
clinical environemnt - lots of new stimuli
OH professionals - lack of education

Question 7

what must a patient be able to do to show they have capacity

Answer 7

act a decision
make a decision
communicate a decision
understand a decision
retain memory of a decision

Question 8

what 5 prinicples must be considered when making a decision on behalf on an adult with incapacity

Answer 8

• must benefit patient
• must be least restrictive option
• take into account the wishes of the person
• consultation with relevant others
• utilise residual capacity

Question 9

why are foam sponge swabs not recommended for cleaning patients teeth

Answer 9

ineffective at removing plaque
risk of aspiration or choking if sponge detaches (particularly an issue when they are wet)

Question 10

what are the 3 units within the open wide training resource

Answer 10

1 - core oral health knowledge
2 - practical oral care
3 - oral health documentation

Question 11

what is the open wide training resource for

Answer 11

manual delivery of oral care for people with additional care needs

Question 12

bridging

Answer 12

technique to help patient engage and understand task.
describe and show them the toothbrush then mimic brushing your own teeth. Give another toothbrush to them and they may mirror your behaviour and brush their own teeth

Question 13

chaining

Answer 13

involved gently bringing patient hand to mouth whilst describing the activity. The carer starts the activity and the individual finishes it

Question 14

hand over hand

Answer 14

technique that may be used if chaining unsuccessful - place hand over individuals hand and brush their teeth together

Question 15

how can we overcome a ‘toothbrush biter’

Answer 15

allow them to continue biting by introducing a second toothbrush to bite on whilst giving oral care with the other

Question 16

do tube fed individuals still require oral care

Answer 16

yes - mucosa should be kept moist and lubricated
teeth should be cleaned using non foaming toothpaste in an upright position to avoid aspiration risk

Question 17

when entering residential care - how soon is an oral health assessment completed and what is its purpose

Answer 17

within 48 hours
identifies risk to oral health and subsequent needs - facilitates development of a daily oral care plan - reviewed every 4 weeks

Question 18

in what 3 ways does disability have an indirect effect on oral health

Answer 18

multiple medications may cause dry mouth which increases caries risk
physical impairment may make OH difficult and dental attendance more tricky
oral health issues often overlooked in health and social care planning

Question 19

name 3 medical conditions associated with down syndrome

Answer 19

congenital heart defects
leukemias
diabetes