Special care dentistry

Question 1

What are the signs and symptoms of Alzheimer’s ? (7)

Answer 1

• Aphasia - less ability to express or understand speech
• Confusion
• Memory and cognition problems
• Communication difficulties
• Mood swings
• Loss of confidence
• Social withdrawal

Question 2

What are the signs and symptoms of Parkinson’s ? (7)

Answer 2

• Mask like face
• Rigidity in movement
• Postural instability and loss of balance
• Resting tumours
• Loss of protective reflexes
• Depression and anxiety
• Cognitive impairment

Question 3

What is alzheimer’s disease?

Answer 3

a brain disorder that slowly destroys memory and thinking skills, and eventually, the ability to carry out the simplest tasks

Question 4

What is Parkinson’s disease?

Answer 4

• A brain disorder that causes unintended and uncontrollable body movements , symptoms begin gradually and worsen over time

Question 5

What problems are there for dental treatment for people who have Parkinson’s and Alzheimer’s? (7)

Answer 5

• Loss of protective reflexes
• Tremors in resting state
• Reduced ability to self care - poor OH and dental care
• Reduced manual dexterity
• Reduced communication - pain unrecognised
• Problems with consent - should assess capacity to consent
• Access to surgery may be difficult

Question 6

What does the adults with incapacity act refers to?

Answer 6

• Act refer to the consent and capacity issues and ensures that no one can make decisions for you if you can make a decision for yourself

Question 7

What are the principles of adults with incapacity act? (5)

Answer 7

• the benefits of the adult
• minimum intervention - least restrictive option
• Take into account present and past wishes of the adult
• Consultation with the adult and relative others
• Encourage the adult to use their skill and develop them

Question 8

What is capacity?

Answer 8

Someone has the capacity to consent when they
* Can make a decision (ACT)
* Can communicate the decision
* Can understand the decision (repeat on their own words)
* Can retain the decision made

Question 9

Who can consent on behalf of someone according to the adults with Incapacity Act?

Answer 9

• Welfare power of attorney
• Welfare guardianship
• Medical and dental practitioner under section 47 of AWI 2000

Question 10

What is the english equivalent law of AWI 2000

Answer 10

Mental Capacity act 2005

Question 11

What is the welfare power of attroney?

Answer 11

• When someone decides to appoint someone else to make decision of their behalf when they lose capacity
• Includes medical and financial welfare
• The other person can then do decisions on behalf of the adult which is passed through by court

Question 12

What is the welfare guardianship?

Answer 12

• Someone who have never had capacity and the court appoint someone to look after the person’s medical welfare and make decision on their behalf

Question 13

What factors can contribute to the aetiology of fear in the dental setting? (5)

Answer 13

• Previous adverse dental and medical experiences
• Attitude and previous experience of family and friends
• Delay in emotional development
• Each person’s psychological make up
• Social media influence

Question 14

How may an anxious patient present ? (7)

Answer 14

• High neuroticism and trait anxiety
• High somatisation - development of symptoms without disease
• Low pain threshold
• Withdrawal
• Sweating
• Shaking
• Upset and crying

Question 15

What is the cycle of behaviour change?

Answer 15

• Pre-contemplation
• Contemplation
• Preparation
• Action
• Maintenance with progress or relapse at any stage

Question 16

Give management techniques for anxious patients?

Answer 16

• Desensitisation
• Acclimisation - tell show do
• CBT
• Progressive relaxation
• Distraction
• Control technique
• Medications - benzodiazepines