Special Care - Neurological Impairment Flashcards
What microorganisms are present in denture stomatitis?
C.albicans
What microorganisms are present in angular chelitis?
C.albicans, staph aureus, streptococci
How do we treat angular chelitis?
Find the reservoir of infection i.e. denture
Provide OHI and denture hygiene
Prescribe miconazole
If the infection is persistent and topical antifungals won’t work then use fluconazole
What are the interactions of antifungals?
Furosemide
Warfarin - both topical and systemic
Statins
When would we remove a retained root?
Caries present
Abscess and sinus
Radical GA approach
What are the issues with GA and dementia?
Can significantly worsen the dementia - only used as a last resort
What group of medications does alandronic acid belong to?
Bisphosphonates - low potency so low risk for MRONJ
What should we record when a patient has an ulcer?
Size, location, features of cause i.e. sharp tooth, what you’ve done to alleviate the ulcer, review 3 weeks later.
Upon review;
if healed - record in notes
if not healed - refer
When are salivary stimulants not licenced for use?
In patients with medication related dry mouth
only used after cancer treatment
Why are salivary stimulants not used frequently?
have intolerable side effects such as increased sweating, gut motility.
Why is the salivary stimulant glandosene never used even in edentulous patients?
Acidic = caries
What are barriers to carers carrying out oral hygiene? (4)
Aggression towards them - patient compliance
lack of staffing
lack of time
attitudes - how they perceive the importance of OH
What is dental neglect?
if you assess the patient, identify problems, implement a care plan and the problems are ongoing regardless of intervention = neglect
also look for other indicators i.e. bruises, lack of cleanliness
What are Bisphosphonates used to treat? (5)
osteoporosis Padgets disease CF primary hyperparathyroidism malignancies - multiple myeloma, breast and prostate
When are patients on Bisphosphonates deemed high risk?
When they’ve been used for > 5 years to treat osteoporosis (oral or IV)
If being used to treat malignancy