SCD Flashcards
barriers to pt care
4 types
physical
attitudinal
people centred
professional centred
impairment
any loss/abnormality of psychological, physiological or anatomical strucutre or function
disability
restriction/lack of abilty to perform an activity in a manner within the range considered normal for a human being
handicap
disadvantages for a given individual, resulting in an impairment or handicap
that limits/prevents normal role fufilamnet for that individual
management techqniues for visual impairment
use nasmes
avoid nonverbals
inform pt of any movement
say what you will do before doing it
management options for hearing impairments
ask about loop system
establish preferred method of communication
face person when speaking
use clear speech with normal lip patterns
be willing to repeat and rephrase
4 types of cerebral palsy
spastic - stiff/jerky movement
athetoid - randon movement
hypotonic/rigid?
ataxic - balance and coordiantion issues
mixed
dental features of cerebral palsy
e
poor OH
gingival hyperplasia (drugs)
enamel hyperplasia
bruxism
malocclusion
drooling
uncontrolled movements
enhanced gag reflex
down syndrome
medical complications
4
- coronary heart disease
- inc risk of haematological malignancy - leukeumia
- epilepsy
- risk of early onset alzheimers
- peridontitis
dental features
downs syndrome
6
- class III occlusion
- AOB
- macrogrossia
- hypodontia and microdontia
- maxillary hypoplasia and high vaulted palate
- predisposition to perio disease
extra oral features of downs syndrome
5
- Large forehead
- Flat nose (hypoplasia of midface)
- Class 3 profile – small maxilla
- Widely spaced eyes
- Short neck
management options for downs syndrome
Enhanced prevention throughout life
* Fluoride varnish application 4xyearly
* High fluoride toothpaste
* Fissures sealants – GIC likely
* 6 monthly radiographs
OHI modification
* Adapted toothbrushes – larger handles or double headed
Diet advice and sugar free medications
acclimatisation
* pre-visit - story
* quieter in surgery
* no waiting
* longer appts
autism
life long development specturm disorder disablity affecting areas of brain controlling language, social interactions, and creative/abstract thinking
features of autism
withdrawn/ isolated
socially awkward and naive
difficulty realting to people
Hypersensitivity
Obsessive habits
Learning difficulties
Non verbal possible/communication issues
interpret language literaly
triad of autism impairment
communication
social interaction
imagination
management for autism
pre-visit
* story boards
* ask the parent about likes/dislikes to ID triggers
appt
* longer
* quiet in surgery
* no wait times
* clear commands
* same nurse
acclimitisation may be required
prevention
equality act
2010
protected characteristics
* age
* gender
* sexual orientation
* marital status / civil partnership
* pregnancy/materneity
* religious belief
* race/ethnicity
* disablity
* gende reassignemnt
disabilty discrimination act
2004
adults with incapacity act
2000
Assess options
Make decision
Communicate
Understand
Retain
section 47 certificate
section 47 certificate
principles of use
Best interest intervention
Minimal intervention
Wishes of pt respected
Others consulted
Residual capacity of individual used
AWI 2000
need to have extra training to warrant it
capacity defintion
ability to recieve impressions, knowledge and act/do something based upon knowledge received
PoA types
Continuing - financial affairs and property
Welfare - health and personal welfare
welfare guardian
court appointed individual when an individual without capacity becomes an adult
involves continuous management of welfare and financial matters for those who have never had capacity
emergency situation when consent not required
preservation of life
prevent serious deterioration of life
e.g. spreading facial infection (airway at risk) and severe bleeding
dentally fit
establish existing oral disease and postential risk of disease
remove any points of infection
establish good OH
develop maintenance and preventative plan
side effects of cancer tx
xerostomia
mucositis
trismus
dysphagia
immunosuppression
mucosititis
acute inflammation and ulceration of mucous membranes
management
* improve OH - CHX on gauze
* adjust ill fitting denture/sharp cusps
* muscosal shields/splints
* ice chips
* anaesthetic mouth wash - benzydamine
grades of mucositis
0 - none
1 - mild - sore/erythema
2 - moderate - erythema, ulcers
3 - severe - oral ulcers (liquid diet)
4 - life-threatening - oral alimentation impossible
dementia
syndrome of chronic progressive natural involving deterioation in cognitive function beyond what might be expected from normal ageing
affects - memory, thinking, orientation, comprehension, language, judgement
4 common types of dementia
alzheimers
vascular
lewy bodies
frontotemporal
alzeheimers
beta amyloid proteins build up and reduction in size of cortex
vascular dementia
reduced blood flow to brain causing ischaemia and necrosis
lewy bodies dementia
deposits of lewy bodies in memory and muscle movement of brain areas
frontotemporal dementia
ubiquitin associated clumps
assoc with TDP-43
early signs dementia
STML
cofnfusion
poor judgement
indescision
medium term symptoms dementia
mood changes
inc forgetfullness
may fail to recognise people
aggression
anger
distress
late signs dementia
fail to regnise familar object/surroundings/people
inc physical frailty
difficulty chewing and swallowing
loss of speech
ART
atraumatic restoration technqiue
removal of caries using hand excavaoty and RMGI resotraiton
no LA or handpieces
communication techniques for elederly
rescuing
bridging
distraction
chaining
