SC-disability & impairment

Question 1

Define impairment.

Answer 1

This is what is preventing the disabled person from completing something.

(what they don’t have)

Question 2

Compare disability and handicap

Answer 2

Disability- the restriction or lack of ability due to the impairement.

Handicap- the disadvantages caused by the impairement

e.g. a woman with no legs, cannot walk(D) so cannot go on hikes (H)

Question 3

What is the aim of the equality act 2010?

Answer 3

To remove the barriers to equality for patients with disability, through removing:

Discrimination- e.g. excluded from oportunities

Predjuice- e.g. imposed identity (“a disabled person”)

Question 4

What are the dental implications of a disability?

Answer 4

• Getting to appointments:
  
  • Is the premises accessible?
  • Is their mobility impaired?
  • Can they reach transport?
• Some disabled people are unable to express views.

Question 5

What is intellectual impairment?

Answer 5

This involves problems with general metal abilities affecting:

• Intellectual functioning (learning/problem solving/ judgement)
• Adapative functioning (activities of daily life e.g. communication and independent living)

Question 6

Compare the social and medical models?

Answer 6

social model- this is the idea that disability is caused by society and its lack of adaptation.

Medical model- that disability is caused by their impairements that should be treated.

Question 7

What is down’s syndrome?

Answer 7

A neurodevelopmental disorder affecting chromosome 21.

Question 8

What is characteristic of Down’s syndrome?

Answer 8

Broad Flat face

epicanthic eyelids.

Slanting eyes

Flat back of head.

Short nose

Neck instability (needs treated)

Question 9

What are the oral manifestations of Down’s syndrome?

Answer 9

Large protrusive, fissured tongue

Small mouth.

Often have AOB or class III occlusion.

CLP is more common.

Higher risk of Periodontal disease due to:

• reduced ability to self care
• Reduced oral clearance
• Altered immune response (impaired neutrophil chemotaxis and upregulated production of inflammatory mediators)

Question 10

How do we dentally manage down’s syndrome?

Answer 10

Prevention

Wider handle toothbrush or electric.

0.2% chlorhexidine mouthwash.

If the patient is compliant we can treat using LA.

Question 11

What is Prader willi?

Answer 11

Problem with chromosome 15.

This results in:

Reduced muscle tone (hypotonia)

A constant desire to eat food.

learning difficulties

Behavioural problems (temper tantrums or stubornness)

Question 12

What is Cerebral palsy?

Answer 12

This is a neurological condition affecting movement and co-ordination.

This causes:

muscle stiffness or floppiness

muscle weakness

random and uncontrolled body movements

Question 13

Compare primary care to specialist services.

Answer 13

Primary care- local to the patient & more convenient.

All their family can be treated there as well.

equal service opportunities.

Specialist services-

Used for complex cases.

Can provide advice.

You can refer patients here.

Question 14

How do you prepare for an appointment?

Answer 14

You want to find out as much information about the patient beforehand (patient passport)

Have the patient in before the appointment to feel comfortable.

Use social stories (for autism so that the patient knows what to expect)

Question 15

Discuss the timing of appointments for a patient with a disability.

Answer 15

Give them the first appointment in the session so that you are not running late.

Do not keep them waiting.

Discuss with carer regarding best time to treat the patient without affecting their routine.

Question 16

What are your aims for the first appointment with a child with disabilities?

Answer 16

To establish trust and a relationship with the child.

Question 17

When is it appropriate to use Clinical holding

Answer 17

When there is failure of all other techniques and recieving the treatment is in the best interest of the patient.

The patient and everyone in the room has to consent to this.

Question 18

How can you treat self-injurious behaviour?

Answer 18

• Treat the symptoms (pain relief)
• Reassurance of the patients with monitoring of the situation.
• Distraction technique when the SIB begins.
• Pharmalogical treatment (e.g. Diazepam)
• Behavioural psychology treatments.
• Removing the teeth that are being used for biting.
• Orthonathic treatment to create an AOB .

Question 19

What causes drooling?

Answer 19

• Problem with swallowing
• Problem moving saliva to the back of the throat (if head is postured forward gravity pushes saliva forward)
• Difficulty closing mouth.
• Jaw instability
• Tongue thrusting.

Question 20

How can we treat drooling?

Answer 20

• Treatment of posture
• Pharmacologically.

Question 21

What is the importance of a healthy mouth in a patient with a disability?

Answer 21

A healthy mouth means if a patient aspirates food, it is less likely to cause pneumonia.

Question 22

How can we alter the diet to prevent aspiration?

Answer 22

Thickeners- this makes liquid thicker and easier to swallow.

Tube feeding-

Question 23

Why is oral hygiene for tube fed patients crucial?

Answer 23

They tend to give patients tasters e.g. jam or honey. So it is vital to brush their teeth.

Question 24

What is a sensory impairment?

Answer 24

When one or more of the senses are no longer normal.

Question 25

What would we call difficulty seeing?

Answer 25

sight impairment.

Question 26

What would we call complete loss of sight?

Answer 26

severe sight impairment.

Question 27

What is the most common cause of visual impairment?

Answer 27

An uncorrected refraction error.

Question 28

What is this?

Answer 28

Cataracts- this is the clouding of the lens of the eye which prevents clear vision. This can be surgically removed.

Question 29

What is age related macular degeneration?

Answer 29

The macula is the part of the eye that helps you see. The macula develops degenerative lesions which can become damaged/scarred and have a reduced blood flow.

Question 30

Compare wet and dry age related macular degeneration.

Answer 30

Wet- Sudden sight loss due to the growth of new and weak vessels under the retina that break. This causes leakage into the macula.

Dry- Gradual loss due to the macula becoming progressively thinner which causes it to function less effectively.

Question 31

What is a Glaucoma?

Answer 31

Fluid buildup in the front part of the eye which increases pressure inside the eye.

Question 32

What is diabetic retinopathy and why does it happen?

Answer 32

High blood glucose level for a long period causes blockages in the blood vessels of the eye. These vessels burst causing bleeding.

Scar tissue and weaker blood vessels which bleed easily develop on the retina (resulting in vision loss)

Question 33

What is Heminaopia?

Answer 33

This is blindness in one half of the visual field, often caused by a stroke.

Question 34

What is the function of a hearing aid?

Answer 34

To make sounds louder in order to assist hearing.

Question 35

What is a loop system?

Answer 35

This works with the hearing aid to overcome backgroudn noises.