Special Care dentistry - access, communication and consent

Question 1

What is the purpose for special care dentistry?

Answer 1

SCD seeks to address the oral health needs of people with a range of primary conditions which may result in their oral health being compromised directly through the condition itself, or indirectly through medication or poor access to care

Question 2

What are the 3 main groups of Special Care Dentistry?

Answer 2

1. People who experience disability due to impairment or oral function who are limited in their activity directly by their oral status
2. People who have a condition that has direct or indirect repercussions on their oral health
3. People who are disabled by their social, environmental or cultural context which reflects their oral health

Question 3

What ratio of adults in the UK are affected by disability?

Answer 3

1:4 adults in the UK

Question 4

Up to 16 years of age, what are the main causes of disability and what % of the population does this effect?

Answer 4

Genetic and congenital disabilities effecting 4.3% of population

Question 5

16-49 year olds, what are the main causes of disability and what % of the population does this represent?

Answer 5

Trauma and neurological conditions effecting 9.65% of population

Question 6

50-64 year olds, what are the main causes of disability and what % of the population does this effect?

Answer 6

Musculoskeletal, cardiorespiratory and neurological disorders effecting 26.65% of population

Question 7

When was the Disability Discrimination Act passed and what did it become replaced by?

Answer 7

DDA, 1996 replaced by the Equality Act, 2010

Question 8

What % of communication is represented by:

1. Words
2. Vocal tone
3. Facial expression and body language

Answer 8

1. Words = 7%
2. Vocal tone = 33%
3. Facial expression and body language = 60%

Question 9

What does the anagram SOLER represent in communication?

Answer 9

S = Square
O = Open
L = Learning
E = Eye contact
R = Relaxed

Question 10

What pitch voice is more effective when treating patient with hearing disabilities?

Answer 10

Lower pitch voices as people lose high pitch hearing first

Question 11

What % of patients aged 65 and over are visually impaired?

Answer 11

90%

Question 12

How many people in the UK are affected by deaf blindness?

What other disabilities are related to congenital deaf blindness? (list 3)

Answer 12

24,000 people in UK

1. Learning difficulties
2. Epilepsy
3. Severe physical disabilities

Question 13

What is aphasia?

What is the most common cause of aphasia?

Answer 13

Aphasia = It is a disorder that impairs a person’s ability to process language

Stroke is the most common cause of aphasia

Question 14

Describe Global aphasia:

Answer 14

Global aphasia = the most severe form where patients can no longer read or write and can only produce a few recognisable words

Question 15

Describe Broca’s aphasia:

Answer 15

Broca’s aphasia = better communication but vocabulary is limited and speech output severely reduced

Question 16

What is Wernicke’s aphasia?

Answer 16

Wernicke’s aphasia = damage to temporal lobe can result in fluent aphasia - add unnecessary or new words

Question 17

What is Anomic aphasia?

Answer 17

Anomic aphasia = people can understand speech well but can no longer speak words to respond or communicate

Question 18

Explain the term ‘Dysarthria’:

How do all conditions under Dysarthria effect speech?

Answer 18

Dysarthria = a collective name for speech disorders caused by neurological disturbances e.g. cerebral palsy, MS, stroke, Parkinson’s

All cause slurring of speech

Question 19

What type of Autism is the most severe?

What is Pervasive Developmental Disorder (PDD)?

Answer 19

Most severe = classic autism

PDD = socially active, higher empathy and greater interaction and communication skills than autism

Question 20

What is Asperger’s Syndrome? (AS)

Answer 20

AS = children and adults with relatively normal language skills and intelligence but have poor social skills and decreased ability to show empathy

Question 21

What are 3 main areas in which patients who come under the ‘triad of impairments’ ?

Answer 21

1. Hyper/Hyposensitivity to normal stimuli e.g. noise, light, sound
2. Reaction to pain - over or under reaction
3. Intolerance e.g. to smells

Question 22

What 4 terms are frequently used to describe the degree of a person’s disability?

Answer 22

1. Profound
2. Severe
3. Moderate
4. Mild

Question 23

What types of tumours are patients living with learning disabilities more at risk of?

Answer 23

Tumours of the oesophagus, stomach and gall bladder

Question 24

What is informed consent?

Answer 24

Informed consent = required from all patients, without it dental treatment technically and legally becomes assault

Question 25

What is implied consent?

Answer 25

Implied consent = is assumed if patient sits in the dental chair and voluntarily opens their mouth for dental examination or treatment

Question 26

Describe the Mental Capacity Act, 2005:

Who does the MCA effect?

Answer 26

MCA = legal framework of how to act and make decisions on behalf of people who LACK CAPACITY to make specific decisions themselves

MCA effects people over 26 years old with mental illnesses, dementia, learning disabilities, brain damage, substance abusers and everyone involved in the care of any individual who lacks the capacity to make their own decisions

Question 27

Define mental capacity:

What does the lack of capacity entail?

Answer 27

The ability to make a decision

An individual who is unable to make a specific decision at the time it needs to be made

Question 28

Give the 4 main factors a person is considered unable to make a decision if the cannot adhere:

Answer 28

1. Understand information relevant to the decision
2. Retain information in their mind
3. Use or weigh up that information
4. Communicate their decision