Paeds - Learning Disability Flashcards
what are the dental implications for children with special needs? (5)
Fewer teeth: delayed presentation/registration to a dental practice
More untreated dental caries: due to poor access to the practice or medication
Increased periodontal disease: especially in those with down syndrome
Dental fear and anxiety
Barriers to care i.e. transport and mobility
what preventative measures are put in place for children with SN? (3)
Arrange more regular dental visits
Practice safe eating and drinking habits: this can be difficult to change in autistic patients
Treat with high caries risk management
how do we support normal function in children with SN? (4)
Allow the patient to eat as they wish
Allow the patient to develop their speech, liaise with speech and language team
Promote self esteem by maintaining good physical appearance of teeth,
Reduce drooling by; Improving lip seal Improving swallowing Use scopolamine/hyoscine patches Botox injections Surgery
What are the barriers to regular dental attendance in children with SN? (5)
The child might have a busy schedule with appointments
The child has challenging behaviour or anxiety
Difficulty with access/transport to the practice
The child could have frequent illness
The parents attitude could be challenging
when giving a child with diabetes treatment involving LA, what do we ask them to bring?
Ask them to bring their testing kit and test bloods before treatment.
Ask them to bring a liquid form of a sugary snack (prevents having to eat and accidentally chew their lip/tongue etc)
what is the cause of cerebal palsy?
Brain damage directly before or after birth.
what are the dental implications of CP? (11)
- Poor OH from lack of manual dexterity
- Head forward posture: CP patients have to be treated in this position to prevent aspiration of the drool
- Drooling/saliva
- Malocclusion: Class II from no lip seal
Gingival hyperplasia Enamel hypoplasia Bruxism Trauma Poor access Uncontrollable movements Enhanced gag reflex
What are parental barriers to carrying out oral hygiene in children with SN? (5)
Poor manual dexterity themselves
Exhaustion
Childs mouth has poor access
Lack of time
Anxiety
what is the most common type of congenital heart defect?
Ventricular septal defect
why do congenital heart defects occur? (6)
Congenital rubella
Maternal drug misuse
Downs syndrome
Marfans syndrome
Noonan syndrome: change to autosomal dominant gene(s)
Elhers danlos syndrome: effects connective tissues
what are the dental implications of CHD? (4)
Susceptible to infective endocarditis
Can be on certain medications that increase bleeding tendency
GA high risk liaise with cardiologist
Caution when using LA with adrenaline
what is the most common type of cancer in children? (2)
Acute leukaemias (1/3)
Brain tumours (1/4)
what is our role in children with cancer? (2)
Palliative care
Some children during stages of treatment have no neutrophils - so we must ensure that their mouths are as caries free and healthy as possible before and during this time.
what are oral signs of cancer/cancer treatment? (7)
Mucosal/gingival haemorrhage Gingival enlargement Throat infections Mouth infections Immunosuppression Thrombocytopenia Oral mucositis
what are the effects of chemo/radiotherapy in a developing childs mouth?
Can affect the permeant successors that are still developing - crown hypoplasia and microdontia
or not developed at all
Can reduce the length of the roots - makes ortho treatment later in life unlikely
what are the most commonly inherited bleeding disorders?
VW disease
Haemophilia A
Haemophilia B
what are the most commonly acquired bleeding disorders in children? (2)
Warfarin therapy - congenital heart defects
Thrombocytopenia - chemotherapy