Special Care Overview Flashcards
What is the definition of an impairment?
Any loss or abnormality of psychological, physiological, or anatomical structure or function
(occurs at the level of organ/system function
What is the definition of disability?
Any restriction or lack (resulting from impairment) of ability to perform an activity in the manner or within the range considered normal for a human
(concerned with functional performance)
What is the definition of a handicap?
A disadvantage for a given individual, resulting from impairment or disability, that limits or prevents the fulfilment of a role that is normal
What are some barriers to care that special care patients may experience?
- physical
- attitudinal
- people centred
- professional centred
What legislation discusses equality in dental care?
The Equality Act 2010
- protects people from discrimination in the workplace & in wider society
Give examples of protected characteristics:
- age
- disability
- gender reassignment
- marriage or civil partnership
- pregnancy and maternity
- race
- religion or belief
- sex
- sexual orientation
What are the different types of discrimination?
- direct
- indirect
- harassment
- victimisation
What is direct discrimination?
treating someone with a protected characteristic less favourably than others
What is indirect discrimination?
putting rules or arrangements in place that apply to everyone, but that put someone with a protected characteristic at an unfair disadvantage
What is harassment?
unwanted behaviour linked to a protected characteristic that violates someones dignity or creates an offensive environment for them
what is victimisation?
treating someone unfairly because they’ve complained about discrimination or harassment
What are the 5 domains of overcoming barriers to healthcare?
- accessibility
- accommodation
- affordability
- acceptability
- availability
How can an upstream approach improve access to healthcare for those with special care needs?
- policies aimed at social inclusion & better access to education/employment
- better insurance policies for this group
- eligibility for free or subsidised dental care
How can a downstream approach improve access to healthcare for those with special care needs?
design of a regional dental care infrastructure to increase access to dental care for disabled people
What legislation is in place to protect individuals who lack capacity?
Adults with Incapacity (Scotland) Act 2000
A person is unable to make a decision for themselves if they are incapable of …….
- acting
- making decisions
- communicating decisions
- understanding decisions
- retaining memory of the decision
What is a bariatric patient defined as?
An individual of any age who has limitations in health and social care due to physical size, health, mobility and environmental access
What does the World Health Organisation define an obese person as in relation to BMI?
> /= 30kg/m2
What are some limitations of the BMI system?
- does not assess body fat distribution
- does not account for age, sex, ethnicity and muscle mass
What is the role of the dental team in relation to bariatric care?
- identify and diagnose health issues associated with bariatric patient
- signpost patients to appropriate services
- be aware of comorbidities or predisposition to dental disease
- referral onto secondary/tertiary care
- may have to provide emergency care
- raise health concerns with patient, parents or carers of vulnerable adults/children
How can obesity affect dental treatment?
- pt does not fit in regular dental chair
- pt may not be able to lie supine
- airway management compromised
- longer needles may be required
- reduced mobility may need longer appt times
- difficult access to oral cavity due to excess weight
- higher risk of MI occurring in practise
- loss of anatomical landmarks
- difficulty taking radiographs
How might obesity affect a pts periodontal disease risk?
Pt at higher risk of diabetes, diabetes is a direct risk factor for periodontal disease development
What are some dental implications of obesity?
- high caries risk
- poor wound healing (bariatric pts tend to have reduced immune function)
- tooth wear risk (GORD prevalence increased)
Why might IV sedation undertaken in a primary care setting be contraindicated in bariatric patients?
- difficulty placing cannula
- compromised airway
- at risk of sleep apnoea
When you are assessing for capacity, what key factors must you always consider?
- presume capacity
- not an all or nothing event
- capacity may fluctuate
- consider residual capacity
- always record your assessment
What condition is pictured here?
Fibroepithelial polyp
What condition is pictured here?
Geographical tongue
What condition is pictured here?
Atrophic Glossitis
What pathology is pictured here?
MRONJ
What pathology is pictured here?
Herpes Zoster (shingles)
