SC-disability & impairment Flashcards
Disability Sensory impairment Intellectual impairment
Define impairment.
This is what is preventing the disabled person from completing something.
(what they don’t have)
Compare disability and handicap
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)
What is the aim of the equality act 2010?
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”)
What are the dental implications of a disability?
- Getting to appointments:
- Is the premises accessible?
- Is their mobility impaired?
- Can they reach transport?
- Some disabled people are unable to express views.
What is intellectual impairment?
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)
Compare the social and medical models?
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.
What is down’s syndrome?
A neurodevelopmental disorder affecting chromosome 21.
What is characteristic of Down’s syndrome?
Broad Flat face
epicanthic eyelids.
Slanting eyes
Flat back of head.
Short nose
Neck instability (needs treated)
What are the oral manifestations of Down’s syndrome?
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)
How do we dentally manage down’s syndrome?
Prevention
Wider handle toothbrush or electric.
0.2% chlorhexidine mouthwash.
If the patient is compliant we can treat using LA.
What is Prader willi?
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)
What is Cerebral palsy?
This is a neurological condition affecting movement and co-ordination.
This causes:
muscle stiffness or floppiness
muscle weakness
random and uncontrolled body movements
Compare primary care to specialist services.
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.
How do you prepare for an appointment?
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)
Discuss the timing of appointments for a patient with a disability.
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.
What are your aims for the first appointment with a child with disabilities?
To establish trust and a relationship with the child.
When is it appropriate to use Clinical holding
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.
How can you treat self-injurious behaviour?
- 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 .
What causes drooling?
- 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.
How can we treat drooling?
- Treatment of posture
- Pharmacologically.
What is the importance of a healthy mouth in a patient with a disability?
A healthy mouth means if a patient aspirates food, it is less likely to cause pneumonia.
How can we alter the diet to prevent aspiration?
Thickeners- this makes liquid thicker and easier to swallow.
Tube feeding-
Why is oral hygiene for tube fed patients crucial?
They tend to give patients tasters e.g. jam or honey. So it is vital to brush their teeth.
What is a sensory impairment?
When one or more of the senses are no longer normal.
What would we call difficulty seeing?
sight impairment.
What would we call complete loss of sight?
severe sight impairment.
What is the most common cause of visual impairment?
An uncorrected refraction error.
What is this?
Cataracts- this is the clouding of the lens of the eye which prevents clear vision. This can be surgically removed.
What is age related macular degeneration?
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.
Compare wet and dry age related macular degeneration.
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.
What is a Glaucoma?
Fluid buildup in the front part of the eye which increases pressure inside the eye.
What is diabetic retinopathy and why does it happen?
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)
What is Heminaopia?
This is blindness in one half of the visual field, often caused by a stroke.
What is the function of a hearing aid?
To make sounds louder in order to assist hearing.
What is a loop system?
This works with the hearing aid to overcome backgroudn noises.
