Paediatric Special Needs Flashcards
what are the classification of disabilities?
intellectual/behavioural (autism etc)
physical (cerebral palsy)
sensory (vision, hearing)
medically compromised (cardiac etc)
what is autism spectrum disorder (ASD)?
used to describe a lifelong developmental disorder which affects with peoples interactions and communication
what are some clinical implications with patients with disabilities?
difficulty with:
- social communication, verbal and non-verbal
- social interaction, expressing or recognising emotions/feelings
- changing routine to come to a dentist
- sensory difficulties like noises and bright lights
what are some dental features of down syndrome?
Maxillary hypoplasia
class 3 occlusion
anterior open bite
hypodontia (born without some teeth)
predisposition to periodontal disease
what are the 3 main types of cerebral palsy?
spastic (80% of them) [increased muscle tone]
ataxic (co-ordination/balance)
dyskinetic (uncontrollable movements)
what are some dental considerations for a patient with cerebral palsy?
difficulty tolerating dental treatment
increased rate malocclusion
drooling
poor oral hygiene
periodontal disease
high prevalence of bruxism (clenching)
etc
what is the most common childhood cancer?
leukaemia
what is leukaemia
blood cancer of WBC
what are the implications for dental care of a child with cancer?
Dental hygiene needs to be good before cancer therapy since it can be very damaging and taxing on the body
children with cancer are managed by the dental team in the children’s hospital
what are the dental implications of a child with a congenital cardiac defect?
meds which increase bleeding tendency (warfarin/aspirin)
higher risk of GA
careful use of adrenaline containing LA
increased risk of enamel hypoplasia
risk of infective endocarditis from oral bacteria in blood stream
what is infective endocarditis?
infection caused by bacteria that enter the bloodstream and settle in the heart lining, a heart valve or a blood vessel
why are patients with infective endocarditis at a greater risk if they have poor oral hygiene?
risk of bacteremia
they must have good oral hygiene to avoid any infection or requiring any major treatment that can expose blood stream like extractions etc
what are some invasive dental procedures?
placing matrix bands
sub-gingival rubber dam clamps
PMPR subgingival
extractions
implants
preformed metal crowns
endo treament
what are some non-invasive dental procedures?
infiltration/block of LA
BPE
supra gingival restoration/scaling
removing sutures
radiographs
what are the name of some bleeding disorders?
von willebrand’s disease
haemophilia A & B
what is von willibrand disease?
inherited deficiency of von willibrand factor. Affects platelet adhesion and aggregation
what is haemophilia?
lack of clotting factors = increased bleeding tendency
haemophilia A = factor VIII
haemophilia B = factor IX
what are the impacts of dental disease in children with disabilities?
- increased risk of caries
delayed diagnosis
delayed management
need for multidisciplinary planning
pain/infection can be difficult to manage
health risk posed by dental infection
risks posed by dental treatment
what are some main dental findings in a special needs patient?
- anomalies of tooth number
anomalies of tooth size
dental trauma
periodontal disease
calculus accumulation
grinding
