SCD: Oral healthcare for People with Learning Disability Flashcards
What barriers to dental care exist in older people?
- cost & fear of cost
- fear (dental anxiety)
- accessibility
- availability
- characteristics of dentist
What is meant by “direct” financial barriers for patients to access healthcare?
cost of treatment
What is meant by “indirect” financial barriers for patients to access healthcare?
- travel
- carers
What individual-level barriers might an individual with a learning disability face surrounding dental treatment?
- lack of ability to consent
- complicating medical history making access difficult
- inability to cooperate with treatment
- inability to communicate dental pain
What organisational-level barriers might an individual with a learning disability face surrounding dental treatment?
- GDPs not willing to treat these patients
- shortage of specially trained/experienced dental professionals in treating individuals with learning disabilities
What barriers to oral care might an individual with a mental health disorder face?
- access to dental care
- fear of dental care
- characteristics of mental illness
- lack of oral health screening by psychiatrists
- lack of general education & training
- stigma of mental illness
- lack of communication
What facilitators . to oral care might an individual with a mental health disorder face?
- reported need for education and training
- financial support
- dentists chairside manner
- community support
- interprofessional communication
What are the components of the biopsychosocial model?
- biological
- psychological
- social factors
A pt attends your practise, they suffer from severe MS and use a wheelchair, they also have difficulty communicating, what issues does this person face in relation to his oral health?
- poor manual dexterity
- unable to access surgery
- unable to communicate with you
- unable to communicate pain
- carers needed to help attend practise
- difficulty getting pt into chair (may need hoist etc)
What do polypharmacy patients struggle with?
Severe xerostomia
What are disability aware changes that can be made to dental practises to make them more accessible?
- ground floor access
- suitable car parks
- disabled toilets
- hand rails
Why shouldn’t you use a plastic mirror in a patient with special care considerations?
If pt bites mirror it will break and aspiration risk
What is clinical holding?
the use of physical holds to assist or support a pt to receive clinical dental care or treatment in situations where behaviour may limit ability of dental team to deliver treatment
Are papoose boards suitable for use in the UK?
NO
- pt strapped to chair
- ethical issue!!!
What is assessment of learning disability dependent on?
- level of understanding
- communication
- physical and emotional access
- cooperation
- medical status
- social status
- dental status
What symptoms and signs may be indicative for people who cannot reliably report or communicate pain?
- tugging at face
- sleep interrupted
- changes in behaviour
- rubbing area
If patient needs drinks etc thickened, what risk do they have that means they require this?
Aspiration risk
If a patient has dysphagia, how should you sit them in the dental chair?
upright or semi-upright position
What oral care methods can help patients with dysphagia?
- pt sitting upright
- if pt able to spit out, encourage this
- suction toothbrush
In patients that are PEG fed, what oral health issue poses the main threat?
Periodontal and fungal issues
- caries less of an issue as no sugar to feed cariogenic microbiome
What can you do to manage a tongue thrust patient when performing oral hygiene?
Use gauze to hold tongue out the way
In order for an epileptic patient to undergo sedation, what is the rule?
The patients epilepsy must be VERY WELL CONTROLLED
In a patient with a BMI of 40, what mode of sedation is best suited for them?
Inhalation