SCD - middle aged people

Question 1

What does the SEAMLESS approach for special care through the ages include?

Answer 1

S = Seamless
E = Education and training
A = Access
M = Multidisciplinary working
L = Liaison and linkwork
E = Empowerment
S = Special care dentistry
S = Service provision and development

Question 2

What is Rheumatoid arthritis?

Which areas of the body are affected first?

Answer 2

A chronic, progressive, multi-system auto-immune disorder

Hands, feet and wrists

Question 3

List 3 physical changes in Rheumatoid arthritis patients:

Answer 3

1. Weight loss
2. Joint damages
3. Fatigue

Question 4

How is Rheumatoid arthritis treated?

Is there a cure?

Answer 4

First line treatment = aspirin, NSAIDs and corticosteroids

Second line treatment = Methotrexate and infliximab

There is currently no cure

Question 5

List 4 oral manifestations of Rheumatoid arthritis:

Answer 5

1. TMJ dysfunction
2. Secondary Sjogren’s syndrome
3. Anaemia
4. Methotrexate oral ulceration

Question 6

What is Huntington’s Disease?

Answer 6

An inherited, progressive, degenerative neurological disorder - faulty gene in Huntington protein

Question 7

List 3 physical presentations of Huntington’s disease:

Answer 7

1. Uncontrollable muscular movements
2. Impaired speech
3. Loss of concentration and short-term memory

Question 8

List 3 symptoms of Multiple Sclerosis (MS):

Answer 8

1. Tremor
2. Impaired speech
3. Spasms

Question 9

What is the most common type of cerebral palsy?

Answer 9

Spastic - tense, contracted muscles

Question 10

List 4 oral features of patients with Cerebral Palsy:

Answer 10

1. Developmental abnormalities
2. Drooling
3. Bruxism and tooth wear
4. Uncontrolled movements

Question 11

With high anxiety and patients with uncontrolled movements, what 2 options may be best for the patient?

Answer 11

Inhalation sedation and General anaesthetic

Question 12

What causes Downs syndrome?

Answer 12

Extra copy of chromosome 21 is derived from the mother

Question 13

List 4 physical features of a patient with Downs syndrome:

Answer 13

1. Learning disability
2. Flattened head
3. Short stature
4. Pelvic dysplasia

Question 14

List 5 oral manifestations in Downs syndrome patients:

Answer 14

1. Open mouth posture with large, protrusive tongue
2. Class III malocclusion common
3. High palate with horizontal palate shelves
4. Missing teeth are common and disordered tooth eruption
5. Severe early onset of periodontal disease and low caries

Question 15

Why do patients with Downs syndrome have increase risk of periodontal disease yet decrease risk of caries?

Answer 15

Periodontal Disease = due to an impaired cell mediated & humoral immunity and a deficient phagocyte system

Caries = high salivary bicarbonate and pH - immune protection from elevated salivary streptococcus mutons IgA concentrations

Question 16

Why should GA be avoided as much as possible for Downs Syndrome patients?

Answer 16

Because problems with intubation and respiratory issues are common

Question 17

How long after a MI should patients not receive dental treatment?

Answer 17

6 months

Question 18

What disease is increased in patients with COPD?

What should be avoided in patients with COPD where possible?

Answer 18

Periodontal disease

General Anaesthetic

Question 19

What is NOT a recommended analgesic for patients with asthma?

Answer 19

Aspirin