Outcome 2 - Special Care Patients Flashcards
The following DA roles are incorporated to assist patients with special needs:
-training and ability to use specialized equipment
-develop preventive measures
-decrease patient anxiety
Define Special Care
Each patient needs will need to be addressed individually and the dental assistant will aid the dentist in various ways.
Dental treatment will be modified to accommodate preexisitng or new medical and/or dental conditions.
Aging population may face certain oral health conditions such as:
-xerostomia
-periodontal disease
-tooth decay
-dark and brittle teeth
-bone resorption
Common Developmental disorders are:
-Intellectual disability
-Down Syndrome
-Autism
Common Physical Disorders:
-Patient using a wheelchair
-Vision impairment
-Hearing Impairment
Common Neurologic Disorders:
-Alzheimer’s Disease
-Seizures
-Multiple Sclerosis
-Cerebrovascular Accident (Stroke)
Common Neuromuscular Disorders:
-Muscular Dystrophy
-Parkinson’s Disease
-Cerebral Palsy
-Arthritis
Common Cardiovascular Disorders:
-Contentive Heart Failure
-Hypertension
-Angina
-Endocarditis
Common Pulmonary Disorders:
-Allergies
-Bronchial Asthma
Common Behavioral and Psychiatric Disorders
-Anxiety
-Depression
-Eating Disorders
-Bipolar Disorders
-Substance Abuse
How are treatment/procedures modified for Special Care Patients?
The Modifications depend on the patient.
Special Care Patients include:
-the elderly
-patients with physical disabilities
-patients with mental disabilities
-patients with disorders
-neglected or abused patients
When does special care for geriatric patients begin?
As soon as they enter the dental office.
How can the dental team assess an elderly patients mobility/level of independent function?
By close observation of their gait, stance and responses to questions, the dental team can assess their mobility and level of independent functioning.
What is most important during elderly patient appointment?
Elimination of dental pain should be foremost, then retention of the existing dentition within the limits of the patient acceptance and ability to pay
What time of day should appointments for elderly patients take place?
Most dental visits for geriatric patients should be kept short, and occur at a time of day they are most comfortable with sitting and keeping their mouths open. Some patients will have exacttimes when they must eat or take medications which must be respected.
Where should a wheelchair or walker be left during a dental appointment?
Remember that wheelchairs or walkers enable patients to have mobility, and as such are very important to them. Leave them within view of the patient when possible and treat them with the same respect that you would any personal belonging.
How to prepare a vision impaired client for treatment?
Ensure that all procedures are fully explained verbally.
How should patients with hearing lost be prepared for treatment?
They should be offered written instructions so they don’t miss or misinterpret directions.
How to manage appointment for a patient with Mental Disabilities?
They may require repetition of instructions or written instructions.
May be best to involve the same members of the dental team in their care at each appointment to ensure consistency and familiarization.
May respond well to reward and reinforcement when being given instructions.
Tell, show, do technique is effective tool
Treatment for Patients with Disorders
Is planned and given when symptoms of the disorder are controlled (often by medication). When treating the patient, plan on following simple routines that will become familiar to the patient. Any increased stimulation should be avoided such as sound or images. The atmosphere should be restful and calming
Documentation of Neglected or Abused Patients
Patients suspected of suffering from neglect or abuse must have documentation completed for future reference and comparision.
- Completed by dentist, witnessed by DA.
- It is a legal obligation to report suspected cases of abuse and neglect of children and persons in institutions in AB. The dental team must be prepared to share findings with authorities and provide evidence in court if necessary.
What must a documentation/record of suspected abuse/neglect contain?
This record must include date, time and place of the observed conditions including if at all possible photographs, radiographs and diagrams.
To make special care patients more comfortable during a dental procedure, use the following:
Mouth Props
Rubber Dam
Nitrous Oxide
Oral Sedation
Headphones
For physical impairments:
Positioning Devices
Stabilizing Devices
How is a Mouth Prop beneficial for a special care patient?
Helps the patient keep their mouth open without tiring the jaw too much
How is a Rubber Dam beneficial for a special care patient?
Helps in keeping the treatment area dry and the tongue out of the way.
How is Nitrous Oxide beneficial for a special care patient?
This is a form of inhalation sedation which diminishes pain sensation and induces a feeling of well-being or euphoria. It is particuarly helpful when working with anxious patients.
How is Oral Sedation beneficial for a special care patient?
Comes in the form of a pill or liquid. This medication is intended to reduce anxiety and/or induce a calming sedative effect much like a sleeping pill.
How are Headphones beneficial for a special care patient?
A simple tool that is often overlooked. Using headphones helps reduce the sounds of the dental hand piece and suction which often causes anxiety in patients.
How are positioning devices beneficial for patients with physical impairments?
These are specially-designed cushions and supports that either allow a patient to remain in a wheelchair for treatment or make them more comfortable when transferred to a dental chair
How are stabilizing devicess beneficial for patients with physical impairments?
These are used to minimize any movement by the patient which may interfere with dental treatment.
At home, special care patients can benefit by using the following:
Powered toothbrushes
Modified toothbrushes
Floss holders
Specialized toothbrushes & mouth rinses
How do powered toothbrushes benefit special care patients?
These are available for those patients with limited manual dexterity. They limit the amount of movement and pressure required to adequately clean the teeth once the device has been properly located on the teeth.
How do modified toothbruses benefit special are patients?
If the special care patient wants to use a traditional toothbrush, the handle can be modified with Styrofoam to increase the circumference and make it easier to grip.
How do floss holders benefit special care patients?
These may be used to allow the patient greater access and dexterity in posterior areas
How do Specialized Toothpastes & mouth rinses benefit special care patients?
These are available for those experiencing xerostomia. They cointain enzymes that mimic those found in saliva as well as medications to stimulate the salivary glands to produce more saliva
What is a Category I Patient?
Healthy patients who require no special modifications.
What is a Category II Patient?
Patients with medical conditions who require scheduling changes or shorter appointments.
What is a Category III Patient?
Patients with medical conditions who have life long impliccations; these patients require modifications in dental treatment planning, including alterations in anesthetic, types of dental materials, and patient positioning
What is a Category IV Patient?
Patients with medical conditions who require more significant modifications in dental treatment planning including treatment to meet dental needs within the operating room.
What is a Category V Patient?
Patients with serious medical conditions who require only limited care to eliminate serious acute oral disease; includes patients who must be kept free of pain and discomfort.
