MS2 - Special Child 2

Question 1

What are the oral and facial features of a pt with Down Syndrome? (7, 4)

Answer 1

Oral:
- Macroglossia
- Delayed eruption
- AOB
- Supernumerary or missing teeth
- bifid uvula
- periodontal disease
- High arch palate

Facial:
- Low set ears
- flattened midface - small maxilla
- oblique palpebral fissures of eyes
- short neck

Question 2

What associated conditions may a pt with down syndrome have?

Answer 2

• *CHD
  -Duodenal atresia
  -umbilical hernia
  -acute lymphoplastic leukaemia

Question 3

*What are your consideration for treating a pt with Downs Syndrome?

Answer 3

• Antibiotic prophylaxis
• Normal preventative regimen
• Tell, show, do
  -may need physical restraints
• may need sedation / GA for some treatment

Question 4

Can you do pulp therapy in a pt with Downs syndrome with a CHD?

Answer 4

NO, pulp therapy contraindicated for Downs syndrome pts with Cardiac conditions

Question 5

What are the types of cerebral Palsy? (4)

Answer 5

-Spasticity
-dyskinetic
-Ataxic
-Mixed

Question 6

What types of abnormal movements/reflexes may a pt with cerebral palsy show?

Answer 6

Question 7

What dental problems may be present in a pt with cerebral palsy, and how should you manage Treatment?

Answer 7

dental problems:
- caries
- perio
- malocclusions
- bruxism
- trauma

Treatment considerations
- wheelchair
- physical restraints?
- LA can be used with stabilisation
- Rubber dam - to avoid hyperactive tongue movement
- GA?

Question 8

What are the oral features of a pt with ectodermal dysplasia?

Answer 8

-Oligodontia
-Enamel developmental defects
-conical teeth
-maxillary hypoplasia
-reduced alveolar growth
-reduced OVD

Question 9

What are may be some oral manifestations of pts with epileipsy?

Answer 9

• gingival overgrowth (DIGO - phenytoin)
• Prone to trauma / facial injuries
• secondary infections
• cervical lymphadenopathy

Question 10

Management strategies of pts with epilepsy

Answer 10

-reduce stress
-avoid dental chair lights
-avoid all sudden movements
- keep short appts
-*avoid seizure promoting drugs
-removable appliances are not advised

Question 11

Managements of pts with deafness

Answer 11

• Use facial expressions
• speak directly infront of the pt
• Smiles
• Physical contact
• adjust hearing aids when noise is being made - eg. dental drilling

Question 12

Mangement strategies in a blind pt?

Answer 12

• describe the office setting
• physical contact - do not suddenly move the patient
• Tell, Feel, Do
• keep sharp instruments away
• Caution while administering LA